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J Consult Clin Psychol. 2019 Apr 22. doi: 10.1037/ccp0000400. [Epub ahead of print]

Utilization of and barriers to treatment among suicide decedents: Results from the Army Study to Assess Risk and Resilience Among Servicemembers (Army STARRS).

Author information

1
Department of Psychology.
2
Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of Health Sciences.
3
Department of Psychiatry, University of Pittsburgh School of Medicine.
4
Institute for Social Research, University of Michigan.
5
Department of Health Care Policy, Harvard Medical School.
6
Department of Psychiatry and Family Medicine & Public Health, University of California, San Diego.

Abstract

OBJECTIVE:

To examine suicide decedents' use of mental health treatment and perceived barriers to initiating and maintaining treatment.

METHOD:

We used a psychological autopsy study conducted as part of the Army Study to Assess Risk and Resilience Among Servicemembers (Army STARRS) that compared suicide decedents (n = 135) to soldiers in two control conditions: those propensity-score-matched on known sociodemographic and Army history variables (n = 137) and those with a history of suicidal thoughts in the past 12 months (n = 118). Informants were next of kin and Army supervisors.

RESULTS:

Results revealed that suicide decedents were significantly more likely to be referred to services and to use more intensive treatments (e.g., medication, overnight stay in hospital) than propensity-matched controls. However, decedents also were more likely to perceive significant barriers to treatment-seeking. All differences observed in the current study were between propensity-matched controls and decedents, with no observed differences between suicide ideators and decedents.

CONCLUSIONS:

Many suicide decedents used some form of mental health care at some point in their lives; however, they also were more likely than propensity-matched controls to perceive barriers that may have prevented service use. The lack of differences between suicide ideators and decedents suggests that more information is needed, beyond knowledge of treatment utilization or perceived barriers, to identify and intervene on those at highest risk for suicide. These findings underscore the importance of reducing attitudinal barriers that may deter suicidal soldiers from seeking treatment, and also improving risk detection among those who are attending treatment. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

PMID:
31008631
DOI:
10.1037/ccp0000400

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