{ "id": "AIBD-0310", "title": "VA's REACH VET suicide-risk model is associated with fewer documented suicide attempts, admissions and ED visits among top-0.1%-risk veterans; no change in mortality", "summary": "VA-authored triple-difference cohort study (173,313 veterans): REACH VET inclusion linked to more completed visits and safety plans and fewer admissions, ED visits and attempts; no mortality effect.", "date_observed": "2021-10-18", "date_basis": "unassessed", "date_precision": "unassessed", "benefit_status": null, "source_collection": null, "source_entry": null, "account": "The Department of Veterans Affairs (VA) announced REACH VET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment) on 3 April 2017. It had begun as a pilot the previous October and was fully implemented across VA. It uses a predictive model on veterans' health records to identify those at statistically elevated risk of suicide and other adverse outcomes. Once a veteran is identified, a VA mental health or primary care provider reaches out. The provider reviews the condition and treatment plan and decides if enhanced care is needed. Nextgov/FCW (17 July 2025) says the model scans records monthly for the top 0.1% risk tier. It says the variable set was cut from 381 to 61 and about 30,000 veterans were identified in the first year. Nextgov (18 October 2024) gives about 6,700 veterans a month. McCarthy and colleagues published the evaluation in JAMA Network Open on 18 October 2021. They are at the VA Office of Mental Health and Suicide Prevention, which built and runs the program. It covered 173,313 individuals, 40,816 of them in the top 0.1% tier during REACH VET (March 2017 to December 2018). The pre-period (March 2014 to December 2015) had 36,604. Triple-difference analyses found REACH VET associated with more completed outpatient appointments (adjusted triple difference 0.31; 95% CI 0.06 to 0.55). The proportion with new safety plans rose (0.08; 0.06 to 0.10). Mental health admissions (-0.08; -0.10 to -0.05), emergency department (ED) visits (-0.03; -0.06 to -0.01) and documented suicide attempts (-0.05; -0.06 to -0.03) fell. Subcohort analyses found no difference in suicide or all-cause mortality. Care evaluations of identified veterans rose from 46.1% to 87.5% over the period. A 2022 Psychiatric Services paper reports that by October 2020, 98% of identified veterans (N=6,579) were contacted and had care evaluated. Dent, Cooper and McCarthy (JAMA Network Open, 8 July 2025; 266,246 observations) again found no association with suicide, external-cause or all-cause mortality. The 6-month suicide hazard ratio was 1.18 (95% CI 0.83–1.69). Nextgov (2024) reports research finding the model “considered being a white man more of an indicator of potential self-harm than other factors”. The model omitted military sexual trauma; a REACH VET 2.0 adding such factors was planned for early 2025. The program's benefit is a cohort-level association over 2017–2018, not a dated event.", "category": "general benefit", "unexpected": false, "purpose": "Built to identify veterans in the top 0.1% of predicted suicide risk each month so that clinicians re-evaluate and enhance their care. The measured associations are that purpose.", "system": "REACH VET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment) suicide-risk predictive model and care-enhancement program", "model_version": "Original 2017 model (381 variables reduced to 61, per Nextgov); REACH VET 2.0 announced for 2025", "developer": "US Department of Veterans Affairs, Office of Mental Health and Suicide Prevention", "deployer": "Veterans Health Administration, all facilities", "location": "United States", "domain": "Suicide prevention / mental health care", "segment": "Health-system predictive risk modeling and outreach", "benefit_type": "Improved Physical Health", "taxonomy_note": "The outcomes are mental-health care results (fewer attempts, admissions and ED visits) with no effect on deaths, from a VA-authored cohort study.", "registry_ids": {}, "ratings": [ { "group": "personal", "depth": null, "reason": "The 2021 study reports population-level reductions in documented suicide attempts, admissions and ED visits for identified veterans. No individual veteran's outcome is documented, and mortality did not differ in 2021 or 2025." }, { "group": "organizational", "depth": null, "reason": "Care evaluations rose from 46.1% to 87.5% of identified veterans and 98% were contacted by October 2020, per VA-authored papers. No independent audit was found." }, { "group": "societal", "depth": null, "reason": "Nextgov notes the top 0.1% tier covers only 2–3% of VA suicides and the model under-identified women; no population suicide-rate effect is shown." } ], "ai_role": { "status": "assessed", "statement": "The predictive model selects the monthly top 0.1% risk tier. Coordinators and providers then re-evaluate care and reach out, so the clinical response, not the model alone, produces any change. The evaluation is observational, uses a triple-difference design to handle non-parallel trends, and is authored by the VA office that built and runs REACH VET. It found no mortality association, replicated in 2025 by the same group. Independent reporting documents that the original model weighted being a white man heavily and omitted military sexual trauma." }, "evidence": [ { "kind": "peer-reviewed study", "citation": "McCarthy JF, Cooper SA, Dent KR, Eagan AE, Matarazzo BB, Hannemann CM, Reger MA, Landes SJ, Trafton JA, Schoenbaum M, Katz IR (2021). Evaluation of the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment Suicide Risk Modeling Clinical Program in the Veterans Health Administration. JAMA Network Open 4(10):e2129900 (PMC8524305). Authors at the VA office that runs the program.", "title": "Evaluation of the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment Suicide Risk Modeling Clinical Program in the Veterans Health Administration", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/", "date": "2021-10-18", "written_by": "makers", "quote": "REACH VET implementation was associated with greater treatment engagement and new safety plan documentation and fewer mental health admissions, emergency department visits, and suicide attempts." }, { "kind": "peer-reviewed study", "citation": "Dent KR, Cooper S, McCarthy JF (2025). The REACH VET Program and Mortality Outcomes Among Veterans at High Risk of Suicide. JAMA Network Open, 8 July 2025 (PMC12238888). VA-authored.", "title": "The REACH VET Program and Mortality Outcomes Among Veterans at High Risk of Suicide", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/", "date": "2025-07-08", "written_by": "makers", "quote": "inclusion in the REACH VET program was not associated with suicide mortality (6-month hazards ratio [HR], 1.18 [95% CI, 0.83-1.69]" }, { "kind": "peer-reviewed study", "citation": "Matarazzo BB, Eagan A, Landes SJ, et al. (2022/2023). The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice. Psychiatric Services (first published 30 August 2022). VA-authored.", "title": "The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice", "url": "https://europepmc.org/article/MED/36039552", "date": "2022-08-30", "written_by": "makers", "quote": "By October 2020, 98% of veterans identified (N=6,579) were contacted by providers and had their care evaluated." }, { "kind": "press release", "citation": "US Department of Veterans Affairs (2017). VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans. Press release, 3 April 2017.", "title": "VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans", "url": "https://news.va.gov/press-room/va-reach-vet-initiative-helps-save-veterans-lives-program-signals-when-more-help-is-needed-for-at-risk-veterans/", "date": "2017-04-03", "written_by": "makers", "quote": "Using a new predictive model, REACH VET analyzes existing data from Veterans' health records to identify those at a statistically elevated risk for suicide, hospitalization, illness or other adverse outcomes." }, { "kind": "news report", "citation": "Graham E (2025). Inside VA's yearslong AI effort to uncover veterans at high risk of suicide. Nextgov/FCW, 17 July 2025.", "title": "Inside VA's yearslong AI effort to uncover veterans at high risk of suicide", "url": "https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/", "date": "2025-07-17", "written_by": "independent", "quote": "It's going to go something like, 'you've been identified as being at elevated risk for suicide at the present time; we'd like to offer you resources.'" }, { "kind": "news report", "citation": "Graham E (2024). VA is updating its AI suicide risk model to reach more women. Nextgov/FCW, 18 October 2024.", "title": "VA is updating its AI suicide risk model to reach more women", "url": "https://www.nextgov.com/artificial-intelligence/2024/10/va-updating-its-ai-suicide-risk-model-reach-more-women/400377/", "date": "2024-10-18", "written_by": "independent", "quote": "considered being a white man more of an indicator of potential self-harm than other factors" } ], "replication": { "produced_by": [ "A predictive model run monthly on VHA electronic health records to rank patients and select the top 0.1% risk tier", "Facility REACH VET coordinators and providers who acknowledge the list, evaluate care, document safety plans and attempt outreach", "A national health system with the data, dashboards and metrics to implement the program at every facility" ], "must_hold": [ "Providers act on the list: care evaluations rose from 46.1% to 87.5% of identified veterans between March 2017 and December 2018", "The model's variables fit the population; the original model under-weighted factors relevant to women veterans, per Nextgov", "Outcome ascertainment is comparable across periods; the authors note that closer attention may increase recorded attempts" ], "echoes": [ { "date": "2025-07-08", "setting": "VA-authored cohort study of 266,246 observations testing suicide, external-cause and all-cause mortality after REACH VET inclusion; found no association at 6, 12 or 24 months (a different endpoint from the 2021 benefit)", "model_version": "Original REACH VET model", "outcome": "unknown", "source": "Dent KR, Cooper S, McCarthy JF (2025) JAMA Netw Open, https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/" }, { "date": "2025-01-01", "setting": "REACH VET 2.0 adding military sexual trauma and intimate partner violence as risk factors, planned for early 2025 deployment per Nextgov (date is the start of the planned window); no outcome reported", "model_version": "REACH VET 2.0", "outcome": "unknown", "source": "Nextgov/FCW, 18 October 2024 and 17 July 2025" } ] }, "paired_incident": null, "headline": "REACH VET tied to fewer suicide attempts, not deaths", "metric": "documented suicide attempts (-0.05; -0.06 to -0.03)", "comparator": { "against": "veterans in the top 0.1% risk tier during the pre-REACH VET period (March 2014 to December 2015) and subthreshold-risk cohorts, in a triple-difference design", "before": null, "after": "suicide attempts (ADT, −0.05; 95% CI, −0.06 to −0.03)", "basis": "measured", "quote": "The REACH VET intervention was associated with significant increases in completed outpatient appointments (adjusted triple difference [ATD], 0.31; 95% CI, 0.06 to 0.55) and proportion of individuals with new safety plans (ATD, 0.08; 95% CI, 0.06 to 0.10) and reductions in mental health admissions (ATD, −0.08; 95% CI, −0.10 to −0.05), emergency department visits (ADT, −0.03; 95% CI, −0.06 to −0.01), and suicide attempts (ADT, −0.05; 95% CI, −0.06 to −0.03).", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/" }, "later": { "status": "persisted", "date": "2025-07-17", "note": "Nextgov reported in July 2025 that REACH VET still scans records monthly with the 61-variable model and that VA is updating it to a 2.0 model; a VA cohort study published 8 July 2025 found no association between REACH VET inclusion and suicide or all-cause mortality, in line with the 2021 evaluation's mortality subanalyses.", "quote": "Each month, REACH VET uses the 61 variables to scan the electronic health records of veterans engaged with the Veterans Health Administration to identify those who are in the top 0.1% of suicide risk.", "url": "https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/" }, "value": null, "developer_country": "United States", "deployer_country": "United States", "unrated_because": null, "brief_notes": null, "brief": null, "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "source": null, "editor": "AIBD" }, { "date": "2026-10-21", "change": "Headline reworded to state the event without naming who claims it.", "source": null, "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Organizational Efficiency among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Added what the benefit is measured against, what happened since from the cited sources.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/; https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer and the deployer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs; https://en.wikipedia.org/wiki/Veterans_Health_Administration", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "source": null, "editor": "AIBD" } ], "confidence": "reported", "shade": "medium", "claim_status": "Independently reported", "claim_basis": "Sources: two independent news reports, three peer-reviewed studies from the makers and the makers' press release. 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2025 found no association between REACH VET inclusion and suicide or all-cause mortality, in line with the 2021 evaluation's mortality subanalyses.", "quote": "Each month, REACH VET uses the 61 variables to scan the electronic health records of veterans engaged with the Veterans Health Administration to identify those who are in the top 0.1% of suicide risk.", "url": "https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/" } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "later" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "human_oversight": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "id": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "id": "AIBD-0310" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "id" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "infrastructure_dependencies[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].beneficiaries": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].beneficiary_count": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].benefit_type": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "benefit_type": "Improved Physical Health", "taxonomy_note": "The outcomes are mental-health care results (fewer attempts, admissions and ED visits) with no effect on deaths, from a VA-authored cohort study." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "benefit_type", "taxonomy_note" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].claim": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "account": "The Department of Veterans Affairs (VA) announced REACH VET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment) on 3 April 2017. It had begun as a pilot the previous October and was fully implemented across VA. It uses a predictive model on veterans' health records to identify those at statistically elevated risk of suicide and other adverse outcomes. Once a veteran is identified, a VA mental health or primary care provider reaches out. The provider reviews the condition and treatment plan and decides if enhanced care is needed. Nextgov/FCW (17 July 2025) says the model scans records monthly for the top 0.1% risk tier. It says the variable set was cut from 381 to 61 and about 30,000 veterans were identified in the first year. Nextgov (18 October 2024) gives about 6,700 veterans a month. McCarthy and colleagues published the evaluation in JAMA Network Open on 18 October 2021. They are at the VA Office of Mental Health and Suicide Prevention, which built and runs the program. It covered 173,313 individuals, 40,816 of them in the top 0.1% tier during REACH VET (March 2017 to December 2018). The pre-period (March 2014 to December 2015) had 36,604. Triple-difference analyses found REACH VET associated with more completed outpatient appointments (adjusted triple difference 0.31; 95% CI 0.06 to 0.55). The proportion with new safety plans rose (0.08; 0.06 to 0.10). Mental health admissions (-0.08; -0.10 to -0.05), emergency department (ED) visits (-0.03; -0.06 to -0.01) and documented suicide attempts (-0.05; -0.06 to -0.03) fell. Subcohort analyses found no difference in suicide or all-cause mortality. Care evaluations of identified veterans rose from 46.1% to 87.5% over the period. A 2022 Psychiatric Services paper reports that by October 2020, 98% of identified veterans (N=6,579) were contacted and had care evaluated. Dent, Cooper and McCarthy (JAMA Network Open, 8 July 2025; 266,246 observations) again found no association with suicide, external-cause or all-cause mortality. The 6-month suicide hazard ratio was 1.18 (95% CI 0.83–1.69). Nextgov (2024) reports research finding the model “considered being a white man more of an indicator of potential self-harm than other factors”. The model omitted military sexual trauma; a REACH VET 2.0 adding such factors was planned for early 2025. The program's benefit is a cohort-level association over 2017–2018, not a dated event.", "benefit_type": "Improved Physical Health" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "benefit_type" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].distribution": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].duration": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].id": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].stakeholder_group": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "ratings": [ { "group": "personal", "reason": "The 2021 study reports population-level reductions in documented suicide attempts, admissions and ED visits for identified veterans. No individual veteran's outcome is documented, and mortality did not differ in 2021 or 2025." }, { "group": "organizational", "reason": "Care evaluations rose from 46.1% to 87.5% of identified veterans and 98% were contacted by October 2020, per VA-authored papers. No independent audit was found." }, { "group": "societal", "reason": "Nextgov notes the top 0.1% tier covers only 2–3% of VA suicides and the model under-identified women; no population suicide-rate effect is shown." } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "ratings" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "outcomes[].status": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].tradeoffs": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "outcomes[].unexpected": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "unexpected": false, "purpose": "Built to identify veterans in the top 0.1% of predicted suicide risk each month so that clinicians re-evaluate and enhance their care. The measured associations are that purpose." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "unexpected", "purpose" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "places[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "location": "United States", "developer_country": "United States", "deployer_country": "United States" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "location", "developer_country", "deployer_country" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "purpose": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "purpose": "Built to identify veterans in the top 0.1% of predicted suicide risk each month so that clinicians re-evaluate and enhance their care. The measured associations are that purpose." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "purpose" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "record_dates": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "date_observed": "2021-10-18", "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Headline reworded to state the event without naming who claims it.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Organizational Efficiency among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Added what the benefit is measured against, what happened since from the cited sources.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/; https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer and the deployer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs; https://en.wikipedia.org/wiki/Veterans_Health_Administration", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "editor": "AIBD" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "date_observed", "revisions" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "replication.attempts[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "replication": { "produced_by": [ "A predictive model run monthly on VHA electronic health records to rank patients and select the top 0.1% risk tier", "Facility REACH VET coordinators and providers who acknowledge the list, evaluate care, document safety plans and attempt outreach", "A national health system with the data, dashboards and metrics to implement the program at every facility" ], "must_hold": [ "Providers act on the list: care evaluations rose from 46.1% to 87.5% of identified veterans between March 2017 and December 2018", "The model's variables fit the population; the original model under-weighted factors relevant to women veterans, per Nextgov", "Outcome ascertainment is comparable across periods; the authors note that closer attention may increase recorded attempts" ], "echoes": [ { "date": "2025-07-08", "setting": "VA-authored cohort study of 266,246 observations testing suicide, external-cause and all-cause mortality after REACH VET inclusion; found no association at 6, 12 or 24 months (a different endpoint from the 2021 benefit)", "model_version": "Original REACH VET model", "outcome": "unknown", "source": "Dent KR, Cooper S, McCarthy JF (2025) JAMA Netw Open, https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/" }, { "date": "2025-01-01", "setting": "REACH VET 2.0 adding military sexual trauma and intimate partner violence as risk factors, planned for early 2025 deployment per Nextgov (date is the start of the planned window); no outcome reported", "model_version": "REACH VET 2.0", "outcome": "unknown", "source": "Nextgov/FCW, 18 October 2024 and 17 July 2025" } ] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "replication.conditions": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "replication": { "produced_by": [ "A predictive model run monthly on VHA electronic health records to rank patients and select the top 0.1% risk tier", "Facility REACH VET coordinators and providers who acknowledge the list, evaluate care, document safety plans and attempt outreach", "A national health system with the data, dashboards and metrics to implement the program at every facility" ], "must_hold": [ "Providers act on the list: care evaluations rose from 46.1% to 87.5% of identified veterans between March 2017 and December 2018", "The model's variables fit the population; the original model under-weighted factors relevant to women veterans, per Nextgov", "Outcome ascertainment is comparable across periods; the authors note that closer attention may increase recorded attempts" ], "echoes": [ { "date": "2025-07-08", "setting": "VA-authored cohort study of 266,246 observations testing suicide, external-cause and all-cause mortality after REACH VET inclusion; found no association at 6, 12 or 24 months (a different endpoint from the 2021 benefit)", "model_version": "Original REACH VET model", "outcome": "unknown", "source": "Dent KR, Cooper S, McCarthy JF (2025) JAMA Netw Open, https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/" }, { "date": "2025-01-01", "setting": "REACH VET 2.0 adding military sexual trauma and intimate partner violence as risk factors, planned for early 2025 deployment per Nextgov (date is the start of the planned window); no outcome reported", "model_version": "REACH VET 2.0", "outcome": "unknown", "source": "Nextgov/FCW, 18 October 2024 and 17 July 2025" } ] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "revision_history[]": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "revisions": [ { "date": "2026-10-20", "change": "Record drafted from the cited sources.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Headline reworded to state the event without naming who claims it.", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Benefit type set to Improved Physical Health under Trustible's full taxonomy of 23 types; it was Improved Organizational Efficiency among the six first used.", "source": "https://trustible.ai/post/a-framework-for-measuring-the-benefits-of-ai/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Added what the benefit is measured against, what happened since from the cited sources.", "source": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/; https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Country of the developer and the deployer added from the organization's own site or a registry.", "source": "https://en.wikipedia.org/wiki/United_States_Department_of_Veterans_Affairs; https://en.wikipedia.org/wiki/Veterans_Health_Administration", "editor": "AIBD" }, { "date": "2026-10-21", "change": "Prose pass: a rating reason, account, purpose, the system's part rewritten in shorter sentences with abbreviations expanded; facts, figures and quotations unchanged.", "editor": "AIBD" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "revisions" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sector": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "domain": "Suicide prevention / mental health care", "segment": "Health-system predictive risk modeling and outreach" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "domain", "segment" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].access_version": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "sources[].citation_locator": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "evidence": [ { "kind": "peer-reviewed study", "citation": "McCarthy JF, Cooper SA, Dent KR, Eagan AE, Matarazzo BB, Hannemann CM, Reger MA, Landes SJ, Trafton JA, Schoenbaum M, Katz IR (2021). Evaluation of the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment Suicide Risk Modeling Clinical Program in the Veterans Health Administration. JAMA Network Open 4(10):e2129900 (PMC8524305). Authors at the VA office that runs the program.", "title": "Evaluation of the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment Suicide Risk Modeling Clinical Program in the Veterans Health Administration", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/", "date": "2021-10-18", "written_by": "makers", "quote": "REACH VET implementation was associated with greater treatment engagement and new safety plan documentation and fewer mental health admissions, emergency department visits, and suicide attempts." }, { "kind": "peer-reviewed study", "citation": "Dent KR, Cooper S, McCarthy JF (2025). The REACH VET Program and Mortality Outcomes Among Veterans at High Risk of Suicide. JAMA Network Open, 8 July 2025 (PMC12238888). VA-authored.", "title": "The REACH VET Program and Mortality Outcomes Among Veterans at High Risk of Suicide", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/", "date": "2025-07-08", "written_by": "makers", "quote": "inclusion in the REACH VET program was not associated with suicide mortality (6-month hazards ratio [HR], 1.18 [95% CI, 0.83-1.69]" }, { "kind": "peer-reviewed study", "citation": "Matarazzo BB, Eagan A, Landes SJ, et al. (2022/2023). The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice. Psychiatric Services (first published 30 August 2022). VA-authored.", "title": "The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice", "url": "https://europepmc.org/article/MED/36039552", "date": "2022-08-30", "written_by": "makers", "quote": "By October 2020, 98% of veterans identified (N=6,579) were contacted by providers and had their care evaluated." }, { "kind": "press release", "citation": "US Department of Veterans Affairs (2017). VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans. Press release, 3 April 2017.", "title": "VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans", "url": "https://news.va.gov/press-room/va-reach-vet-initiative-helps-save-veterans-lives-program-signals-when-more-help-is-needed-for-at-risk-veterans/", "date": "2017-04-03", "written_by": "makers", "quote": "Using a new predictive model, REACH VET analyzes existing data from Veterans' health records to identify those at a statistically elevated risk for suicide, hospitalization, illness or other adverse outcomes." }, { "kind": "news report", "citation": "Graham E (2025). Inside VA's yearslong AI effort to uncover veterans at high risk of suicide. Nextgov/FCW, 17 July 2025.", "title": "Inside VA's yearslong AI effort to uncover veterans at high risk of suicide", "url": "https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/", "date": "2025-07-17", "written_by": "independent", "quote": "It's going to go something like, 'you've been identified as being at elevated risk for suicide at the present time; we'd like to offer you resources.'" }, { "kind": "news report", "citation": "Graham E (2024). VA is updating its AI suicide risk model to reach more women. Nextgov/FCW, 18 October 2024.", "title": "VA is updating its AI suicide risk model to reach more women", "url": "https://www.nextgov.com/artificial-intelligence/2024/10/va-updating-its-ai-suicide-risk-model-reach-more-women/400377/", "date": "2024-10-18", "written_by": "independent", "quote": "considered being a white man more of an indicator of potential self-harm than other factors" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "evidence" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].id": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "AIBD-0310-source-0001", "AIBD-0310-source-0002", "AIBD-0310-source-0003", "AIBD-0310-source-0004", "AIBD-0310-source-0005", "AIBD-0310-source-0006" ], "role": "Existing evidence items, in their original order" }, "provenance": { "kind": "curatorial", "basis": "Stable within the fingerprinted record version; no source content or source review has been added.", "record_fields": [], "source_refs": [] }, "review_state": "record_mapped", "coverage": "complete" }, "sources[].language": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "sources[].relationship": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "evidence": [ { "kind": "peer-reviewed study", "citation": "McCarthy JF, Cooper SA, Dent KR, Eagan AE, Matarazzo BB, Hannemann CM, Reger MA, Landes SJ, Trafton JA, Schoenbaum M, Katz IR (2021). Evaluation of the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment Suicide Risk Modeling Clinical Program in the Veterans Health Administration. JAMA Network Open 4(10):e2129900 (PMC8524305). Authors at the VA office that runs the program.", "title": "Evaluation of the Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment Suicide Risk Modeling Clinical Program in the Veterans Health Administration", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC8524305/", "date": "2021-10-18", "written_by": "makers", "quote": "REACH VET implementation was associated with greater treatment engagement and new safety plan documentation and fewer mental health admissions, emergency department visits, and suicide attempts." }, { "kind": "peer-reviewed study", "citation": "Dent KR, Cooper S, McCarthy JF (2025). The REACH VET Program and Mortality Outcomes Among Veterans at High Risk of Suicide. JAMA Network Open, 8 July 2025 (PMC12238888). VA-authored.", "title": "The REACH VET Program and Mortality Outcomes Among Veterans at High Risk of Suicide", "url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/", "date": "2025-07-08", "written_by": "makers", "quote": "inclusion in the REACH VET program was not associated with suicide mortality (6-month hazards ratio [HR], 1.18 [95% CI, 0.83-1.69]" }, { "kind": "peer-reviewed study", "citation": "Matarazzo BB, Eagan A, Landes SJ, et al. (2022/2023). The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice. Psychiatric Services (first published 30 August 2022). VA-authored.", "title": "The Veterans Health Administration REACH VET Program: Suicide Predictive Modeling in Practice", "url": "https://europepmc.org/article/MED/36039552", "date": "2022-08-30", "written_by": "makers", "quote": "By October 2020, 98% of veterans identified (N=6,579) were contacted by providers and had their care evaluated." }, { "kind": "press release", "citation": "US Department of Veterans Affairs (2017). VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans. Press release, 3 April 2017.", "title": "VA REACH VET Initiative Helps Save Veterans Lives: Program Signals When More Help Is Needed for At-risk Veterans", "url": "https://news.va.gov/press-room/va-reach-vet-initiative-helps-save-veterans-lives-program-signals-when-more-help-is-needed-for-at-risk-veterans/", "date": "2017-04-03", "written_by": "makers", "quote": "Using a new predictive model, REACH VET analyzes existing data from Veterans' health records to identify those at a statistically elevated risk for suicide, hospitalization, illness or other adverse outcomes." }, { "kind": "news report", "citation": "Graham E (2025). Inside VA's yearslong AI effort to uncover veterans at high risk of suicide. Nextgov/FCW, 17 July 2025.", "title": "Inside VA's yearslong AI effort to uncover veterans at high risk of suicide", "url": "https://www.nextgov.com/artificial-intelligence/2025/07/inside-vas-yearslong-ai-effort-uncover-veterans-high-risk-suicide/406781/", "date": "2025-07-17", "written_by": "independent", "quote": "It's going to go something like, 'you've been identified as being at elevated risk for suicide at the present time; we'd like to offer you resources.'" }, { "kind": "news report", "citation": "Graham E (2024). VA is updating its AI suicide risk model to reach more women. Nextgov/FCW, 18 October 2024.", "title": "VA is updating its AI suicide risk model to reach more women", "url": "https://www.nextgov.com/artificial-intelligence/2024/10/va-updating-its-ai-suicide-risk-model-reach-more-women/400377/", "date": "2024-10-18", "written_by": "independent", "quote": "considered being a white man more of an indicator of potential self-harm than other factors" } ] } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "evidence" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "sources[].upstream_sources": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "strategic_assessments[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial", "family": "strategic assessments" }, "summary": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "summary": "VA-authored triple-difference cohort study (173,313 veterans): REACH VET inclusion linked to more completed visits and safety plans and fewer admissions, ED visits and attempts; no mortality effect.", "account": "The Department of Veterans Affairs (VA) announced REACH VET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment) on 3 April 2017. It had begun as a pilot the previous October and was fully implemented across VA. It uses a predictive model on veterans' health records to identify those at statistically elevated risk of suicide and other adverse outcomes. Once a veteran is identified, a VA mental health or primary care provider reaches out. The provider reviews the condition and treatment plan and decides if enhanced care is needed. Nextgov/FCW (17 July 2025) says the model scans records monthly for the top 0.1% risk tier. It says the variable set was cut from 381 to 61 and about 30,000 veterans were identified in the first year. Nextgov (18 October 2024) gives about 6,700 veterans a month. McCarthy and colleagues published the evaluation in JAMA Network Open on 18 October 2021. They are at the VA Office of Mental Health and Suicide Prevention, which built and runs the program. It covered 173,313 individuals, 40,816 of them in the top 0.1% tier during REACH VET (March 2017 to December 2018). The pre-period (March 2014 to December 2015) had 36,604. Triple-difference analyses found REACH VET associated with more completed outpatient appointments (adjusted triple difference 0.31; 95% CI 0.06 to 0.55). The proportion with new safety plans rose (0.08; 0.06 to 0.10). Mental health admissions (-0.08; -0.10 to -0.05), emergency department (ED) visits (-0.03; -0.06 to -0.01) and documented suicide attempts (-0.05; -0.06 to -0.03) fell. Subcohort analyses found no difference in suicide or all-cause mortality. Care evaluations of identified veterans rose from 46.1% to 87.5% over the period. A 2022 Psychiatric Services paper reports that by October 2020, 98% of identified veterans (N=6,579) were contacted and had care evaluated. Dent, Cooper and McCarthy (JAMA Network Open, 8 July 2025; 266,246 observations) again found no association with suicide, external-cause or all-cause mortality. The 6-month suicide hazard ratio was 1.18 (95% CI 0.83–1.69). Nextgov (2024) reports research finding the model “considered being a white man more of an indicator of potential self-harm than other factors”. The model omitted military sexual trauma; a REACH VET 2.0 adding such factors was planned for early 2025. The program's benefit is a cohort-level association over 2017–2018, not a dated event." } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "summary", "account" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].autonomy_permissions": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].component_role": { "state": "value_present", "value": { "kind": "text", "text": "The model ranked patients by predicted suicide risk for clinical follow-up." }, "provenance": { "kind": "legacy_record", "basis": "Restated the mechanical task already described in the existing system and AI-role fields. No new source review is claimed.", "record_fields": [ "system", "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].deployment_configuration": { "state": "value_present", "value": { "kind": "text", "text": "The original 2017 REACH VET model selected 61 variables from 381. The later REACH VET 2.0 announcement concerns a different version." }, "provenance": { "kind": "legacy_record", "basis": "Separated the model, software, hardware, or operation already described in the existing record. No new source review is claimed.", "record_fields": [ "model_version", "system", "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].inputs_outputs": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "systems[].model_name": { "state": "value_present", "value": { "kind": "text", "text": "The original REACH VET model used 61 variables selected from 381." }, "provenance": { "kind": "legacy_record", "basis": "Separated the model, software, hardware, or operation already described in the existing record. No new source review is claimed.", "record_fields": [ "model_version", "system", "ai_role" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].model_version": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "model_version": "Original 2017 model (381 variables reduced to 61, per Nextgov); REACH VET 2.0 announced for 2025" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "model_version" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial", "display": { "answer": "The original model introduced in 2017.", "editor_note": "" } }, "systems[].product_name": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "system": "REACH VET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment) suicide-risk predictive model and care-enhancement program" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "system" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "systems[].provider": { "state": "value_present", "value": { "kind": "structured", "data": { "application_developer": "US Department of Veterans Affairs, Office of Mental Health and Suicide Prevention" } }, "provenance": { "kind": "legacy_record", "basis": "Mapped from the existing case description without a new external source review.", "record_fields": [ "developer" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "taxonomy_crosswalks[]": { "state": "not_assessed", "review_state": "not_assessed", "coverage": "partial" }, "title": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "title": "VA's REACH VET suicide-risk model is associated with fewer documented suicide attempts, admissions and ED visits among top-0.1%-risk veterans; no change in mortality", "headline": "REACH VET tied to fewer suicide attempts, not deaths" } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "title", "headline" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" }, "version": { "state": "value_present", "value": { "kind": "identifiers", "identifiers": [ "a48d242a22658ffd883e03ccffe0dc3a534a068b283614f69edab5a0e7e95dda" ], "role": "SHA-256 of normalized original case data" }, "provenance": { "kind": "curatorial", "basis": "Deterministic content version assigned by the local migration.", "record_fields": [], "source_refs": [] }, "review_state": "record_mapped", "coverage": "complete" }, "workflow": { "state": "value_present", "value": { "kind": "record_fields", "fields": { "account": "The Department of Veterans Affairs (VA) announced REACH VET (Recovery Engagement and Coordination for Health - Veterans Enhanced Treatment) on 3 April 2017. It had begun as a pilot the previous October and was fully implemented across VA. It uses a predictive model on veterans' health records to identify those at statistically elevated risk of suicide and other adverse outcomes. Once a veteran is identified, a VA mental health or primary care provider reaches out. The provider reviews the condition and treatment plan and decides if enhanced care is needed. Nextgov/FCW (17 July 2025) says the model scans records monthly for the top 0.1% risk tier. It says the variable set was cut from 381 to 61 and about 30,000 veterans were identified in the first year. Nextgov (18 October 2024) gives about 6,700 veterans a month. McCarthy and colleagues published the evaluation in JAMA Network Open on 18 October 2021. They are at the VA Office of Mental Health and Suicide Prevention, which built and runs the program. It covered 173,313 individuals, 40,816 of them in the top 0.1% tier during REACH VET (March 2017 to December 2018). The pre-period (March 2014 to December 2015) had 36,604. Triple-difference analyses found REACH VET associated with more completed outpatient appointments (adjusted triple difference 0.31; 95% CI 0.06 to 0.55). The proportion with new safety plans rose (0.08; 0.06 to 0.10). Mental health admissions (-0.08; -0.10 to -0.05), emergency department (ED) visits (-0.03; -0.06 to -0.01) and documented suicide attempts (-0.05; -0.06 to -0.03) fell. Subcohort analyses found no difference in suicide or all-cause mortality. Care evaluations of identified veterans rose from 46.1% to 87.5% over the period. A 2022 Psychiatric Services paper reports that by October 2020, 98% of identified veterans (N=6,579) were contacted and had care evaluated. Dent, Cooper and McCarthy (JAMA Network Open, 8 July 2025; 266,246 observations) again found no association with suicide, external-cause or all-cause mortality. The 6-month suicide hazard ratio was 1.18 (95% CI 0.83–1.69). Nextgov (2024) reports research finding the model “considered being a white man more of an indicator of potential self-harm than other factors”. The model omitted military sexual trauma; a REACH VET 2.0 adding such factors was planned for early 2025. The program's benefit is a cohort-level association over 2017–2018, not a dated event.", "replication": { "produced_by": [ "A predictive model run monthly on VHA electronic health records to rank patients and select the top 0.1% risk tier", "Facility REACH VET coordinators and providers who acknowledge the list, evaluate care, document safety plans and attempt outreach", "A national health system with the data, dashboards and metrics to implement the program at every facility" ], "must_hold": [ "Providers act on the list: care evaluations rose from 46.1% to 87.5% of identified veterans between March 2017 and December 2018", "The model's variables fit the population; the original model under-weighted factors relevant to women veterans, per Nextgov", "Outcome ascertainment is comparable across periods; the authors note that closer attention may increase recorded attempts" ], "echoes": [ { "date": "2025-07-08", "setting": "VA-authored cohort study of 266,246 observations testing suicide, external-cause and all-cause mortality after REACH VET inclusion; found no association at 6, 12 or 24 months (a different endpoint from the 2021 benefit)", "model_version": "Original REACH VET model", "outcome": "unknown", "source": "Dent KR, Cooper S, McCarthy JF (2025) JAMA Netw Open, https://pmc.ncbi.nlm.nih.gov/articles/PMC12238888/" }, { "date": "2025-01-01", "setting": "REACH VET 2.0 adding military sexual trauma and intimate partner violence as risk factors, planned for early 2025 deployment per Nextgov (date is the start of the planned window); no outcome reported", "model_version": "REACH VET 2.0", "outcome": "unknown", "source": "Nextgov/FCW, 18 October 2024 and 17 July 2025" } ] } } }, "provenance": { "kind": "legacy_record", "basis": "Preserved from the existing AIBD record; external sources were not rechecked.", "record_fields": [ "account", "replication" ], "source_refs": [] }, "review_state": "record_mapped", "coverage": "partial" } }, "summary": { "total": 91, "addressed": 91, "known": 32, "reviewed": 0, "record_mapped": 32, "not_assessed": 59, "complete": false, "by_state": { "value_present": 32, "not_reported": 0, "unresolved": 0, "not_assessed": 59, "not_applicable": 0, "withheld": 0, "source_unavailable": 0 } } } }