Earlier Identification of Suicide Risk
Suicide risk is reported to be higher among Veterans than non-Veterans. Most people who die from suicide have at least one mental health disorder. Common conditions are major depressive disorder, bipolar disorder, schizophrenia and substance use disorders. However, not everyone with one of these disorders becomes suicidal. Researchers at the VISN 3 MIRECC are looking to the brain to improve our understanding of who is at risk for suicide. This team compared chemicals in the brains of people who died of suicide with those who died of other reasons. They found particular changes to a gene related to serotonin, a brain chemical that has been linked to mood. These alter the intermediate step (Messenger RNA) between DNA (the gene) and the manufacture of proteins. These proteins are involved in the way the brain sends its serotonin signals. The changes were found only in the brains of Veterans who died by suicide. This same pattern occurred no matter what mental health disorder was present. The researchers are now looking for a marker that could be detected with a simple blood test. Such a test may indicate who is at higher risk for suicide. In the future, tests like this may help us to quickly identify individuals at very high risk for suicide, even before they have become suicidal. Veterans in need could then get suicide prevention care before they harm themselves.

For the complete story, see: Dracheva,S., Patel, N., Woo, D.A., Marcus, S.M., Siever, L.J. & Haroutunian, V. (2008). Increased serotonin 2C receptor mRNA editing: a possible risk factor for suicide. Molecular Psychiatry, 13, 1001-1010.

Improving Services for Veterans at Risk
A new program called SAFE VET reaches out to Veterans at risk of suicide who are seen in Emergency Departments (ED) and in Urgent Care Services. SAFE VET stands for Suicide Assessment and Follow-up Engagement: Veteran Emergency Treatment. The program is designed to help Veterans in distress but who do not require immediate psychiatric hospitalization. It provides brief intervention and follow-up for potentially suicidal Veterans. SAFE VET engages Veterans in targeted safety planning, finding ways for them to stay and feel safer. Follow-up contact after leaving the ED is done by a trained Acute Services Coordinator (ASC). The ASC helps these Veterans connect with outpatient mental health services and encourages them to use their safety plan with regular calls to check in about safety. To date, over 900 Veterans have benefitted from SAFE VET. Early results show that Veterans find the intervention acceptable. Almost all (92%) of those offered the program agreed to participate. Findings also suggest that participation makes it more likely that Veterans will connect with outpatient mental health care. In addition, ED staff report finding SAFE VET to be extremely helpful. This program fills an important gap in services. It may dramatically improve our ability to get at-risk Veterans the care they need.

For the complete story, see: Knox, K.L., Stanley, B., Currier, G.W., Brenner, L., Ghahramanlou-Holloway, M. & Brown, B. (2012). An Emergency Department- based brief intervention for Veterans at risk for suicide (SAFE VET). American Journal of Public Health, 102, s.1, s33-s37.