Virtual Mental Health Services Reduce Suicide-Related Events Among Veterans
BACKGROUND:
Rising U.S. suicide rates emphasize the need for effective prevention. While telehealth has transformed access to mental health care, the impact of telehealth on suicide outcomes is unknown. This retrospective study evaluated whether virtual mental health service use affects the risk of individual-level suicide-related events (SREs). The sample included 16,236 recently separated Veterans (67% male, 51% White, 69% non-Hispanic; average age 33 years) who completed their active-duty service between March 1, 2019, and December 31, 2020; received at least two outpatient diagnoses or a single inpatient diagnosis related to major depressive disorder, substance use disorder, or PTSD within the year before their most recent separation date; and received mental health care in VA between March 1, 2020, and December 31, 2021. Researchers reviewed 66,387 data points to identify the percentage of each Veteran's total mental health visits that were conducted virtually by psychiatrists, psychologists, or social workers within a specific month. The main outcome measure was whether a Veteran experienced an SRE (defined as a nonfatal suicide attempt, intentional self-harm, or suicide death) during the same calendar month as their visits. Researchers accounted for factors that are associated with use of virtual mental health care and SRE risk, such as race/ethnicity, rurality, and available broadband internet access.
FINDINGS:
- A 1% increase in the percentage of virtual mental health visits relative to total visits was associated with a nearly 3% decrease in SREs among Veterans.
- Virtual mental health visits comprised 45% of all mental health visits.
- A total of 929 SREs (1%) occurred during the same calendar months as mental health visits.
IMPLICATIONS:
- Although virtual mental health care does not serve all Veterans uniformly, offering virtual mental health services, in addition to in-person care, is an effective component of a suicide prevention strategy.
LIMITATIONS:
- Unmeasured confounders may influence broadband access and the outcome of suicide events.
- Findings might not be generalizable to all Veterans, as recently separated Veterans might face distinct challenges.
AUTHOR/FUNDING INFORMATION:
This study was funded by QUERI. All authors are with QUERI’s Partnered Evidence-Based Policy Resource Center (PEPREC).
Tenso K, Strombotne K, Garrido MM, Lum J, Pizer S. Virtual Mental Health Care and Suicide-Related Events. JAMA Network Open. November 5, 2024;7(11):e2443054.
