VA researchers are taking important steps to help Veterans who are at risk for suicide. They are developing new and better ways to assess suicide risk; treat depression and other serious mental illnesses; and address chronic pain in Veterans. VA investigators are also working to develop effective interventions that can address complicating factors like homelessness and PTSD.

Bronx VA psychiatrist-researcher cited for work in suicide prevention
Veteran Wilfredo Santo was so grateful for Dr. Marianne Goodman's suicide prevention program at the Bronx VA that he arranged to have a flag flown over the U.S. Capitol in honor of the physician-researcher.... (09/11/2019)

VA helps at-risk Veterans avoid suicide through support network
While group therapy sessions for those with issues like PTSD or anger are commonplace at VA hospitals, clinics, and Vet Centers, a research team at the Bronx VA is doing relatively pioneering work by running a group for suicidal Veterans.... (03/28/2018)

Crisis prevention through REACH Vet
The REACH VET program uses predictive modeling and medical record data to identify Veterans at high risk for suicide. In its first year, the program identified 30,000 at-risk Veterans. VA researchers are now evaluating the program’s overall effectiveness. ... (09/20/2018)

Veterans with PTSD twice as likely to die from suicide, accidental injury, liver damage
A new study finds that Veterans who have been treated for PTSD are twice as likely as the U.S. population to die from suicide, accidental injury, and viral hepatitis, an infection that causes liver inflammation and damage.... (07/10/2019)

Veterans with multiple brain injuries twice as likely to consider suicide
A new study finds that post-9-11 Veterans with a history of repeated traumatic brain injuries—versus none—are at much greater risk for considering suicide... (11/20/2018)

Podcast: Veterans with multiple brain injuries at greater risk for suicide

Studies examines Veteran contact with mental health care prior to suicide
Two recent studies examined the phenomenon of Veterans and service members taking their lives shortly after contact with mental health providers. One points to high risk in the week following discharge from a psychiatric unit. The other study says many soldiers who die by suicide access health care shortly before death.... (04/26/2017)

Podcast: Emotional Effects on Military Personnel, Veterans Bereaved by Suicide

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Seeking new ways to alert physicians to Veteran suicide risk
Dr. Hal Wortzel is a neuropsychiatrist at the VA Rocky Mountain Mental Illness Research and Education Clinical Center in Denver. He serves as director of neuropsychiatric consultation services and codirector of the VA Suicide Risk Management Consultation Program. VARQU spoke with Wortzel about his research into suicide prevention, and more specifically, his thoughts on using a suicide-specific diagnosis code in Veterans' medical records. - September 2018

Three psychotherapies for depression reduce suicidal thoughts

(07/09/2019)
A VA Office of Mental Health and Suicide Prevention study looked at the effectiveness of three psychotherapies for depression at reducing suicidal thoughts. The researchers studied treatment data on interpersonal psychotherapy, cognitive-behavioral therapy, and acceptance and commitment therapy. The analysis showed that all three treatments reduced suicidal thoughts, especially in women Veterans. For male Veterans, decreases in suicidal thoughts were significantly greater in interpersonal psychotherapy and cognitive-behavioral therapy, compared with acceptance and commitment therapy. The results show that all three therapies are effective treatments for suicidal thoughts and depression, say the researchers. They suggest that more research be done on how gender influences the effectiveness of these treatments. (Women’s Health Issues, June 25, 2019)

For those with chronic illness, brief cognitive behavioral therapy reduces suicidal thought

(02/28/2019)
Brief cognitive behavioral therapy (bCBT) can reduce suicidal thoughts, found a Michael E. DeBakey VA Medical Center study. Cognitive behavioral therapy is a psychotherapy that focuses on changing thoughts and behaviors that contribute to emotional distress. Patients with congestive heart failure or chronic obstructive pulmonary disease who also had depression and anxiety symptoms received four months of bCBT. Those who received bCBT were less likely to have suicidal thoughts after treatment, compared with patients who received usual care. They were also less likely to have suicidal thoughts four, eight, and 12 months after treatment. The results suggest that bCBT delivered in primary care can reduce suicidal ideation, even when the therapy does not directly target suicide. (General Hospital Psychiatry, Feb. 8, 2019)

Chronic hypoxia a risk factor for suicide

(02/01/2019)
Chronic hypoxia is a risk factor for suicide, found a White River Junction VA Medical Center study. Hypoxia is when the body does not get enough oxygen. The researchers looked at data on more than 9 million patients, a little over 22,000 of whom died by suicide. They assessed three causes of chronic hypoxia: altitude, smoking, and chronic obstructive pulmonary disease (COPD). Patients who had at least one of the three hypoxia conditions had a significantly increased risk of suicide. Current smokers had nearly two-times greater odds of dying by suicide than those who never smoked. Suicide risk increased as the elevation where a person lives increased. Having multiple hypoxia conditions greatly raised odds of suicide. Patients with all three conditions were nearly four times more likely to die by suicide than patients with no conditions. Patients with these risk factors may need specialized treatments to prevent suicide, say the researchers. (Psychiatry Research, Jan. 12, 2019)

Survey: Most Vets OK with curbing gun access during times of high suicide risk

(01/14/2019)
Veterans receiving mental health care were in favor of voluntary programs to reduce firearm access during high-risk periods for suicide, in a VA Ann Arbor Health Care System survey. Veterans in mental health care have high rates of firearm-related suicide. Of Veterans surveyed receiving mental health care at one VA facility, 93 percent were in favor of health system interventions to limit firearm access. Of those, 75 percent were in favor of substantially limiting firearm access during times of crisis. While Veterans with household firearms were less likely to be in favor of interventions, 50 percent of the group that owns firearms still said they would participate in an intervention to limit firearm access during high-risk periods. The results suggest that VA and other health systems should consider more intensive efforts to voluntarily limit firearm access during high-risk periods, say the researchers. (General Hospital Psychiatry, Nov.-Dec. 2018)

Risk factors for transition from suicidal thoughts to attempts

(01/03/2019)
A team co-led by a VA San Diego Healthcare System researcher identified characteristics that differed between service members who contemplated suicide and those who went on to make a suicide attempt. As part of the Army STARRS study, researchers surveyed more than 10,000 soldiers. They found that, compared with soldiers without suicidal thoughts, those with suicidal thoughts had higher rates of interpersonal violence, relationship problems, major depressive disorder, PTSD, and substance use disorder. Soldiers with combat trauma in the past 12 months, intermittent explosive disorder, or any college education were less likely to have suicidal thoughts. Of those with suicidal thoughts in the past 30 days, those with PTSD had higher risk of suicide attempt. Those with intermittent explosive disorder or some college education were less likely to have attempted suicide. The results show that PTSD, intermittent explosive disorder, and education should be considered when studying what makes suicidal ideation transition into suicide attempts. (Depression and Anxiety, Dec. 14, 2018)

Intimate relationships may buffer against suicide

(12/26/2018)
Strong intimate relationships could help protect service members from suicide, according to a VA Ann Arbor Health Care System study. Researchers surveyed 712 National Guard members after they returned home from deployment. The found that lower relationship satisfaction and more depressive symptoms at six months after deployment were linked to greater risk of suicide 12 months after deployment. Couple satisfaction was related to suicide risk for service members with PTSD, depression, and anxiety. The results show that the strength of an intimate relationship could serve as a buffer against suicide for patients who have these conditions, say the researchers. (Suicide and Life-Threatening Behavior, Dec. 3, 2018)

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