Development of and Reflections on VA Health System Suicide Monitoring

Suicide is a national concern and a major priority of the Veterans Affairs (VA) health system. This presentation reviews the development of VA suicide monitoring efforts, approaches taken, and advancements in our understanding of suicide rates, risks factors, and prevention opportunities in the VA health system. These analyses began over 6 years ago, building on VA research regarding suicide risk among VA patients with depression. VA tracks suicide mortality among all VA health system users. Study findings document trends in rates and describe new insights regarding risk times and high-risk patient subpopulations. Using national patient cohorts, we assessed differ¬ences in suicide rates, risks, and methods among veterans. We identified all Department of Veterans Affairs (VA) patients in fiscal years 2001 to 2009 (FY01-09). Mortality was assessed from National Death Index searches. Individual and community factors used to calculate suicide risk include demographic characteristics, medical and psychiatric diagnoses, place of residence, and period of service. We used proportional hazards regressions to calculate differences in risks, controlling for age, gender, psychiatric diagnoses, VA mental health services accessibility, and regional administrative network. Sui¬cide method was categorized as firearms, poisoning, strangulation, or other.