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在访问 VHA 服务并被确定为新无家可归者的患者中进行自杀风险筛查和评估。

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

机构信息

Rocky Mountain Mental Illness Research, Education and Clinical Center for Suicide Prevention, Aurora, Colorado, USA.

Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

出版信息

Health Serv Res. 2024 Oct;59(5):e14301. doi: 10.1111/1475-6773.14301. Epub 2024 Apr 8.

Abstract

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.

摘要

目的

评估新无家可归退伍军人的普遍自杀风险筛查和评估流程。

研究地点

不适用。

研究设计

在 2021 年日历年,使用新无家可归患者的健康记录数据对退伍军人健康管理局(VHA)进行检查。

数据收集

不适用。

数据来源

健康记录数据。

主要发现

在无家可归确定之前和/或之后的一年中,大多数患者接受了自杀风险筛查和/或评估(n=49505;87.4%)。较小比例的患者在接近确定时(n=7358;16.0%)、确定前 1-30 天(n=12840;39.6%)或确定后 1-30 天(n=14263;34.3%)接受了筛查和/或评估。常见的筛查场所包括初级保健、急诊和紧急护理以及心理健康服务。在阳性筛查(即自杀风险可能升高)中,72.6%的患者及时完成了全面自杀风险评估(CSRE)(即当天或 24 小时内)。年龄、种族和性别与筛查和/或评估基本无关。

结论

尽管许多新发现的无家可归患者接受了自杀风险的筛查和/或评估,但仍有约 13%的患者未接受筛查;并且 27%的阳性筛查未及时进行 CSRE。需要继续努力促进自杀风险识别,以确保无家可归患者能够获得循证干预措施。

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