Virtual Mental Health Care and Suicide-Related Events DOI Creative Commons
Kertu Tenso, Kiersten L. Strombotne, Melissa M. Garrido

и другие.

JAMA Network Open, Год журнала: 2024, Номер 7(11), С. e2443054 - e2443054

Опубликована: Ноя. 5, 2024

Importance The rising suicide rates in the US emphasize need for effective prevention. While telehealth has transformed access to mental health care, impact of on outcomes is unknown. Objective To evaluate association virtual services with individual-level suicide-related events (SREs). Design, Setting, and Participants This retrospective cohort study using broadband as an instrumental variable assessed a national sample Veterans Health Administration patients who received care between March 1, 2020, December 31, 2021. were recently separated (ie, discharged or released from active duty) veterans completed their duty service 2019, at least 2 outpatient inpatient diagnoses related major depressive disorder, substance use posttraumatic stress disorder within year before most recent separation date. Data analyzed May 1 October 2023. Exposure Percentage patient’s total visits that conducted virtually by psychiatrists, psychologists, social workers calendar month. Main Outcomes Measures Binary measure indicating whether patient had experienced SRE (defined nonfatal attempt, intentional self-harm, death) specific month evaluated probit model. Results included 66 387 data points 16 236 unique veterans. Among these entries, 44 766 male (67.4%), mean (SD) age across was 32.9 (8.9) years, representative veteran population. There 929 SREs (1.4%). Virtual comprised 44.6% (46.1%) all visits. In analyses accounting factors simultaneously associated risk, 1% increase probability 2.5% decrease SREs. Conclusions Relevance Findings this quasi-experimental design found relative statistically significant SREs, suggesting providing may reduce outcomes.

Язык: Английский

Suicide Risk Evaluations and Suicide in the Veterans Health Administration DOI Creative Commons
Kevin G. Saulnier, Courtney L. Bagge, Dara Ganoczy

и другие.

JAMA Network Open, Год журнала: 2025, Номер 8(2), С. e2461559 - e2461559

Опубликована: Фев. 25, 2025

Importance The Veterans Health Administration (VHA) implemented the Comprehensive Suicide Risk Evaluation (CSRE) in 2019 to standardize suicide risk assessment across health care system. Identifying CSRE responses associated with could inform management and prevent suicide. Objective To identify subsequent Design, Setting, Participants This cohort study examines acute (within 30 days) chronic 365 after 269 374 CSREs were administered. included US VHA patients undergoing evaluation between November 1, 2019, December 31, 2020. Data collection analysis performed from April 5 August 20, 2024. Exposures responses, including suicidal ideation, behaviors, warning signs, factors, protective factors. Main Outcome Measure per death certificate data Department of Affairs Defense Mortality Repository. Outcomes analyzed using multivariable Cox proportional hazards regression. Results A total 153 736 valid (86.26% male; mean [SD] age, 50.48 [15.26] years) multivariable-adjusted analyses Suicidal ideation (hazard ratio [HR], 3.14; 95% CI, 1.51-6.54), firearm access (HR, 2.62; 1.49-4.61), making preparations for a attempt 2.15; 1.27-3.62), seeking lethal means 2.04; 1.11-3.75), anxiety 1.80; 1.16-2.81), psychiatric hospitalization history 1.63; 1.02-2.61) increased within days, whereas anger 0.50; 0.30-0.85) was decreased risk. 1.20-2.21), 1.55; 1.13-2.13), 1.56; 1.09-2.23), reckless behaviors 1.40; 1.00-1.95), 1.68; 1.32-2.13) 0.56; 0.44-0.71), preexisting factors (eg, trauma; HR, 0.77; 0.62-0.96), recent transition military 0.39; 0.22-0.70) analyses. days elevated among identified by clinicians be at intermediate 1.39; 1.13-1.71), 1.34; 1.01-1.77), high 1.74; 1.22-2.47) compared low Conclusions Relevance In this following assessments, findings suggest that only few constructs are suicide, particularly access, preparatory behaviors. Developing prediction algorithms may enhance clinical evaluation.

Язык: Английский

Процитировано

2
Suicide after leaving the UK Armed Forces 1996–2018: A cohort study DOI Creative Commons
Cathryn Rodway, Said A. Ibrahim, Jodie Westhead

и другие.

PLoS Medicine, Год журнала: 2023, Номер 20(8), С. e1004273 - e1004273

Опубликована: Авг. 8, 2023

Background There are comparatively few international studies investigating suicide in military veterans and no recent UK–wide studies. This is important because the wider context of being a UK Armed Forces (UKAF) veteran has changed years following period intensive operations. We aimed to investigate rate, timing, risk factors for personnel who left UKAF over 23–year period. Methods findings carried out retrospective cohort study regular between 1996 2018 linking national databases discharged deaths, using survival analysis examine compared general population conditional logistic regression most strongly associated with after discharge. The 458,058 individuals accumulated 5,852,100 person at risk, median length follow–up 13 years, were mostly male (91%), had age 26 1,086 (0.2%) died by suicide. overall rate was slightly lower than (standardised mortality ratio, SMR [95% confidence interval, CI] 94 [88 99]). However, 2 3 times higher female aged under 25 same groups (age–specific ratios ranging from 160 409). Male 35 older reduced 47 80). sex, Army service, discharge ages 16 34 untrained on discharge, service 10 risk. Factors included married, rank, deployment combat contact specialist NHS mental health services (273/1,086, 25%) lowest youngest (10% 16– 19–year–olds; 23% 20– 24–year–olds). Study limitations include fact that information obtained administrative role pre–service vulnerabilities other may have influenced later could not be explored. In addition, support only available those social care services. Conclusions this study, we found leaving high but there differences according age, young men women. number which elevated focus should improving maintaining access leavers, as well implementing prevention measures all regardless age.

Язык: Английский

Процитировано

14
Homeless Outreach: Framework, Influencers, and Best Practices DOI
Dina Hooshyar,

Jenny D’Olympia,

Jaclyn C. Kearns

и другие.

Illness Crisis & Loss, Год журнала: 2025, Номер unknown

Опубликована: Фев. 28, 2025

This article aims to enrich the conceptualization and implementation of community-based health outreach focused on housing stabilization homeless prevention from a public framework. First, it will conceptualize outreach. Next, identify describe selected influencers as well review best practices. Finally, clinical application these theoretical approaches in project with U.S. military Veterans be highlighted. The framework allows for granular appreciation instability operationalize primary (i.e., stably housed) secondary at risk homelessness) tertiary homeless) measures. address how intersectional identities relate stigma shame internalization factors may impact engagement services. A international practices outreach, including social identity, presented. this highlight critical time intervention trauma-informed care demonstrated quality improvement that provides services transitioning Army Veterans. use commentary clinicians, Veteran consultants, vignettes, literature review. Taken together, advance policies by drawing attention biases current adding understanding identity related housed status its implication provision acceptance

Язык: Английский

Процитировано

0
Exploring Moral Injury and Reintegration Challenges Among Post-9/11 U.S. Veterans: A Qualitative Study DOI
Leah Danson,

Katrina Spontak,

Ai-Nghia Do

и другие.

Military Psychology, Год журнала: 2025, Номер unknown, С. 1 - 11

Опубликована: Апрель 1, 2025

Military Veterans face many barriers when reintegrating into civilian society. A growing body of evidence shows that may experience identity confusion, social isolation, and moral pain during Veteran reintegration. These issues might compound with exposure to traumatic events, leading the development injury (MI). This study utilizes an exploratory, qualitative approach look at relationship between MI reintegration better understand their impact on each other. Twelve who endorsed experiences completed a cognitive interview utilizing two existing measures MI. appeared have dynamic significantly impacted Veteran's emotions, ability trust others, disclose potentially morally injurious experiences, make meaning service. Mental health practitioners need be especially attuned assess for in Veterans, particularly as onset occur reflect military come new conclusions. Clinicians researchers must also foster significant degree facilitate disclosure (PMIEs).

Язык: Английский

Процитировано

0
Predicting suicide attempts among U.S. Army soldiers after leaving active duty using information available before leaving active duty: results from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS) DOI
Ian H. Stanley, Carol Chu, Sarah M. Gildea

и другие.

Molecular Psychiatry, Год журнала: 2022, Номер 27(3), С. 1631 - 1639

Опубликована: Янв. 20, 2022

Язык: Английский

Процитировано

22
Contribution of veterans' initial post‐separation vocational, financial, and social experiences to their suicidal ideation trajectories following military service DOI
Claire A. Hoffmire, Shelby Borowski, Dawne Vogt

и другие.

Suicide and Life-Threatening Behavior, Год журнала: 2023, Номер 53(3), С. 443 - 456

Опубликована: Март 15, 2023

Abstract Background Veterans' success with navigating the challenges of transition from military service may contribute to their risk for suicidal outcomes. The concept well‐being can help conceptualize and assess successful navigation reintegration serve as an optimal target public health‐oriented suicide prevention. Methods relationship between US veterans' psychosocial experiences ideation (SI) during first 3 years following separation was evaluated using multinomial logistic regression predicting SI trajectories over time in a population‐based, longitudinal, post‐9/11 veteran cohort. At 3‐months post‐separation, veterans reported on socio‐material conditions, functioning, satisfaction respect vocational, financial, social domains. frequency assessed at 3‐, 9‐, 15‐, 21‐, 27‐months post‐separation Patient Health Questionnaire‐9. Results were associated trajectories, even after accounting mental health. Socio‐material all emerged important predictors although results varied across Effects largest well‐being. Conclusions Suicide prevention efforts benefit holistic approach that considers needs support well‐being, inclusive within each domain.

Язык: Английский

Процитировано

11
Well-being and suicidal ideation in U.S. Veterans: Age cohort effects during military-to-civilian transition DOI
Shelby Borowski,

Eric D. Caine,

Shaina A. Kumar

и другие.

American Journal of Preventive Medicine, Год журнала: 2025, Номер unknown

Опубликована: Фев. 1, 2025

Язык: Английский

Процитировано

0
Embodied Harms of Militarisation and War DOI
Hannah Wilkinson

Critical criminological perspectives, Год журнала: 2025, Номер unknown, С. 203 - 229

Опубликована: Янв. 1, 2025

Язык: Английский

Процитировано

0
Modeling Contingency in Veteran Community Reintegration: A Mixed Methods Approach DOI Creative Commons
Nicholas A. Rattray, Edward J. Miech, Gala True

и другие.

Journal of Mixed Methods Research, Год журнала: 2022, Номер 17(1), С. 70 - 92

Опубликована: Фев. 24, 2022

Researchers need approaches for analyzing complex phenomena when assessing contingency relationships where specific conditions explain an outcome only combined with other conditions. Using a mixed methods design, we paired configurational and qualitative thematic analysis to model in veteran community reintegration outcomes, identifying combinations of that led success or lack among US military veterans. This pairing allowed modeling at detailed level beyond the capabilities either approach alone. Our revealed multiple contingent work explaining reintegration, including social support, purpose, cultural adjustment, separation experiences. study contributes field by mathematical cross-case method contingency.

Язык: Английский

Процитировано

16
Partnership building for scale‐up in the Veteran Sponsorship Initiative: Strategies for harnessing collaboration to accelerate impact in suicide prevention DOI Creative Commons
Erin P. Finley, Sheila Frankfurt, Nipa Kamdar

и другие.

Health Services Research, Год журнала: 2024, Номер 59(S2)

Опубликована: Апрель 30, 2024

To evaluate the implementation and trust-building strategies associated with successful partnership formation in scale-up of Veteran Sponsorship Initiative (VSI), an evidence-based suicide prevention intervention enhancing connection to U.S. Department Veterans Affairs (VA) other resources during military-to-civilian transition period.

Язык: Английский

Процитировано

3