SUICIDE-RELATED OUTCOMES IN OLDER VETERANS: IMPLICATIONS FOR INTERVENTION AND PREVENTION OF SUICIDE: Session 301

Abstract

This session will highlight the particular challenges of addressing suicide among older veterans in VHA care using epidemiological and novel statistical approaches, and offer a promising way forward for early identification and prevention of late-life suicide. The research presented here will highlight various unique factors in older veterans that may be missing from the suicide prevention conversation, including the saliency of physical health, pain, high-risk subpopulations, and psychosocial interventions. Drs. Byers and Morin will present findings on late life suicide in VHA using medical record data for novel investigations of administrative data. First, using her database of over 5 million veterans receiving VHA care, Dr. Byers will provide a big picture overview of nationally based estimates of the occurrence of suicide-related outcomes, including non-fatal attempts and death by suicide, in veterans over age 50. Additionally, she will discuss factors that influence risk of a first attempt in later life, as well as factors that further influence, among survivors, who goes on to repeat an attempt and who does not. Next, Dr. Morin will describe physical and mental health comorbidity profiles of 2,131 veterans over 65 who attempted suicide between 2012 and 2014, and last saw a primary care provider prior to their attempt. The relatively minimal depression prevalence as well as high incidence of chronic pain in more than half of these attempters, as well as higher rates of fatality using firearms among these individuals compared to those with multiple mental health comorbidities will be discussed. These findings raise awareness about possible points of intervention in a group that may otherwise not be considered to be as high-risk as a population with significant comorbid mental health concerns. Drs. Barry and Van Orden will speak about more specific subgroups of older veterans, with recommendations for possible intervention to reduce unintended death and suicide, emphasizing the importance of transition of care models for prevention of late-life suicide. Dr. Barry will provide an example of increased risk for suicide and unintended death among older veterans transitioning from prison to the community. Findings show that those re-entering society following a prison sentence are at significantly higher risk for suicide attempt by multiple means, with higher rates of fatality compared to matched controls. These results highlight the urgent need for assistance during this vulnerable period of transition. Finally, Dr. Van Orden will discuss transition of care models more specifically and their importance in combating loneliness, a major risk factor for late-life suicide. She will share compelling findings related to a novel intervention currently being studied on the benefits of volunteer-provided peer companionship for older veterans transitioning from community living center (CLC) stays back into the community. This intervention is targeted to support upstream suicide prevention.