TY  - JOUR
PY  - 2023//
TI  - Factors associated with a lack of healthcare utilization among veterans after a positive suicide screen in the emergency department
JO  - Academic emergency medicine
A1  - Laliberte, Avery Z.
A1  - Salvi, Apoorva
A1  - Hooker, Elizabeth
A1  - Roth, Brandon
A1  - Handley, Robert
A1  - Carlson, Kathleen
A1  - Hynes, Denise
A1  - Tuepker, Anaïs
A1  - Chen, Jason I.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - OBJECTIVES: Many Veterans at high risk for suicide are identified in Veterans Health Administration (VHA) Emergency Departments (ED). Little is known about what may predict care utilization in this population. To address this knowledge gap, we explored factors associated with Veterans' lack of VHA care utilization following a positive suicide risk screen in the ED. <br><br>METHODS: In a retrospective observational study, we identified all patients who were seen in a VHA ED from October 1, 2019 to September 30, 2020. We examined factors associated with not utilizing VHA mental health (MH) and all VHA care in the six months following a positive suicide ED screen. Predictors included comorbidity, homelessness, and MH visit and diagnosis history. <br><br>RESULTS: We identified 23,446 Veterans with a positive suicide risk screen in the ED in fiscal year 2020. Overall, 4.1% had no VHA MH visits six months post-screen. The probability of not utilizing MH care was significantly higher for Veterans with no comorbidity (4.7% vs. 3.4% for mild comorbidity), no MH diagnosis (10.5% vs 2.8%), no past-year MH visits (13.6% vs 2.3%), and no past-year homelessness (5.4% vs. 1.1%). A smaller proportion of the population did not receive any VHA care six months post-screen (0.5%). Veterans who did not experience homelessness (0.6% vs 0.2%), had no MH diagnosis (1.6% vs. 0.3%), and had no previous MH visits (1.9% vs 0.2%) were significantly more likely to not utilize VHA care. <br><br>CONCLUSIONS: Veterans who do not utilize VHA care after a positive suicide risk screen appear to have fewer documented health and housing concerns than those who do receive care. Yet, Veterans with a positive suicide risk screen who are otherwise healthy may remain at elevated risk for suicide following their ED visit. ED providers may consider enhanced follow-up care to mitigate suicide risk for these Veterans.<p />  <p>Language: en</p>
LA  - en
SN  - 1069-6563
UR  - http://dx.doi.org/10.1111/acem.14695
ID  - ref1
ER  -