Data linkage studies on veteran suicidality: a scoping review of the field, knowledge gaps and evidence appraisal

Suicidality among veterans is a serious issue that impacts veterans, their families, friends, and communities. Using data linkage to examine suicidality among veterans remains an emerging area. This review examines the application of data linkage to questions on suicidality among veterans from within the Five Eyes alliance to generate learnings that can be applied to the Australian context. This scoping review was conducted in accordance with PRISMA guidelines. Peer reviewed databases and grey literature were searched. Studies were assessed against the Reporting of studies Conducted using Observational Routinely-Collected Data (RECORD) Statement. 58 studies were included in the review. 60% of these were identified as being of good or excellent quality. Most (72.4%) were conducted in the US, followed by Canada (13.8%) and Australia (8.6%). The majority of studies examined suicide deaths (81%), while 31% assessed ideation, self-harm, or attempts. Studies were overwhelmingly health focussed, with examination of psychosocial determinants and social care pathways lacking. The literature was inconsistent in describing methods and there was no documented evidence of lived experience involvement. The review highlights benefits to undertaking data linkage research within the Australian context and has noted several gaps to address that could enhance the evidence-base globally. Enhancements to the RECORD statement are recommended. Enhancements in ethics, governance and information sharing protocols between institutions should be investigated to support more comprehensive linkages that facilitate the examination of longitudinal risk factors, health and psychosocial trajectories, service transitions, and multi-systemic influences on veteran suicidality. Not applicable