Date of Award

2014

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Graduate Group

Nursing

First Advisor

Marilynn Sommers

Abstract

ABSTRACT

SUICIDE RISK IN HOMELESS VETERANS WITH

TRAUMATIC BRAIN INJURY

Dr. Briana Lafferty

Dr. Marilynn Sommers

Every sixty-five minutes a veteran takes his or her own life. Suicide is now the second leading cause of death among United States (US) military service members, with rates almost three times that of the general population. An association may exist between suicide and traumatic brain injury (TBI). One in six military service members involved in the wars in Iraq and Afghanistan are said to have been subjected to at least one TBI. With the growing number of service members exposed to blast injuries, the consequences of TBI, such as changes in mood, personality, cognition, and behavior, expose them to the risk of suicide. Veterans are also 50% more likely than other Americans to become homeless, and homelessness is another problem contributing to a greater risk for suicide in this population. Rates of suicide among individuals experiencing homelessness are reported to be approximately ten times higher than the annual percentage of suicides within the housed population. Currently, there is no existing literature that examines suicide risk in veterans affected by both TBI and homelessness. The aim of my study was to examine the associations among suicide risk and specific physical, psychological, social, and military factors, as well as to describe the association of suicide risk and utilization of Veterans Affairs (VA) healthcare services, in a sample of homeless US Veterans who have experienced at least one TBI. I conducted a cross-sectional study using secondary data from the National Center for Homelessness Among Veterans, in addition to performing retrospective chart reviews. My findings demonstrated strong associations between high risk for suicide and marital status, PTSD, issues with memory/problem solving, seizures, and inpatient admissions for mental health treatment. My findings have implications for health care and policy change related to decreasing stigmatization of mental health issues, overcoming barriers and increasing eligibility to VA healthcare benefits, and mandating more aggressive screening and prevention efforts. These changes are needed particularly during the transition to civilian life.

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