Suicide risk screening and evaluation among patients accessing VHA services and identified as being newly homeless

Abstract

Objective: To evaluate universal suicide risk screening and evaluation processes among newly homeless Veterans. Study Setting: Not applicable. Study Design: Examination of Veterans Health Administration (VHA) using newly homeless patients' health record data in Calendar Year 2021. Data Collection: Not applicable. Data Source: Health record data. Principal Findings: Most patients received suicide risk screening and/or evaluation in the year prior to and/or following homeless identification (n = 49,505; 87.4%). Smaller percentages of patients were screened and/or evaluated in close proximity to identification (n = 7358; 16.0%), 1–30 days prior to identification (n = 12,840; 39.6%), or 1–30 days following identification (n = 14,263; 34.3%). Common settings for screening included primary care, emergency and urgent care, and mental health services. Of positive screens (i.e., potentially elevated risk for suicide), 72.6% had a Comprehensive Suicide Risk Evaluation (CSRE) completed in a timely manner (i.e., same day or within 24 h). Age, race, and sex were largely unrelated to screening and/or evaluation. Conclusions: Although many newly identified homeless patients were screened and/or evaluated for suicide risk, approximately 13% were not screened; and 27% of positive screens did not receive a timely CSRE. Continued efforts are warranted to facilitate suicide risk identification to ensure homeless patients have access to evidence-based interventions.