Characteristics and Injury Mechanisms of Veteran Primary Care Suicide Decedents with and without Diagnosed Mental Illness

• Published in: Journal of general internal medicine : JGIM 2020-03
• Main Authors: Simonetti, Joseph A, Piegari, Rebecca, Maynard, Charles, Brenner, Lisa A, Mori, Alaina, Post, Edward P, Nelson, Karin, Trivedi, Ranak
• Format: Article
• Language: English
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1007/s11606-020-05787-1

In the United States, suicide rates are increasing among nearly all age groups. Primary care is a critical setting for suicide prevention, where interventions often rely on identifying mental health conditions as indicators of elevated suicide risk. Quantify the proportion of suicide decedents within primary care who had no antecedent mental health or substance use diagnosis. Retrospective cohort study. Veterans who received Veterans Health Administration (VHA) primary care any time from 2000 to 2014 and died by suicide before 2015 (n = 27,741). We categorized decedents by whether they had any mental health or substance use diagnosis (yes/no) using ICD-9 codes available from VHA records. We compared sociodemographic, clinical, and suicide mechanism characteristics between groups using chi-square, Student's T, or Wilcoxon tests. Forty-five percent of decedents had no mental health or substance use diagnosis. Decedents without such a diagnosis were older (68 vs. 57 years, p