Differences between two cohorts of veterans crisis line callers: Veterans with and without a history of veterans health administration care

OBJECTIVE: To better understand subgroups of Veterans who call the Veterans Crisis Line (VCL) and accept a Veterans Health Administration (VHA) referral, we compared the characteristics of two cohorts of callers: those with and without a history of VHA care. METHODS: Data were extracted from VCL call-logs and VHA medical records. Calls were included if they occurred during calendar year 2010, caller provided key identifiers (name and SSN), accepted a referral, had not previously accepted a referral, and presented for services. Chi-square and Fishers exact tests were used to compare groups, using p<0.05 to identify significant differences. RESULTS: The database included 13,444 calls. Among the callers, 91% had a history of VHA care, and 9% had no history. Those with a history were older and more likely to be diagnosed with at least one mental health disorder; whereas those without a history were more likely to have documented social and environmental problems. Callers with a history were more likely to present for care the same day as their index call; whereas the no prior use group more often presented after fifteen days. Length of stay in inpatient or residential facilities was longer for the group with no history than the group with a history. CONCLUSION: The VCL serves callers both with and without a history of VHA care. The majority of callers already receive VHA care and may require different services than those who use the VCL as an entryway into VHA.