What now?: Experiences of VHA patients following disclosure of suicidal ideation in primary care and mental health settings

Abstract: OBJECTIVE: While screening and treatment options for patients who disclose suicidal ideation in clinical settings have grown in recent decades, little is known about patient experiences following disclosure. We characterize patient perspectives of responses following disclosure of suicidal ideation in Veteran Health Administration (VHA) primary care and mental health settings. METHOD: Qualitative thematic analysis using a conventional/directed hybrid approach. RESULTS: A national sample comprised of sixty participants who recently screened for suicidal ideation in primary care (n = 28) and mental health (n = 32) settings completed interviews. Many patients described therapeutic experiences following disclosure, including caring staff, timely follow-up care, and offers of multiple treatment options. Other patients, however, reported deficits in staff empathy, long waits for follow-up care, or inadequate treatment options. CONCLUSIONS: While many VA clinical settings provided empathic and helpful responses, these experiences were not universal. Our findings reinforce the importance of a patient-centered approach to screening and response to disclosure, including collaboration with patients in treatment planning. Improved follow-up care coordination processes are needed. Following disclosure, contact with the staff who received the disclosure also helps patients feel cared about, and provides opportunity to troubleshoot barriers a patient may experience in accessing care.

Read the full article
Report a problem with this article

Related articles

  • More for Researchers

    Access to outpatient occupational therapy services after inpatient psychiatric hospitalization in the Veterans Health Administration

    Abstract: IMPORTANCE: Veterans with occupational performance (e.g., activities of daily living [ADL]) limitations who are receiving inpatient psychiatric care may benefit from outpatient occupational therapy upon discharge, but access disparities have not been investigated. OBJECTIVE: To investigate whether ADL limitations, an indicator of need, are associated with outpatient occupational therapy utilization after inpatient psychiatric hospitalization in the Veterans Health Administration (VHA) and whether this relationship differs by facility characteristics. DESIGN: Secondary analysis of VHA medical record data. Modified Poisson regression was used to model outpatient occupational therapy utilization (yes or no) as a function of ADL limitations, facility characteristics, and sociodemographic and clinical characteristics. Interactions were used to estimate whether the relationship between ADL limitations and outpatient occupational therapy utilization differs across facility characteristics. SETTING: VHA outpatient setting. PARTICIPANTS: Veterans who received VHA inpatient psychiatric care from 2015 to 2020 and lived