919 - Implementation of Suicide Screenings in a Veterans Affairs Chronic Pain Clinic

Objectives: Suicide rates in the veteran population are 1.5 times higher than the rates in the general population. Chronic pain presents as a salient factor for increased suicide risk in veterans. Early suicide risk identification allows for an opportunity to provide evaluation and management. All new patients seen in the chronic pain clinic must have a suicide screening performed at the initial visit. The screening is repeated at one year. The aim of the study is to determine the rates of suicide screens using the Columbia-Suicide Severity Rating Scale (C-SSRS) in patients seen in the chronic pain clinic at the initial visit and 1 year follow-up.

Design: A retrospective chart review was performed on new patients seen in the chronic pain clinic from October 1, 2022 to September 30, 2023. For a randomized sample of patients, the suicide screening documentation was reviewed at the initial visit and at 1 year follow-up.

Results: The C-SSRS screening was completed in 100% of the sample population at the initial visit. For those who had a positive C-SSRS, 100% received additional screening, the Comprehensive Suicide Risk Evaluation (CSRE), within 24 hours. However, the completion of the C-SSRS screening after 1 year fell to below 10%.

Conclusions: Among veterans who are seen in the chronic pain clinic, initial suicide risk screenings were performed consistently. Positive C-SSRS screenings had timely follow-up. However, the completion of suicide screens after 1 year dropped off dramatically. The process for completing suicide screens after 1 year can be improved with an electronic reminder system to alert clinicians to complete the screening. More interventions will be needed to determine the best method to assure timely and efficient follow up of this vulnerable population.