Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration.
<h4>Importance</h4>Understanding the extent to which population-level suicide risk screening facilities follow-up and engagement in mental health treatment is important as engaging at-risk individuals in treatment is critical to reducing suicidal behaviors.<h4>Objective</h4>T...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0265474 |
| _version_ | 1818194982102630400 |
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| author | Nazanin Bahraini Daniel J Reis Bridget B Matarazzo Trisha Hostetter Christina Wade Lisa A Brenner |
| author_facet | Nazanin Bahraini Daniel J Reis Bridget B Matarazzo Trisha Hostetter Christina Wade Lisa A Brenner |
| author_sort | Nazanin Bahraini |
| collection | DOAJ |
| description | <h4>Importance</h4>Understanding the extent to which population-level suicide risk screening facilities follow-up and engagement in mental health treatment is important as engaging at-risk individuals in treatment is critical to reducing suicidal behaviors.<h4>Objective</h4>To evaluate mental health follow-up and treatment engagement in the Veterans Health Administration (VHA) following administration of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen, a component of the VHA's universal suicide risk screening program.<h4>Design</h4>This cross-sectional study used data from VA's Corporate Data Warehouse.<h4>Settings</h4>140 VHA Medical Centers.<h4>Participants</h4>Patients who completed the C-SSRS screen in ambulatory care between October 1, 2018-September 30, 2020.<h4>Exposure</h4>Standardized suicide risk screening.<h4>Main outcomes and measures</h4>Mental health follow-up (one or more visits within 30 days of C-SSRS screening) and treatment engagement (two or more visits within 90 days of C-SSRS screening) were examined.<h4>Results</h4>97,224 Veterans in Fiscal Year 2019 (FY19) (mean age 51.4 years; 86.8% male; 64.8% white, 22.4% African-American) and 58,693 Veterans in FY20 (mean age 49.6 years; 85.5% male; 63.4% white, 21.9% African-American) received the C-SSRS screen. Across FYs, a positive C-SSRS screen was associated with increased probability of mental health follow-up and treatment engagement. Patients who were not seen in mental health in the year prior to screening had the greatest increase in probability of mental health follow-up and engagement following a positive screen (P<0.001). For FY19, a positive C-SSRS screen in non-mental health connected patients was associated with an increased probability of follow-up from 49.8% to 79.5% (relative risk = 1.60) and engagement from 39.5% to 63.6% (relative risk = 1.61). For mental health-connected patients, a positive C-SSRS screen was associated with a smaller increase in probability of follow-up from 75.8% to 87.6% (relative risk = 1.16) and engagement from 63.3% to 76.4% (relative risk = 1.21). Results for FY20 were similar.<h4>Conclusions and relevance</h4>Identification of suicide risk through population-level screening was associated with increased mental health follow-up and engagement, particularly for non-mental health connected patients. Findings support the use of a standardized, comprehensive suicide risk screening program for managing elevated suicide risk in a large healthcare system. |
| first_indexed | 2024-12-12T01:10:56Z |
| format | Article |
| id | doaj.art-1a631b25c4ae4630a001896a03ef38b8 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T01:10:56Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-1a631b25c4ae4630a001896a03ef38b82022-12-22T00:43:27ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01173e026547410.1371/journal.pone.0265474Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration.Nazanin BahrainiDaniel J ReisBridget B MatarazzoTrisha HostetterChristina WadeLisa A Brenner<h4>Importance</h4>Understanding the extent to which population-level suicide risk screening facilities follow-up and engagement in mental health treatment is important as engaging at-risk individuals in treatment is critical to reducing suicidal behaviors.<h4>Objective</h4>To evaluate mental health follow-up and treatment engagement in the Veterans Health Administration (VHA) following administration of the Columbia-Suicide Severity Rating Scale (C-SSRS) screen, a component of the VHA's universal suicide risk screening program.<h4>Design</h4>This cross-sectional study used data from VA's Corporate Data Warehouse.<h4>Settings</h4>140 VHA Medical Centers.<h4>Participants</h4>Patients who completed the C-SSRS screen in ambulatory care between October 1, 2018-September 30, 2020.<h4>Exposure</h4>Standardized suicide risk screening.<h4>Main outcomes and measures</h4>Mental health follow-up (one or more visits within 30 days of C-SSRS screening) and treatment engagement (two or more visits within 90 days of C-SSRS screening) were examined.<h4>Results</h4>97,224 Veterans in Fiscal Year 2019 (FY19) (mean age 51.4 years; 86.8% male; 64.8% white, 22.4% African-American) and 58,693 Veterans in FY20 (mean age 49.6 years; 85.5% male; 63.4% white, 21.9% African-American) received the C-SSRS screen. Across FYs, a positive C-SSRS screen was associated with increased probability of mental health follow-up and treatment engagement. Patients who were not seen in mental health in the year prior to screening had the greatest increase in probability of mental health follow-up and engagement following a positive screen (P<0.001). For FY19, a positive C-SSRS screen in non-mental health connected patients was associated with an increased probability of follow-up from 49.8% to 79.5% (relative risk = 1.60) and engagement from 39.5% to 63.6% (relative risk = 1.61). For mental health-connected patients, a positive C-SSRS screen was associated with a smaller increase in probability of follow-up from 75.8% to 87.6% (relative risk = 1.16) and engagement from 63.3% to 76.4% (relative risk = 1.21). Results for FY20 were similar.<h4>Conclusions and relevance</h4>Identification of suicide risk through population-level screening was associated with increased mental health follow-up and engagement, particularly for non-mental health connected patients. Findings support the use of a standardized, comprehensive suicide risk screening program for managing elevated suicide risk in a large healthcare system.https://doi.org/10.1371/journal.pone.0265474 |
| spellingShingle | Nazanin Bahraini Daniel J Reis Bridget B Matarazzo Trisha Hostetter Christina Wade Lisa A Brenner Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. PLoS ONE |
| title | Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. |
| title_full | Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. |
| title_fullStr | Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. |
| title_full_unstemmed | Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. |
| title_short | Mental health follow-up and treatment engagement following suicide risk screening in the Veterans Health Administration. |
| title_sort | mental health follow up and treatment engagement following suicide risk screening in the veterans health administration |
| url | https://doi.org/10.1371/journal.pone.0265474 |
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