It is one of those topics that we often do not want to think about much less talk about; however, if we are to effectively work to decrease the rate of suicide in the US and the world, we need to not only think and talk about suicide, we need to actively increase our efforts to prevent suicide.

Suicide, 10th leading cause of death in usa

Suicide is the fourth leading cause of death for people between the ages of 35-54. Suicide is highest in people between the ages of 45-54, and second highest in people 85 and older. Overall, the rate of suicide is highest in middle-aged white men.

In 2010, the National Action Alliance for Suicide Prevention (NAASP) was launched as a public-private partnership to advance and update the National Strategy for Suicide Prevention; yet, the evidence continues to show that “US suicide rates have risen in recent years compared to other nations.”

My brother committed suicide in 1988. He initially attempted to kill himself, was admitted to the hospital and discharged with advice to follow-up with a counselor. His story ended in tragedy. The system failed my brother then and it continues to fail so many people today. When someone is in a crisis, sending them home without giving them enough time to stabilize is a very dangerous risk to take.

The health, environmental & historical risk factors for suicide are:

• Depression
• Substance use problems
• Serious mental illness
• Serious physical health conditions including pain
• Access to lethal means
• Stressful life events (divorce, unemployment, financial crisis, or relationship problems)
• Previous suicide attempts
• Family history of suicide
• History of childhood abuse or trauma

Recommended standard of care

I have read the “Recommended Standard Care for People with Suicide Risk: Making Health Care Suicide Safe, 2018” and I can say that there are still too many gaps in the system. Many families are not adequately equipped to deal with their loved ones who are contemplating suicide; thus, they need more help from the health care system.

Waiting two months to get an appointment with a therapist is another indication of just how much the system is failing those who are in desperate need. The evidence shows that “the risk of suicide in the four weeks after leaving inpatient behavioral health care is 200-300 times greater than for the general population, and highest in the first few days after discharge.”

Yet, the gap from discharge to first appointment with an outpatient care provider remains HUGE. There is also the problem that many places do not take insurance and the ones that do are overburdened, necessitating long wait times to get an appointment. I ask, “What is the NAASP doing?”

What needs to be done

• We need to have more outpatient centers with providers equipped to help those contemplating suicide.
• A patient should not be discharged unless they have an appointment already made to see a provider in the outpatient setting within 1-2 days of discharge.
• These outpatient centers should accept all insurance plans.
• These outpatient centers should offer the option to incorporate integrative care and holistic counseling.