Age Differences in Suicide Risk Screening and Management Prior to Suicide Attempts

Abstract

Objective: This study examined differences by age in suicide risk screening and clinical actions to reduce suicide risk among patients with visits to Veterans Health Administration (VHA)medical facilities in the year prior to an attempt. Methods: Ninety-three VHA patient records were reviewed specific to the last visit before an attempt. Information was extracted regarding documentation of individual suicide risk factors and provider actions to reduce risk. Results: The authors examined differences by patient age (≥50 versus 18–49). Older patients’ medical records were less likely to have evidence of 1)screening for impulsivity and firearms access and 2)engagement in safety planning, referrals for mental health services, and consideration of psychiatric hospitalization. General medical providers were less likely to document these risk factors and action steps in comparison with mental health clinicians. Conclusion: Lethal means education and collaborative care are universal strategies that may improve identification of and lower suicide risk in older veterans.