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

Alcoholism: Clinical and Experimental Research (OnlineEarly Articles).

• Mark A. Ilgen¹

• ¹Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.,
• Alex H. S. Harris¹
• ¹Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.,
• Rudolf H. Moos¹
• ¹Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025., and
• Quyen Q. Tiet¹
• ¹Department of Veterans Affairs, Center for Health Care Evaluation, Palo Alto Health Care System and Stanford University School of Medicine, Menlo Park, California 94025.

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

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.