Citation

Schmutte T, Olfson M, Xie M, Marcus SC. Am. J. Geriatr. Psychiatry 2023; ePub(ePub): ePub.

Copyright

(Copyright © 2023, American Association for Geriatric Psychiatry, Publisher Elsevier Publishing)

DOI

10.1016/j.jagp.2023.08.011

PMID

37690981

Abstract

OBJECTIVE: To evaluate whether timely follow-up outpatient mental health care is associated with reduced short-term suicide risk following hospitalization for suicidal thoughts or behaviors.

METHODS: Retrospective cohort analysis using 2015 Medicare data for adults aged ≥ 65 years who were hospitalized for suicidal ideation or behaviors (n = 36,557) linked with the National Death Index. Adjusted risk ratios (ARR) estimated the association between 7-day follow-up and suicide risk at 30-, 90-, and 180-days, adjusted for confounding by indication using inverse probability of treatment weights of observable covariates.

RESULTS: Overall, 39.3% of patients received 7-day follow-up, which was associated with 41% higher risk of suicide within 180 days. Follow-up care was associated with higher suicide risk for Medicare Advantage enrollees, patients with no recent prior mental health care, and those admitted for suicidal behaviors.

CONCLUSION: Results suggest 7-day follow-up care was not associated with lower post-discharge suicide risk. For this high-risk group, suicide-specific interventions may be needed during the critical postdischarge period.

Language: en

Keywords

Suicide; older adults; self-harm; suicidal ideation; follow-up care