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Challenges Associated with the Use of Policy to Identify and Manage Risk for Suicide and Interpersonal Violence Among Veterans and Other Americans

  • Robert M. Bossarte
Commentary
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In this issue, Swanson et al. (2018) presents findings from a study of more than 3000 U.S. veterans to describe associations between proxy indicators of need for fiduciary services and risk for suicide or interpersonal violence. The main objectives of this study were to evaluate the potential impact of current policies restricting access to firearms among Veterans determined to be incapable of responsibly managing their own finances and assess underlying assumptions about the associations between decision making as it relates to financial matters and increased risk for self-harm or interpersonal violence. The authors reported statistically significant increases in risk for thoughts of suicide and interpersonal violence associated with three proxy indicators of need for fiduciary services. Findings from this study raise several important questions about strategies for reducing rates of suicide among Veterans and members of other high-risk groups.

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Notes

Funding

This project was supported, in part, by Grant #5R49CE001170 from the National Center for Injury Prevention and Control, CDC, to the West Virginia University Injury Control Research Center directed by R. Bossarte.

Compliance with Ethical Standards

Conflict of interest

Dr. Bossarte declares that he has no conflict of interest.

Human and Animal Participants

This article does not contain any studies with human participants or animals performed by any of the authors.

References

  1. Barnes, S. M., Monteith, L. L., Gerard, G. R., Hoffberg, A. S., Homaifar, B. Y., & Brenner, L. A. (2017). Problem-solving therapy for suicide prevention in veterans with moderate-to-severe traumatic brain injury. Rehabilitation Psychology, 62(4), 600–608.  https://doi.org/10.1037/rep0000154.CrossRefPubMedGoogle Scholar
  2. Centers for Disease Control and Prevention. (2018). Web-based interactive statistical query and reporting system (WISQARS). www.cdc.gov/injury/wisqars. Accessed 2 May 2018.
  3. Conner, K. R., Bohnert, A. S., McCarthy, J. F., Valenstein, M., Bossarte, R., Ignacio, R., … Ilgen, M. A. (2013). Mental disorder comorbidity and suicide among 2.96 million men receiving care in the Veterans Health Administration health system. Journal of Abnormal Psychology, 122(1), 256–263.  https://doi.org/10.1037/a0030163.CrossRefPubMedGoogle Scholar
  4. Conner, K. R., Bossarte, R. M., He, H., Arora, J., Lu, N., Tu, X. M., & Katz, I. R. (2014). Posttraumatic stress disorder and suicide in 5.9 million individuals receiving care in the veterans health administration health system. Journal of Affective Disorders, 166, 1–5.  https://doi.org/10.1016/j.jad.2014.04.067.CrossRefPubMedGoogle Scholar
  5. Conner, K. R., Bridge, J. A., Davidson, D. J., Pilcher, C., & Brent, D. A. (2017). Metaanalysis of mood and substance use disorders in proximal risk for suicide deaths. Suicide and Life-Threatening Behavior.  https://doi.org/10.1111/sltb.12422.PubMedCrossRefGoogle Scholar
  6. Deisenhammer, E. A., Schmid, S. K., Kemmler, G., Moser, B., & Delazer, M. (2018). Decision making under risk and under ambiguity in depressed suicide attempters, depressed non-attempters and healthy controls. Journal of Affective Disorders, 226, 261–266.  https://doi.org/10.1016/j.jad.2017.10.012.CrossRefPubMedGoogle Scholar
  7. Department of Veterans Affairs. (2016). Suicide among Veterans and Other Americans. 2001–2014. Retrieved from Washington D.C.Google Scholar
  8. Department of Veterans Affairs. (2017). VA REACH VET Initiative Helps Save Veterans LIves; program signals when more help is needed for at-risk veterans. The Reach Vet press release. https://www.va.gov/opa/pressrel/pressrelease.cfm?id=2878.
  9. Gaynes, B. N., West, S. L., Ford, C. A., Frame, P., Klein, J., & Lohr, K. N. (2004). Screening for suicide risk in adults: A summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine, 140(10), 822–835.CrossRefPubMedGoogle Scholar
  10. Goldstick, J. E., Carter, P. M., Walton, M. A., Dahlberg, L. L., Sumner, S. A., Zimmerman, M. A., & Cunningham, R. M. (2017). Development of the SaFETy score: A clinical screening tool for predicting future firearm violence risk. Annals of Internal Medicine, 166(10), 707–714.  https://doi.org/10.7326/m16-1927.CrossRefPubMedPubMedCentralGoogle Scholar
  11. Gunnell, D., Knipe, D., Chang, S. S., Pearson, M., Konradsen, F., Lee, W. J., & Eddleston, M. (2017). Prevention of suicide with regulations aimed at restricting access to highly hazardous pesticides: A systematic review of the international evidence. The Lancet Global Health, 5(10), e1026–e1037.  https://doi.org/10.1016/s2214-109x(17)30299-1.CrossRefPubMedGoogle Scholar
  12. Kessler, R. C., Hwang, I., Hoffmire, C. A., McCarthy, J. F., Petukhova, M. V., Rosellini, A. J., … Bossarte, R. M. (2017). Developing a practical suicide risk prediction model for targeting high-risk patients in the Veterans health Administration. International Journal of Methods in Psychiatric Research.  https://doi.org/10.1002/mpr.1575.CrossRefPubMedPubMedCentralGoogle Scholar
  13. Mann, J. J., & Michel, C. A. (2016). Prevention of firearm suicide in the United States: What works and what is possible. American Journal of Psychiatry, 173(10), 969–979.  https://doi.org/10.1176/appi.ajp.2016.16010069.CrossRefPubMedGoogle Scholar
  14. McCarthy, J. F., Bossarte, R. M., Katz, I. R., Thompson, C., Kemp, J., Hannemann, C. M. … Schoenbaum, M. (2015). Predictive modeling and concentration of the risk of suicide: Implications for preventive interventions in the US Department of veterans affairs. American Journal of Public Health, 105(9), 1935–1942.  https://doi.org/10.2105/ajph.2015.302737.CrossRefPubMedPubMedCentralGoogle Scholar
  15. McClatchey, K., Murray, J., Rowat, A., & Chouliara, Z. (2017). Risk factors for suicide and suicidal behavior relevant to emergency health care settings: A systematic review of post-2007 reviews. Suicide and Life-Threatening Behavior, 47(6), 729–745.  https://doi.org/10.1111/sltb.12336.CrossRefPubMedGoogle Scholar
  16. National Action Alliance and Office of the U.S. Surgeon General. (2012). 2012 National Strategy for suicide prevention: Goals and objectives for action: A report of the U.S. Surgeon General and of the National Action alliance for suicide prevention. Retrieved from Washington D.C.Google Scholar
  17. Pirkis, J., Too, L. S., Spittal, M. J., Krysinska, K., Robinson, J., & Cheung, Y. T. (2015). Interventions to reduce suicides at suicide hotspots: A systematic review and meta-analysis. The Lancet Psychiatry, 2(11), 994–1001.  https://doi.org/10.1016/s2215-0366(15)00266-7.CrossRefPubMedGoogle Scholar
  18. Stack, S. (2014). Differentiating suicide ideators from attempters: Violence—A research note. Suicide and Life-Threatening Behavior, 44(1), 46–57.  https://doi.org/10.1111/sltb.12054.CrossRefPubMedGoogle Scholar
  19. Swanson, J., Easter, M., Brancu, M., & Fairbank, J. (2018). Informing federal policy on firearm restrictions for Veterans with fiduciaries: Risk indicators in the Post-Deployment Mental health Study. Administration in Mental Health and Mental health Services Research.Google Scholar
  20. Szanto, K., Galfalvy, H., Vanyukov, P. M., Keilp, J. G., & Dombrovski, A. Y. (2018). Pathways to late-life suicidal behavior: Cluster analysis and predictive validation of suicidal behavior in a sample of older adults with major depression. The Journal of Clinical Psychiatry.  https://doi.org/10.4088/JCP.17m11611.PubMedCrossRefPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Injury Control Research CenterWest Virginia UniversityMorgantownUSA
  2. 2.Department of Behavioral Medicine and PsychiatryWest Virginia UniversityMorgantownUSA
  3. 3.Center of Excellence for Suicide PreventionCanandaigua VA Medical CenterCanandaiguaUSA

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