A latent class analysis to identify subgroups of VHA using homeless veterans at greater risk for suicide mortality

Background: Homeless Veterans are at substantially elevated risk for suicide mortality; however, understanding of drivers of suicide in this population remains limited.Method: Building upon prior work, we conducted a retrospective chart review, comprised of a latent class analysis of 724,752 Veterans with use of Veterans Health Administration (VHA) homeless services 2005-2018.Results: A five-model class membership solution was identified. Among these classes, risk for suicide mortality was greatest among Veterans with the highest psychiatric burden and high VHA service use. Those experiencing moderate psychiatric burden or primarily experiencing substance use disorders also experienced elevated risk for suicide mortality relative to those with low burden and service use.Limitations: Models were specific to Veterans accessing VHA homeless services and may not generalize to those not using such services outside VHA care.Conclusions: Continued research and programing remain necessary to determine how to address mental health conditions and engage homeless Veterans in services to facilitate suicide prevention.