Suicide-related outcomes in veterans experiencing criminal-legal involvement and/or homelessness: Insights from clinician-administered risk assessments.

BACKGROUND

Veterans experiencing criminal-legal involvement and/or homelessness (VCLI/H) are at elevated risk for suicide attempt and death relative to the broader Veteran population. Characterizing suicide-related outcomes in these Veteran groups is vital for Veteran suicide prevention efforts.

METHODS

Using data from clinician-administered suicide risk assessments gathered from Veteran electronic medical records, this study examined rates and correlates of suicide-related outcomes in 249,011 VCLI/H.

RESULTS

At assessment, 1 in 7 VCLI/H endorsed suicidal ideation, and 1 in 32 were designated by clinicians as high acute risk for suicide. Within 12 months following assessment, 1 in 37 VCLI/H had a documented suicide attempt. These outcomes were more common among Veterans experiencing both criminal-legal involvement and homelessness than Veterans experiencing only one of these. Suicide attempts were most common among Veterans with bipolar disorders, psychotic disorders other than schizophrenia, and personality disorders compared to other psychiatric disorders. Clinician-identified risk demonstrated high specificity but low sensitivity in predicting subsequent suicide attempts of VCLI/H.

CONCLUSIONS

Findings reiterate the exceptionally high prevalence of suicide-related outcomes among VCLI/H and suggest a potential need to augment current risk assessment practices to increase sensitivity to better predict suicide-related outcomes among members of these populations.