247715 Getting into treatment is not “happily ever after”: Need for innovations in suicide prevention

Monday, October 31, 2011

Paula Tavrow, PhD , Department of Community Health Sciences, University of California at Los Angeles, Los Angeles, CA
Matthew Beymer, MPH candidate , Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA
Beth Mahar, B Arch , No affiliation, Independent consultant, Jamaica Plain, MA
Most suicide prevention activities in the U.S. focus on identifying depressed people and encouraging them to start or remain in treatment. Unfortunately, this medical model fails to prevent about 35,000 Americans from committing suicide every year. While suicide rates among youth and elderly have declined slightly over time, suicides among adults aged 25-64 are increasing. Providers, suicide survivors and the media may have become complacent about suicide prevention among non-military adults. In this session, we present findings about weaknesses in the American mental health system and suggest alternatives. Currently, most depressed adults have the burden of navigating the system and determining treatment efficacy. Their social circle is rarely provided with the tools to assist in this navigation and to serve as an effective support system. Calibration of mental pain, which could help determine when immediate intervention is required, infrequently occurs. Those waiting for medications to take effect do not receive special attention. Technology is not being used optimally to monitor and support depressed persons. Lastly, providers of outpatient care do not participate in systematic, post-mortem learning after a suicide. We put forward a new model for alleviating severe depression which focuses on five components: wellness monitoring, support circle enhancements, promoting depressed people's sense of purpose or passion, appropriate treatment with all available options, and holistic pain management. We conclude by identifying specific low-cost changes to the current mental health system which could be implemented in the next five years, and urge organizations to advocate for their testing and evaluation.

Learning Areas:
Chronic disease management and prevention
Systems thinking models (conceptual and theoretical models), applications related to public health

Learning Objectives:
1. Describe trends in U.S. suicide rates for the past few decades 2. Identify the main weaknesses of the current mental health system for depressed adults in the U.S. 3. Explain how a new model might reduce suicide among depressed adults already in treatment

Keywords: Suicide, Depression

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a public health researcher on the faculty at UCLA School of Public Health. I have been investigating weaknesses in the mental health system for the past 12 months. I use objectivity and scientific rigor in my investigations, do not promote any specific goods or services, and do not receive funding from any commercial entity for my research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.