Predictors of a Suicide Attempt One Year After Entry Into Substance Use Disorder Treatment

Authors

  • Mark A. Ilgen,

    1. Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.
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  • Alex H. S. Harris,

    1. Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.
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  • Rudolf H. Moos,

    1. Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.
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  • Quyen Q. Tiet

    1. Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.
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  • This work was funded by the Department of Veterans Affairs (VA) Health Services Research and Development Service and Mental Health Strategic Health Group.

Reprint requests: Mark A. Ilgen, Department of Veterans Affairs Palo Alto, Center for Health Care Evaluation, Health Care System, 795 Willow Road (MPD 152), Menlo Park, CA 94025; Fax: 650-493-5000 ext: 27575; E-mail: mark.ilgen@va.gov

Abstract

Background: The present study examined the patient intake and treatment-related risk factors associated with a suicide attempt in the 30 days before a 1-year posttreatment assessment.

Methods: A national sample of 8,807 patients presenting for treatment of substance use disorders (SUDs) in the Department of Veterans Affairs healthcare system were assessed at treatment intake and follow-up. Using the MacArthur Model, the risk and protective factors for suicide attempt were identified at baseline and during treatment.

Results: At follow-up, 4% (314/8,807) of the patients reported a suicide attempt within the past 30 days. Baseline predictors of a suicide attempt before follow-up included elevated suicidal/psychiatric symptoms, more recent problematic alcohol use, and longer duration of cocaine use. Contact with the criminal justice system was a protective factor that reduced the likelihood of a future suicide attempt. Greater engagement in SUD treatment was also associated with a reduction in suicide risk.

Conclusions: More involvement in SUD treatment reduced the likelihood of a future suicide attempt in high-risk patients. Substance use disorder treatment providers interested in reducing future suicidal behavior may want to concentrate their efforts on identifying at-risk individuals and actively engaging these patients in longer treatment episodes.

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