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Abraham, Dent, Resnick, McCarthy, Zivin. Associations of Mortality Outcomes With Employment Status at Discharge From VA Vocational Rehabilitation Service Programs. Psychiatric services (Washington, D.C.). 2024 Nov 1; 75(11):1101-1108, DOI: 10.1176/appi.ps.20230489.
OBJECTIVE: The authors evaluated associations between employment at discharge from Veterans Health Administration Vocational Rehabilitation Service (VR) programs and suicide and other causes of death. METHODS: For veterans receiving VR between October 1, 2005, and September 30, 2014 (N = 78,293), proportional hazards analyses were used to test associations of employment with suicide, drug overdose, and external and natural cause mortality rates over 1 and 5 years postdischarge and through December 31, 2019. The analyses were adjusted for clinical and sociodemographic characteristics and propensity for employment. RESULTS: Of the veterans, 94.1% had a psychiatric diagnosis, and 35.5% were employed at VR discharge. In proportional hazards analyses, employment was associated with lower mortality rates through 1 year (suicide, hazard ratio [HR] = 0.54; overdose, HR = 0.70; external causes, HR = 0.62; and natural causes, HR = 0.51) and 5 years postdischarge (overdose, HR = 0.72; external causes, HR = 0.81; and natural causes, HR = 0.72). Through December 31, 2019, employment was associated with lower risks for overdose (HR = 0.80) and death by external (HR = 0.81) and natural (HR = 0.80) causes. CONCLUSIONS: Employment at VR discharge was associated with lower mortality risk among veterans with psychiatric diagnoses.