Background

Homeless Veterans are at substantially elevated risk for suicide mortality; however, understanding of drivers of suicide in this population remains limited.

Method

Building upon prior work, we conducted a retrospective chart review, comprised of a latent class analysis of 724,752 Veterans with use of Veterans Health Administration (VHA) homeless services 2005–2018.

Results

A five-model class membership solution was identified. Among these classes, risk for suicide mortality was greatest among Veterans with the highest psychiatric burden and high VHA service use. Those experiencing moderate psychiatric burden or primarily experiencing substance use disorders also experienced elevated risk for suicide mortality relative to those with low burden and service use.

Limitations

Models were specific to Veterans accessing VHA homeless services and may not generalize to those not using such services outside VHA care.

Conclusions

Continued research and programing remain necessary to determine how to address mental health conditions and engage homeless Veterans in services to facilitate suicide prevention.

中文翻译：

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使用无家可归的退伍军人进行潜在类别分析以确定 VHA 亚组的自杀死亡率更高

背景

无家可归的退伍军人自杀死亡的风险大大增加；然而，对这一人群中自杀驱动因素的了解仍然有限。

方法

在之前的工作的基础上，我们进行了回顾性图表审查，包括对 2005-2018 年退伍军人健康管理局 (VHA) 无家可归者服务的 724,752 名退伍军人的潜在类别分析。

结果

确定了一个五模型类成员资格解决方案。在这些类别中，具有最高精神负担和高 VHA 服务使用率的退伍军人的自杀死亡率风险最高。与那些负担和服务使用量低的人相比，那些经历中度精神负担或主要经历物质使用障碍的人也经历了更高的自杀死亡率风险。

限制

模型特定于获得 VHA 无家可归者服务的退伍军人，可能无法推广到那些在 VHA 护理之外不使用此类服务​​的人。

结论

仍然有必要继续研究和规划，以确定如何解决心理健康状况并让无家可归的退伍军人参与服务以促进预防自杀。