Abstract
Background
Suicide continues to be a growing public health issue, and suicidal behaviors have been identified as a critical problem in the military population, with the number of soldiers dying by suicide exceeding those killed in action.
Objective
This study aimed to characterize the population with attempted or completed suicides at the South Texas Veterans Health Care System and to analyze differences between those 2 populations. Other outcomes included adherence to psychiatric medications 6 months before suicide attempt or completion and psychiatric hospitalizations, psychiatric emergency department visits, and “no-show” appointments to mental health providers.
Methods
Data were collected from the Suicide Prevention and Application Network for patients from South Texas Veterans Health Care System who had attempted or completed suicide between September 1, 2011, and September 30, 2013. Those data were supplemented with data from the computerized patient-record system. A retrospective chart review was conducted to collect further information.
Results
Of 120 events included in the analysis, there were 97 attempts (81%) and 23 completions (19%). Men were significantly more likely to complete a suicide than women were (P = .025). Those that attempted suicide were more likely to have previous attempts compared with those who completed suicide (mean of 1.01 versus 0.17 respectively, P = .0035). The most frequent method for attempt was toxic ingestion (accounting for 61.9% of attempts), while the most frequent method of completing suicide was by using a firearm (87.0%); there was a statistically significant difference found between methods used for suicide attempt versus completion (P < .0001). Significantly more attempts than completions involved alcohol (21 versus 0 respectively; P = .013). Those on divalproex were less likely to complete suicide (16 attempts, 0 completions; P = .040). There were no differences between groups for the secondary outcomes studied.
Conclusions
Characteristics associated with completion of suicide in this analysis include male gender and using a firearm, while having previous attempts, being on divalproex, or using alcohol are associated with being more likely to attempt rather than complete suicide. More information is needed on how to appropriately identify high-risk veterans, and suicide safety plans should be developed for these patients to minimize their risk.
The alcohol detoxification protocol and creation of the e-consult at Central Texas Veterans health care system
