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Rising suicide rates: A call for improved crisis services

Note: This is the second blog in a series on behavioral health crisis services, where Beacon Health Options will provide context on the rising demand for crisis services and Beacon’s vision for building a system that goes above and beyond the moment of crisis.

There are several critical factors that have contributed to the rising demand for crisis services: reliance on emergency departments and law enforcement as the de facto crisis system; high suicide rates; stigma around mental illness; inadequate access to behavioral health care; and a relentless opioid epidemic. As part of our ongoing, in-depth look at that those factors, today Beacon Lens will focus on suicide.

Suicide is on the rise in the United States. Consider the following statistics:

• Between 2001 and 2017, the rate has increased by 31 percent, according to the National Institute for Mental Health citing Centers for Disease Control and Prevention (CDC) data.

• In 2017, the CDC reports there were more than twice as many suicides as there were homicides.

• An analysis of government records indicates that the suicide rate is as high as it has been in 50 years, according to AP News.

The crisis has hit white, middle-aged, rural Americans the hardest. More specifically, 2016 data from the National Center for Health Statistics indicate suicide rates for middle-aged women rose 64 percent, outpacing men whose rate grew by 43 percent from the period of 1999 to 2014. Suicide rates for youth are rising as well, with a 56 percent increase from 2000 to 2017.

One explanation for the rise in suicide rates is economic downturns. However, suicide hits the United States harder than it does other first world countries, which have also suffered economic turmoil. Another cited reason is the country’s unrelenting opioid epidemic and the sense of helplessness that often results from a substance use disorder.

People thinking about suicide aren’t getting care

Studies have shown that there’s a correlation between the greater availability of mental health services and reduced suicide rates, which is one possible explanation for the rise in suicide rates in rural areas compared to urban ones. More specifically, states with more mental health providers have lower rates of suicide.

However, regardless of availability, not everyone with mental health conditions is seeking treatment. In one study that looked at data from the National Violent Death Reporting System from 2005 to 2010, 38.5 percent of people who had died by suicide received mental health treatment during the two months before death. Another study puts the percentage at 19 percent in the month before their death. Therefore, many individuals who need treatment are not seeking it.

Studies have shown that there’s a correlation between the greater availability of mental health services and reduced suicide rates.

Interestingly, it’s the individuals themselves who can be the greatest barriers to care, according to one study in Utah. For example:

• >70 percent believe that treatment would not help

• 52-79 percent cited stigma as a barrier

• 58-79 percent are reluctant to admit there’s a problem

Another issue is expense. A larger-scale analysis found higher rates of suicide in those states where a higher proportion of the population reported they were unable to obtain behavioral health services because of cost.

It’s time to reinvent behavioral health crisis services

Anyone who is contemplating suicide is in a state of crisis; just thinking about it is justification for accessing crisis services. In fact, a mental health crisis is defined by the person experiencing it.

The time is now to reinvent the behavioral health crisis system. Beacon’s new model of crisis management focuses on prevention, followed by early intervention and then reintegration back into the community. Therefore, best-in-class crisis management results in crises not occurring in the first place, and when they do occur, prevents them from escalating by alleviating the individual’s distress in the safest setting and as quickly as possible.

The goal of an effective crisis system needs to broaden. It’s no longer just about responding to a crisis in real-time. It’s about providing individuals the opportunity to enter the behavioral health system – whether someone is experiencing debilitating depression or doesn’t know where else to turn in trying to connect to services. Ultimately, it’s about helping people reach their long-term recovery goals in order to lead fulfilling lives.

To learn more, visit Beacon’s website.

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