Association of 7-Day Follow-Up With 6-Month Suicide Mortality Following Hospitalization for Suicidal Thoughts or Behaviors Among Older Adults

Am J Geriatr Psychiatry. 2024 Jan;32(1):128-134. doi: 10.1016/j.jagp.2023.08.011. Epub 2023 Aug 22.

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.

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

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aftercare
  • Aged
  • Follow-Up Studies
  • Humans
  • Medicare
  • Patient Discharge
  • Retrospective Studies
  • Suicidal Ideation*
  • Suicide* / psychology
  • Suicide, Attempted / psychology
  • United States / epidemiology