Suicidal Ideation among Veterans Living with Cancer Referred to Mental Health.

Objectives: Eliminating Veteran suicide is a top priority for the Department of Veterans' Affairs (VA). This study identified factors associated with suicidal ideation (SI) among a rarely studied subgroup of Veterans: those with cancer.Methods: Veterans (age M = 61.83) with cancer (N= 175) referred for psychological evaluation completed measures of pain, sleep, depressive, anxiety, and PTSD symptoms. SI was defined by endorsing on paper-and-pencil questionnaire thoughts of killing oneself in the past 2 weeks or during clinical interview.Results: 25.1% reported SI. Compared to those without SI, Veterans with SI had higher ratings on measures of depression, anxiety, and PTSD symptoms. History of suicide attempt(s) was included in the model due to clinical significance. Logistic regression was performed with these variables as predictors of SI. The omnibus model was significant (p< .001). However, only anhedonia and depressed mood had a statistically significant contribution to the model (ß = 0.540, p= .001).Conclusions: Anhedonia and depressed mood predicted SI among Veterans with cancer above and beyond other risk factors.Clinical Implications: This study's findings highlight the importance of incorporating suicide risk screenings in oncology clinics across VA medical centers.

An examination of transdisciplinary implementation of measurement-based care in a Veterans Affairs Healthcare System.

Measurement-based care (MBC) is an effective pantheoretical practice framework that enhances mental health treatment outcome. MBC entails routine, systematic administration of standardized scales to measure patients' treatment response, inform clinical decisions, and tailor practice approaches and treatment planning to the individual needs of each patient. In 2016, the Office of Mental Health Operations and Mental Health Services in the Veterans Affairs Central Office launched the MBC in Mental Health Care Initiative. In accordance with this initiative, MBC was implemented within 2 mental health clinics at a large VA Health Care System in the southeastern United States. This program evaluation project examined the utilization of MBC measures across disciplines (i.e., psychiatry, psychology, social work) in the 2 clinics and clinicians' perspectives on MBC processes. Results suggested no significant differences between clinics in terms of rate of MBC measures administration. However, there were significant differences in the relative number of measures and the relative number of patients who were administered MBC measures across disciplines. Input from clinicians regarding their perspectives and experiences with the MBC implementation in their respective clinics were qualitatively and quantitatively evaluated, and barriers to MBC implementation were examined from the perspective of stakeholders. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychological Sequelae in Family Caregivers of Critically III Intensive Care Unit Patients. A Systematic Review.

Rationale: Family members of critically ill patients hospitalized in the intensive care unit (ICU) often become caregivers, and they are at risk to develop adverse psychological outcomes. There is a need to understand the psychological impact of critical illness on family caregivers. Objectives: The aim of this systematic review is to document the prevalence of depression, anxiety, and post-traumatic stress disorder (PTSD) in family caregivers of critically ill patients and identify potential risk factors for psychological outcomes to inform clinical and future research recommendations. Methods: A literature search for psychological outcomes for family caregivers of critically ill patients was conducted. A total of 1,148 studies from PsycINFO, CINAHL, Web of Science, SCOPUS, and Medline were identified. Results: Forty studies met inclusion criteria and were included in the review. The prevalence of psychological outcomes in family caregivers ranged from 4% to 94% for depression, 2% to 80% for anxiety, and 3% to 62% for PTSD. Caregiver depression, anxiety, and PTSD decreased in most studies that assessed longitudinal outcomes. Common risk factors identified for adverse psychological outcomes included younger caregiver age, caregiver relationship to the patient, lower socioeconomic status, and female sex. Conclusions: The prevalence of depression, anxiety, and PTSD varies greatly across studies of family caregivers of critically ill patients. This finding highlights the need for more systematic investigations of psychological outcomes and the implementation of clinical interventions to prevent or reduce depression, anxiety, and PTSD in family caregivers of critically ill patients.