Whole Health Care Model May Decrease Suicide Risk in Veterans

The Whole Health (WH) model of health care being implemented by the Veterans Health Administration (VHA) may help reduce the risk for suicide and the need for mental health services among Veterans with a mental health diagnosis, according to findings published in Complementary Therapies in Medicine.

Researchers conducted a retrospective study at a VHA medical center that included 7138 veterans diagnosed with mental health disorders from March 2017 through February 2020. The primary endpoints were medication prescriptions, pain scores and suicide-related behaviors, and the usage of mental health treatment services.

Among the 7138 study patients, 6833 did not utilize WH services. A total of 305 veterans had at least 1 WH program appointment, and the mean number of completed appointments per individual was 6.9 for all WH programs, 3.1 for general WH programs, and 4.4 for the mindfulness center, respectively.

Researchers observed no significant demographic differences between who utilized WH programs and those did not except for period of military service (a lower proportion of patients who utilized WH programs served in the Vietnam War and a greater proportion served after the Vietnam War).

Utilization of WH programs was associated with the existence of several specific mental health disorders. Patients with PTSD, substance use disorder, depressive disorder, and anxiety disorders comprised a significant portion of the utilizer group. There was also a greater proportion of tobacco use disorder, substance and alcohol use disorders, and chronic pain among patients in this group. Those who utilized WH programs were also more likely to report self-harm and history of suicidal thoughts.

Participation in WH was associated with a decreased risk for suicide (8.9% to 3.6%; P =.002) and reduced use of mental health services (median of 3 visits to a median of 2 visits; P =.002). There were no significant changes in other outcome variables.

A statistical mixed effects model adjusting for tobacco use, chronic pain, age, and the Charlson Comorbidity Index showed a significant increase in suicide attempts for patients who did not utilize WH programs and no significant difference in suicide attempts for patients who did.

Limitations of the study include the uncontrolled retrospective nature, utilizing a convenience sample conducted at only 1 site, restriction to data collected in the electronic health record, possibility of inaccuracies of suicide documentation, and the WH model in the early stages of implementation at this facility.

Study authors concluded, “WH programming was acceptable to the population, but utilization rates were low….the WH model of care may have a role in suicide prevention efforts.”