Category: Health Care System / Public Policy

Symposium

Suicide Prevention and Treatment Utilization During the Transition From Inpatient to Outpatient Care

Saturday, November 18
8:30 AM - 10:00 AM
Location: Indigo Ballroom B, Level 2, Indigo Level

Keywords: Suicide | Treatment Integrity / Adherence / Compliance | Veterans
Presentation Type: Symposium

Twenty Veterans die each day by suicide and rates have not decreased in the last 10 years. The period following hospital discharge is a time of substantially increased risk for suicidal behavior. Risk is highest in the first month after discharge and then declines over time, but remains high for at least a year. Adequate use of treatment could reduce risk during transition out of the hospital; however, Veterans are often reluctant to utilize psychiatric services. The Coping Long Term with Active Suicide Program (CLASP) is an intervention developed to reduce suicide behavior. CLASP targets several mechanisms including treatment engagement. This presentation will describe CLASP, examine the impact of CLASP on mental health service utilization, and describe treatment patterns post discharge.
     Recruitment is ongoing and will be completed in September. To date, 97 Veterans, hospitalized for suicide risk have been recruited for a randomized clinical trial (RCT) to assess the efficacy of CLASP. Participants were randomly assigned to either CLASP or an enhanced monitoring + treatment as usual control condition. Suicide severity and treatment utilization were assessed at baseline and 3, 6, 9, & 12-month post hospital discharge. Regression analyses will examine the predictive role of social support and treatment utilization in reducing suicide ideation and behaviors.
     Veterans reported an average of 12.63 treatment contacts (SD = 21.85) in the 3 months following discharge. Veterans in CLASP attended more outpatient treatment (M = 17.78, SD = 31.50) than those in the control condition (M = 8.61, SD = 7.93), F(39) = 5.42, p = 0.025 and utilized the suicide hotline less frequently (M = 0, SD = 0) than those in the control group (M = 0.28, SD = 0.752); F(26) = 6.23, p = 0.019. Preliminary analysis of partial 6-month data shows a lower rate of emergency room mental health care visits in the CLASP group  (M = 0.50, SD = 1.15) compared to controls (M = 0.15, SD = 0.376; F(29)=4.72, p = 0.038). Treatment use did not predict reduced suicidal ideation. Implications for aftercare services and suggestions for future suicide prevention efforts will be discussed.

Jennifer M. Primack

Brown University & Providence VA Medical Center

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