Association of 7-Day Follow-Up With 6-Month Suicide Mortality Following Hospitalization for Suicidal Thoughts or Behaviors Among Older Adults

Objective: To evaluate whether timely follow-up outpatient mental health care is associated with reduced short-term suicide risk following hospitali-zation for suicidal thoughts or behaviors. Methods: Retrospective cohort analysis using 2015 Medicare data for adults aged >= 65 years who were hospitalized for suicidal ideation or behaviors (n = 36,557) linked with the National Death Index. Adjusted risk ratios (ARR) estimated the association between 7-day follow-up and suicide risk at 30-, 90-, and 180-days, adjusted for confounding by indication using inverse probability of treatment weights of observable covariates. Results: Overall, 39.3% of patients received 7-day follow-up, which was associated with 41% higher risk of sui-cide within 180 days. Follow-up care was associated with higher suicide risk for Medicare Advantage enrollees, patients with no recent prior mental health care, and those admitted for suicidal behaviors. Conclusion: Results suggest 7-day follow-up care was not associated with lower post-discharge suicide risk. For this high-risk group, suicide-specific interventions may be needed during the critical postdischarge period. (Am J Geriatr Psychiatry 2024; 32:128-134)