Health-Related Outcomes Among Veterans Identified as Being at Increased Risk During a Crisis Line Contact

Abstract

Research has focused on developing ways to prevent death by suicide, such as 24-hr crisis lines. The purpose of the study was to examine health-related outcomes among individuals using Veterans Crisis Line services who were evaluated to be at increased risk. Among those with identifying information, records were linked with electronic medical record and death data. 36, 133 contacts were coded, and 9, 010 Veteran contacts were linked to external data. For 3, 331 contacts (37.0%), responders initiated a facility transport plan (FTP; self-transport). For 5, 325 contacts (59.1%) responders contacted police department (PD) or emergency medical services (EMS) to facilitate transport. Among those with FTPs, 2, 876 Veterans (86.3% of arranged FTPs, and 32.0% of all Veteran callers) were noted as arriving at a health care facility, versus 3, 324 Veterans (62.9% of PD/EMS contacts and 36.9% of all Veteran callers) involving PD/EMS dispatch. Over 90% of Veterans in the cohort had a Veterans Health Administration (VHA) health encounter in the year prior to their first contact. Of the 769 previously unengaged Veterans, 765 lived for at least 3 months following their first contact, and 639 (83.5%) had a VHA encounter. Among identified Veterans, the age- and sex-adjusted rates for death by suicide, unintentional drug overdoses, and all causes were 370.8, 456.8, and 3, 018.4 per 100, 000, respectively. Among members of this high-risk cohort, self-transport resulted in arrival at health care facilities more frequently than PD/EMS transport. Although many engaged in some treatment posttransport, death rates remained high. Ongoing efforts are needed to identify novel ways to prevent suicide among this group of Veterans.