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Leah Russell, MA, 1 Maria D. Devore, MS, 1 Lisa A. Brenner, PhD, 1-4 Roger Casey, PhD, LCSW, 5,6 John Schinka, PhD, 6-8 Ann Elizabeth Montgomery, PhD, 9,10 Vincent Kane, PhD 5,6 1 VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), 2 Department of Psychiatry, 3 Department of Physical Medicine and Rehabilitation, & 4 Department of Neurology, University of Colorado Anschutz Medical Campus, School of Medicine, University of Colorado Anschutz Medical Campus, School of Medicine, 5 VA Homeless Providers Grant and Per Diem Program, DC, 6 National Center on Homelessness Among Veterans, Tampa, 7 James A. Haley VA Medical Center, Tampa, 8 Department of Psychiatry, University of South Florida, 9 National Center on Homelessness Among Veterans, Philadelphia, 10 Philadelphia VA Medical Center Leah Russell, MA, 1 Maria D. Devore, MS, 1 Lisa A. Brenner, PhD, 1-4 Roger Casey, PhD, LCSW, 5,6 John Schinka, PhD, 6-8 Ann Elizabeth Montgomery, PhD, 9,10 Vincent Kane, PhD 5,6 1 VISN 19 Mental Illness Research, Education and Clinical Center (MIRECC), 2 Department of Psychiatry, 3 Department of Physical Medicine and Rehabilitation, & 4 Department of Neurology, University of Colorado Anschutz Medical Campus, School of Medicine, University of Colorado Anschutz Medical Campus, School of Medicine, 5 VA Homeless Providers Grant and Per Diem Program, DC, 6 National Center on Homelessness Among Veterans, Tampa, 7 James A. Haley VA Medical Center, Tampa, 8 Department of Psychiatry, University of South Florida, 9 National Center on Homelessness Among Veterans, Philadelphia, 10 Philadelphia VA Medical Center To examine suicidal thoughts and/or behaviors (as measured by Module B of the MINI International Neuropsychiatric Interview [MINI]) and their associations with demographic factors and psychiatric disorders in a sample of homeless Veterans. Hypotheses: Being married and having a higher military rank at time of separation will be associated with lower suicidality scores on the MINI. Having served in combat will be associated with higher suicidality scores on the MINI. A direct correlation will be found between the number of psychiatric diagnoses and suicidality scores on the MINI. Objectives Subjects 196 Veterans who sought homeless services from the Denver VA and were later interviewed by researchers with the Mental Illness Research Education and Clinical Center (MIRECC). Measures Demographics Form Asks about an individuals age, gender, education, socio-economic status, race/ethnicity, age at first incidence of homelessness, religious affiliation, and branch of military service. MINI International Neuropsychiatric Interview (MINI) The MINI is a validated psychiatric interview used to assess for a number of psychiatric disorders including, but not limited to, suicidality, hypo/mania, major depressive disorder, panic disorder, agoraphobia, social anxiety disorder, post traumatic stress disorder (PTSD), alcohol/substance abuse and dependence (past 12 months), and psychotic disorders. Methods Background and Purpose The Department of Veterans Affairs has made it a priority to eliminate homelessness within the Veteran population. The National Center on Homelessness Among Veterans was established, in part, to assist the VA in programming efforts to provide care for Veterans who are homeless or at risk for homelessness. Recent estimates suggest that one in every seven people experiencing homelessness is a Veteran (Khuddari, 2010). Both Veterans and people experiencing homelessness are high risk groups for suicidal thoughts and behaviors. Research by McCarthy et al. indicates that when compared to the general population, Veterans receiving care from the VHA are at 66% higher risk of suicide. Additionally, people in the homeless population are 10 times more likely than the general population to have suicidal ideation (Fitzpatrick, 2007). Suicidal Thoughts and/or Behaviors Among Homeless Veterans Fitzpatrick, K. M., Irwin, J., Lagory, M., & Ritchey, F. (2007). Just thinking about it: Social capital and suicide ideation among homeless persons. Journal of Health Psychology, 12(5), 750-760. Khuddari, J., Culhane, D. P., Cortes, A.Veteran Homelessness: A Supplemental Report to the 2009 Annual Homeless Assessment Report to Congress. Washington, DC: US Department of Housing and Urban Development & Department of Veterans Affairs: 2010. McCarthy, J. F., Blow, F. C., Ignacio, R. V., Ilgen, M. A., Austin, K. L., & Valenstein, M. (2012). Suicide among patients in the Veterans Affairs health system: Rural-urban differences in rates, risks, and methods. American Journal of Public Health, 102, Supp l 1, S111-117. References. Predictions regarding marital status, combat service, and rank at separation were not supported by our data. Despite statistical significance, the increase in suicidality related to number of psychiatric disorders is not likely clinically meaningful. Existing research indicates that homeless Veterans are at higher risk for suicidal thoughts and behaviors and have a high comorbidity of psychiatric disorders. Examining demographic factors and number of psychiatric disorders did little to differentiate severity of suicidality in this population. Discussion There were no significant relationships between rank, marital status, combat experience, and suicidality scores on the MINI. There was a significant relationship between the number of psychiatric disorders and suicidality scores on the MINI. Preliminary Results Attendance at Religious Services Race/EthnicityEducation Demographics Of the 196 Veterans who participated, 94% of participants were male, 88% of participants were unemployed, and 94% were unmarried. The average age of the Veterans who participated was 51 years old. The mean age at first homelessness of Veterans who participated was approximately 40 years old. The average length of service was approximately four years (46 months). 20% of these Veterans served in combat.. Rank at SeparationSuicidalityFrequency of Diagnosis Military Service and Mental Health PredictorEstimateSEtp Rank0.81420.61391.330.1863 Married-2.07523.6563-0.570.5710 Combat Experience0.604412.10910.290.7747 Number of Disorders0.80830.37672.150.0331 A positive relationship exists between the number of psychiatric diagnoses and suicidality. However, as the number of disorders indicated on the MINI increases by 1, the suicidality score increases by 0.8. 49% of our sample separated from the military at a rank of E4 or higher. 73% of this sample of Veterans endorsed at least low suicidality scores on the MINI. Mean = 3 diagnoses on MINI 49% of our sample self-identified as African American, Hispanic, or Other. 61% of our sample completed additional years of education past a high school diploma or GED. 43% of participants endorsed attendance of religious services at least once a month.
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