Gender comparison of Veterans crisis line risk ratings and consequent suicidal self-directed violence outcomes during the COVID era

Abstract: Introduction: Improving gender-sensitive suicide prevention programming for women veterans is crucial. Veterans Crisis Line (VCL) is a preventive strategy used by the US Department of Veterans Affairs. Public health measures implemented during COVID-19 pandemic may have affected the nature of VCL calls. Objectives: To assess the gender differences in the VCL contacts made in year 2020 and subsequent suicidal self-directed violence (SSDV) outcomes in the 12 months follow-up. Methods: Cohort study. Outcomes: Composite measure of SSDV (dichotomized as nonfatal suicide event and/or suicide) in the 12 months following VCL call. Results: Compared to veterans with low-risk assessment, those with high/moderate risk had significantly higher odds of SSDV in the follow-up year (OR = 4.12, 95% CI: 3.82, 4.45). We assessed the association of gender, combination of VCL risk, and suicide attempt (SA) history, on SSDV. The VCL risk and SA history combinations were independently associated with SSDV. However, there was no differential association on SSDV for different gender/VCL risk and SA history combinations (p = 0.6247). Conclusions and Relevance: Our 2020 VCL data outcomes are largely consistent with those from our prior work examining 2018 VCL contacts. Overall, VCL risk assessment was relatively stable across the gender binary during COVID pandemic.

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