Suicide risk screening and evaluation among patients accessing VHA services and identified as being newly homeless

Objective

To evaluate universal suicide risk screening and evaluation processes among newly homeless Veterans.

Study Setting

Not applicable.

Study Design

Examination of Veterans Health Administration (VHA) using newly homeless patients' health record data in Calendar Year 2021.

Data Collection

Not applicable.

Data Source

Health record data.

Principal Findings

Most patients received suicide risk screening and/or evaluation in the year prior to and/or following homeless identification (n = 49,505; 87.4%). Smaller percentages of patients were screened and/or evaluated in close proximity to identification (n = 7358; 16.0%), 1–30 days prior to identification (n = 12,840; 39.6%), or 1–30 days following identification (n = 14,263; 34.3%). Common settings for screening included primary care, emergency and urgent care, and mental health services. Of positive screens (i.e., potentially elevated risk for suicide), 72.6% had a Comprehensive Suicide Risk Evaluation (CSRE) completed in a timely manner (i.e., same day or within 24 h). Age, race, and sex were largely unrelated to screening and/or evaluation.

Conclusions

Although many newly identified homeless patients were screened and/or evaluated for suicide risk, approximately 13% were not screened; and 27% of positive screens did not receive a timely CSRE. Continued efforts are warranted to facilitate suicide risk identification to ensure homeless patients have access to evidence-based interventions.