Firearm Injury, Overdose, Suicide
Conditions
Keywords
suicide
Brief summary
Seventeen United States Veterans die by suicide each day. Nearly three-fourths of those Veterans die from firearm injury or poisoning, and many seek care in VA Emergency Departments (ED) prior to suicide attempts. In 2019, the VA began screening all Veterans seeking ED care for increased suicide risk. Interventions that promote firearm and medication safety are recommended for Veterans identified as at-risk. The investigators work will provide important information that will aid the development and testing of such an intervention for Veterans who seek care in VA EDs. The investigators will interview at-risk Veterans who recently sought VA ED care to identify factors relevant to developing the intervention, and work with Veterans and VA healthcare staff to develop and test an intervention.
Detailed description
Veterans will be recruited from the Rocky Mountain Regional VA Medical Center (RMRVAMC) ED who are identified as having elevated suicide risk by VHA's new suicide risk screening initiative. All Veterans visiting VHA EDs are screened using an eight-item version of the Columbia Suicide Severity Rating Scale (C-SSRS) Screener, a valid predictor of future suicidal behavior. The C-SSRS Screener assesses suicide risk using eight items about recent suicidal ideation and intent, preparatory behaviors, and action. Deductive and inductive content analysis of qualitative interviews will occur in parallel with recruitment, and participants will be recruited until thematic saturation is achieved. Veterans' visits (approx. 90 minutes) will be scheduled at their preferred times at RMRVAMC within two weeks of discharge from the ED. Sociodemographic and military service data will be collected using the Rocky Mountain Mental Illness Research, Education, and Clinical Center (MIRECC) Demographics Survey. During this visit, individuals will participate in qualitative interviews to identify contextual factors that may inform development of VA-based lethal means safety interventions.
Interventions
None listed
Sponsors
VA Office of Research and Development
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Veteran * Recent Emergency Room care * Screen positive for elevated suicide risk
Exclusion criteria
* Severe cognitive impairment * Lack decisional capacity * Unable to provide informed consent * Lack reliable phone access * Admitted to the hospital
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | baseline | Perspectives on VA-based interventions that aim to reduce access to firearms and medications. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| Study Group 28 Veterans who were recently discharged from a VHA emergency care. Veteran participants were: \>18 years of age, had access to firearms and/or medications at home, and were determined to be at elevated suicide risk based on the presence of suicide risk factors, including screening positive for having elevated suicide risk at the time of admission via the Columbia Suicide Severity Rating Scale Screener. Veterans were excluded if they were critically ill (intensive care unit requirements), are severely cognitively impaired, or had severe psychiatric symptoms that would preclude study participation. | 28 |
| Total | 28 |
Baseline characteristics
| Characteristic | Study Group |
|---|---|
| Age, Continuous | 55.9 years STANDARD_DEVIATION 14.9 |
| Race/Ethnicity, Customized Race / Ethnicity African American / Black | 1 Participants |
| Race/Ethnicity, Customized Race / Ethnicity missing | 1 Participants |
| Race/Ethnicity, Customized Race / Ethnicity Other | 2 Participants |
| Race/Ethnicity, Customized Race / Ethnicity White | 24 Participants |
| Region of Enrollment United States | 28 Participants |
| Sex/Gender, Customized Gender Cisgender female | 4 Participants |
| Sex/Gender, Customized Gender Cisgender male | 24 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 0 |
| other Total, other adverse events | 0 / 28 |
| serious Total, serious adverse events | 0 / 28 |
Outcome results
Primary
Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions
Perspectives on VA-based interventions that aim to reduce access to firearms and medications.
Time frame: baseline
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Study Group | Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Acceptability | 26 participants |
| Study Group | Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Uncertainty about intent and efficacy | 20 participants |
| Study Group | Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Cost and convenience are critical | 24 participants |
| Study Group | Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Uncertainty regarding engaging other people in interventions | 14 participants |
| Study Group | Qualitative Theme Among 28 Patients on Perspectives on Lethal Means Interventions | Influence of prior opioid exposure | 12 participants |