RESEARCH/Original Article An examination of suicidal behaviour among veterans receiving mental-health appointments in person versus clinical video telehealth Sasha M Rojas 1,2 , Marilyn L Piccirillo 1,3 , Russell A McCann 1,4 , Mark A Reger 1,4 and Bradford Felker 1,4 Abstract Introduction: The US Department of Veterans Affairs (VA) is a national leader in the implementation of clinical video telehealth (CVT) services. Despite the growth of mental-health services offered via CVT, it is unclear to what extent these services are offered and accessed by veterans with previous suicidal behaviour. Methods: The current quality improvement project examined this question within a local VA health-care system using data from suicide behaviour reports (SBRs), the Veteran Health Administration’s official reporting and surveillance system. The frequency of SBRs was compared during two different time points among veterans who received individual mental-health appointments in person only or via CVT during the 2017 calendar year. Among veterans with a SBR, time in days elapsed from their first mental-health appointment to a SBR was examined as a function of treatment modality. Results: Results indicated veterans who received in-person treatment only were more likely to present with a SBR six months prior to their first mental-health appointment compared to those who received CVT during the observation period. There were no differences in SBRs during the 12 months after the first appointment or the time from the first appointment to the SBR as a function of treatment modality used. Discussion: Although veterans who received in-person mental-health services were more likely to have had a SBR six months prior to treatment, suicide risk throughout the observation period did not differ between groups. Clinical implications that arise from these findings are described in the discussion. Keywords Clinical video telehealth (CVT), telemental health, suicide behaviour report (SBR), veteran Date received: 17 April 2020; Date accepted: 18 June 2020 Introduction Suicide prevention has been identified as a top clinical priority for the US Department of Veterans Affairs (VA). 1 Yet, suicide rates among veterans continue to rise. 2 Among the many objectives outlined within the National Strategy for Preventing Veteran Suicide, 3 there is an emphasis on strengthening efforts to increase access to mental health (MH) services and timely and effective care for veterans at heightened risk for suicide. In light of these efforts, it is important to examine and address disparities in access to MH care for veterans at risk for suicide. The VA is a national leader in the implementation of digital-health services – the provision of health care remotely via technological modalities, including clinical video telehealth (CVT). In 2018 alone, the VA provided more than one million episodes of care via the CVT 1 VA Puget Sound Health Care System, USA 2 VISN 20 Clinical Resource Hub, USA 3 Department of Psychological and Brain Sciences, Washington University in St Louis, USA 4 Department of Psychiatry and Behavioral Sciences, University of Washington, USA Corresponding author: Sasha M. Rojas, VISN 20, 1601 E E 4th Plain Blvd, Vancouver, WA 98660, USA. Email: sasha.rojas@va.gov Journal of Telemedicine and Telecare 0(0) 1–7 ! The Author(s) 2020 Article reuse guidelines: sagepub.com/journals-permissions DOI: 10.1177/1357633X20942041 journals.sagepub.com/home/jtt