Last night I read the heartbreaking Facebook entry of a Vermont mother who lost her daughter to suicide five years ago. Her daughter would have been 21 today. She implored anyone suffering from suicidal thoughts to reach out and get help. What happens when someone asks for help?
If you ask people what you should do to help a person who may be suicidal, most – if not all – would say that person should be referred to a health care professional or organization. It may then come as a shock to learn that many professionals and organizations do not know what to do…and in some cases wonder whether it is their responsibility to do anything. Preventing suicide deaths in health care requires a systematic clinical approach across a system of care carried out by trained providers and supported by policies and procedures that ensure continuity of care and follow-up – not just the heroic efforts of crisis staff and individual clinicians. So then what does all this mean for those seeking and providing help?
Vermont has recently adopted a Zero Suicide approach to creating health system changes that will lead to effective care and treatment for those who are suicidal. The focus for this work is on training clinicians in health care, primary care, emergency departments, mental health and substance abuse treatment programs and outpatient mental health settings to not only effectively identify someone who is suicidal, but to also provide treatment. The premise of Zero Suicide is that suicide prevention must become a core responsibility of health care organizations and systems.
Suicide prevention requires detection, timely, and effective response. It requires a systematic approach that includes screenings for those who are at risk and a timely pathway of care for them to receive effective treatment and follow-up. By applying new knowledge about detection and treatment we will develop the ability for health care systems to become more effective in trying to reach the Zero Suicide goals.
As with many illnesses, suicidality is a health problem that waxes and wanes. It may be in the background for an individual at times, and it sometimes emerges as an acute problem. Others are just one crisis away from suicide. Not treating suicide directly, by identifying suicidality, and ensuring that the patient is on a pathway of effective care would be like seeing someone in the midst of a heart attack and not sending them to the Coronary Care Unit.
Anyone who has lost a loved one to suicide knows that the aftermath leaves a pain that never goes away. We have the ability to turn the tide on suicide. The question is, “Do we have the will?”
Did You Know?
- U.S. health care data from 2013 indicated that 45% of the people who died by suicide had contact with primary care providers in the month before death and among older adults it was 78%. That same year 20% of the people who died from suicide had at least one service from state-funded mental health or treatment agencies within 1 year of death.
- Suicide is a growing problem in Vermont. Since 2004, Vermont’s suicide death rates have averaged 30% higher than the US rates (1). Between 2005 and 2013, Vermont’s suicide death rate per 100,000 people increased from 12.0 to 17.2, an increase of over 40%.(2).