Medical community could play a greater role in suicide prevention

The recent suicide deaths of fashion designer Kate Spade and celebrity chef/television host Anthony Bourdain have once again raised discussion about the importance of breaking down the barriers that still exist for individuals to get help.

Their deaths also highlight what has become a growing public health issue, as rates of suicide throughout the country have increased sharply over the past two decades. Figures released last week by the Centers for Disease Control and Prevention show that in 25 states there was a more than 30% rise in suicide rates between 1999 and 2016.

As part of the discussion, some experts have called for a more medicalized approach toward treating anxiety and depression to help increase the chances of identifying a problem earlier before it becomes severe. Much like early screening for conditions such as diabetes and breast cancer has led to better health outcomes and survival rates, they believe a similar approach for depression could lead to making access to help more readily available.

"Getting depressed and becoming suicidal is a medical issue, it's not about something happening in their lives or some deficit or trauma," said Dr. Soraya Bacchus, a board-certified private practice psychiatrist based in Los Angeles. "Those things can trigger events, but that's not what causes them."

But such an approach would require changes in the way much of the medical community views mental health disorders. Lingering stigmas regarding behavioral health among providers and patients have been a barrier in terms knowing the signs of a potential disorder or when to refer patients to a behavioral healthcare specialist for help.

"Mental health and addiction was something that was separated from overall healthcare and therefore there is limited training in medical schools with respect to mental health and addiction types of issues," said Mark Covall, CEO of the National Association for Behavioral Healthcare. "It's not something that physicians are necessarily comfortable with because they didn't have that training, and it was not really something that they see as part of the basics of healthcare."

But there has been considerable effort on the part of a growing number of health systems to better integrate behavioral health within the overall healthcare framework.

More hospitals are providing behavioral health screenings for patients as part of their primary-care assessments, while some have embedded behavioral healthcare specialists in their primary-care settings for a more immediate hand-off of care when help is needed.

Covall was optimistic such changes were the beginning of a movement that will lead to diminishing stigma around mental health among providers.

"There's still a lot more that needs to be done, but I think we're going in the right direction," he said.