Screening for Suicide Risk among Older Long-Term Care Residents: Assessing the Prevalence and Correlates of Suicide Ideation in an at-risk Demographic

Older adults have the highest rates of suicide in Canada and worldwide. Efforts are needed to establish the prevalence of suicide thoughts and behaviour in older adults and promote understanding of risk and resiliency factors, to inform suicide risk detection and intervention with vulnerable individuals. The COVID-19 pandemic highlighted serious healthcare challenges in Long-Term Care (LTC) homes, necessitating decisive action to enhance identification of critical health risks and attend to their amelioration. Although Accreditation requirements mandate routine assessment of suicide risk in LTC residents, scant research exists on suicide and its prevention in LTC, basic questions remain unanswered as to the scope of the problem and associated risk factors, and few validated measures have been developed to identify suicide thoughts and behaviour in older adults in LTC contexts. In the present study, we propose to evaluate the assessment of suicide risk in LTC homes. We specifically propose to conduct initial interviews with LTC administrators and frontline providers regarding perceived challenges and possible remedies for integrating suicide screening in LTC. We will then provide an online training program for LTC staff to sensitively screen for and effectively respond to suicide risk in older residents, employing the Geriatric Suicide Ideation Scale-Screen (GSIS-Screen), a brief version of a Canadian tool designed to assess suicide risk among older adults in residential, clinical, and community settings. We will use the GSIS-Screen, along with additional screening tools, to establish the prevalence of suicide thoughts and behaviour in LTC, to assess the measurement characteristics of these tools, and to test a theoretical model of the onset and worsening of suicide risk in later life. Study findings will be shared through the media and mental health and aging networks to enhance understanding of suicide risk in LTC and inform suicide prevention efforts.