Association between suicide attempts and homelessness in a population-based sample of US veterans and non-veterans.

BACKGROUND: Suicide and homelessness share many of the same risk factors, but there is little understanding of how they are related to each other.
METHODS: Data on 36 155 US adults (3101 veterans and 33 024 non-veterans) in the National Epidemiological Survey of Alcohol and Related Conditions-III were analysed to examine the association between lifetime homelessness and suicide, net of other factors, in a nationally representative US sample.
RESULTS: US veterans with homeless histories were 7.8 times more likely to have attempted suicide than veterans with no homeless histories (24.5% vs 2.8%). Non-veterans with homeless histories were 4.1 times more likely to have attempted suicide than those with no homeless histories (23.1% vs 4.5%). Lifetime homelessness was independently associated with lifetime suicide attempts in veterans (AOR=3.75, 95% CI 3.72 to 3.77) and non-veterans (AOR=1.83, 95% CI 1.83 to 1.84).
CONCLUSION: The findings suggest a unique link between homelessness and suicide, especially among US veterans. Strategies to synergise homeless and suicide prevention services, particularly in the Veterans Health Administration, may benefit high-risk individuals. © Author(s) (or their employer(s)) 2019. No commercial re-use. See rights and permissions. Published by BMJ.