Associations of Mortality Outcomes With Employment Status at Discharge From VA Vocational Rehabilitation Service Programs.

Autor:	Abraham KM; Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs (VA), Ann Arbor (Abraham, Dent, McCarthy); Department of Psychology, University of Detroit Mercy, Detroit (Abraham); Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention, VA, West Haven, Connecticut (Resnick); Department of Psychiatry, School of Medicine, Yale University, New Haven (Resnick); Suicide Prevention Program, Office of Mental Health and Suicide Prevention, VA, Washington, D.C. (McCarthy); Center for Clinical Management Research, VA, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Zivin)., Dent KR; Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs (VA), Ann Arbor (Abraham, Dent, McCarthy); Department of Psychology, University of Detroit Mercy, Detroit (Abraham); Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention, VA, West Haven, Connecticut (Resnick); Department of Psychiatry, School of Medicine, Yale University, New Haven (Resnick); Suicide Prevention Program, Office of Mental Health and Suicide Prevention, VA, Washington, D.C. (McCarthy); Center for Clinical Management Research, VA, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Zivin)., Resnick SG; Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs (VA), Ann Arbor (Abraham, Dent, McCarthy); Department of Psychology, University of Detroit Mercy, Detroit (Abraham); Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention, VA, West Haven, Connecticut (Resnick); Department of Psychiatry, School of Medicine, Yale University, New Haven (Resnick); Suicide Prevention Program, Office of Mental Health and Suicide Prevention, VA, Washington, D.C. (McCarthy); Center for Clinical Management Research, VA, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Zivin)., McCarthy JF; Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs (VA), Ann Arbor (Abraham, Dent, McCarthy); Department of Psychology, University of Detroit Mercy, Detroit (Abraham); Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention, VA, West Haven, Connecticut (Resnick); Department of Psychiatry, School of Medicine, Yale University, New Haven (Resnick); Suicide Prevention Program, Office of Mental Health and Suicide Prevention, VA, Washington, D.C. (McCarthy); Center for Clinical Management Research, VA, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Zivin)., Zivin K; Serious Mental Illness Treatment Resource and Evaluation Center, Office of Mental Health and Suicide Prevention, U.S. Department of Veterans Affairs (VA), Ann Arbor (Abraham, Dent, McCarthy); Department of Psychology, University of Detroit Mercy, Detroit (Abraham); Northeast Program Evaluation Center, Office of Mental Health and Suicide Prevention, VA, West Haven, Connecticut (Resnick); Department of Psychiatry, School of Medicine, Yale University, New Haven (Resnick); Suicide Prevention Program, Office of Mental Health and Suicide Prevention, VA, Washington, D.C. (McCarthy); Center for Clinical Management Research, VA, and Department of Psychiatry, University of Michigan Medical School, Ann Arbor (Zivin).
Jazyk:	angličtina
Zdroj:	Psychiatric services (Washington, D.C.) [Psychiatr Serv] 2024 Nov 01; Vol. 75 (11), pp. 1101-1108. Date of Electronic Publication: 2024 May 02.
DOI:	10.1176/appi.ps.20230489
Abstrakt:	Objective: The authors evaluated associations between employment at discharge from Veterans Health Administration Vocational Rehabilitation Service (VR) programs and suicide and other causes of death. Methods: For veterans receiving VR between October 1, 2005, and September 30, 2014 (N=78,293), proportional hazards analyses were used to test associations of employment with suicide, drug overdose, and external and natural cause mortality rates over 1 and 5 years postdischarge and through December 31, 2019. The analyses were adjusted for clinical and sociodemographic characteristics and propensity for employment. Results: Of the veterans, 94.1% had a psychiatric diagnosis, and 35.5% were employed at VR discharge. In proportional hazards analyses, employment was associated with lower mortality rates through 1 year (suicide, hazard ratio [HR]=0.54; overdose, HR=0.70; external causes, HR=0.62; and natural causes, HR=0.51) and 5 years postdischarge (overdose, HR=0.72; external causes, HR=0.81; and natural causes, HR=0.72). Through December 31, 2019, employment was associated with lower risks for overdose (HR=0.80) and death by external (HR=0.81) and natural (HR=0.80) causes. Conclusions: Employment at VR discharge was associated with lower mortality risk among veterans with psychiatric diagnoses. Competing Interests: The authors report no financial relationships with commercial interests.
Databáze:	MEDLINE
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