Predictive Modeling to Prevent Veteran Suicides

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A study entitled “Predictive Modeling and Concentration of the Risk of Suicide: Implications for Preventive Interventions in the US Department of Veterans Affairs,” has recently been published online by the American Journal of Public Health.  In the extract cited below, the VA claims that predictive modeling can help identify Veterans with a high risk to commit suicide and, therefore, provide enhanced intervention to prevent Veteran Suicides:

 Objectives. The Veterans Health Administration (VHA) evaluated the use of predictive modeling to identify patients at risk for suicide and to supplement ongoing care with risk-stratified interventions.

Methods. Suicide data came from the National Death Index. Predictors were measures from VHA clinical records incorporating patient-months from October 1, 2008, to September 30, 2011, for all suicide decedents and 1% of living patients, divided randomly into development and validation samples. We used data on all patients alive on September 30, 2010, to evaluate predictions of suicide risk over 1 year.

Results. Modeling demonstrated that suicide rates were 82 and 60 times greater than the rate in the overall sample in the highest 0.01% stratum for calculated risk for the development and validation samples, respectively; 39 and 30 times greater in the highest 0.10%; 14 and 12 times greater in the highest 1.00%; and 6.3 and 5.7 times greater in the highest 5.00%.

Conclusions. Predictive modeling can identify high-risk patients who were not identified on clinical grounds. VHA is developing modeling to enhance clinical care and to guide the delivery of preventive interventions. (Am J Public Health. Published online ahead of print June 11, 2015: e1–e8. doi:10.2105/AJPH.2015.302737)
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Assuming the findings our correct, this is a great tool in helping to provide targeted preventative treatment to those Veterans.

Veteran Suicides Still at Crisis Levels

While many public and private studies have provided hope that Veterans can reclaim control of their lives, veteran suicides continue to remain at near crisis levels.  Since the historic 2010 US Army study on veteran suicides and suicide prevention, most evidence continues to suggest that 22 veterans commit suicide each day.

Senator Richard Blumenthal (Democrat of Connecticut) is quoted as saying “When you have 8,000 veterans a year committing suicide, then you have a serious problem.”

Many other government leaders on both sides of the aisle echo similar views, but there has been little meaningful improvement in veteran suicide rates over the past five years.

While we are hopeful that the diagnostic modeling with bring targeted relief to long-suffering Veterans, past experience would suggest that VA is slow to implement change and many Veterans will not receive the help they require.

It has become very fashionable to blame the VA for all problems – real or imagined – but clearly more must be done to address this alarming problem.


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