A report recently published by JAMA reveals a tragic, albeit unsurprising, correlation between the widespread reduction of mental health treatment resources and the collective increase in suicides across the country. The authors of the paper, which was published on November 3, 2016 on the JAMA website, asserted that the decline in access to non-forensic beds (those accessible to patients outside the criminal justice system) is contributing to the risks of violence, incarceration, homelessness, premature mortality, and suicide among patients with psychiatric disorders. They also assert that a “safe minimum” number of psychiatric beds is required to prevent or mitigate suicide attempts.
It’s hard to argue with the logic behind this claim, as suicide was the second most common cause of death in 2014 between Americans aged 10-34 and the tenth-leading cause overall. This is a trend that has continued in 2016. The teenage suicide rate increased from eight deaths per 100,000 in 1999 to 8.7 deaths per 100,000 in 2014. The United States ranks comparatively low with other developed countries in their availability of psychiatric beds, offering only 22 per 100,000 citizens. The collection of countries known as the Organisation for Economic Cooperation and Development (OECD) averages 71 beds per 100,000. Only four nations within the OECD have smaller averages than the US. Bed availability has dropped 35 percent in the past few decades.
The link between addiction and mental health issues, specifically suicidal thoughts, needs not be pointed out. Addicts suffer depression and other mental health issues at three to four times the rate of the general public. Some studies indicate that over 50 percent of all suicides are associated with alcohol and drug dependence and over 70 percent of adolescent suicides are related to drug or alcohol use or dependence. Co-occurring disorders must be treated on an ongoing and simultaneous basis, and often rely on treatment facilities to provide safety nets in the event of a setback.
When dual-diagnosis sufferers don’t have these mechanisms in place, they often have a more difficult time staying clean and keeping their lives on track. This can lead to relapse and suicide. There has been a variety of suggestions regarding ways to improve the continuum of mental health care for each patient in this country; however, suicide remains a leading cause of death and beds continue to be scarce despite a clear need for expansion and reform.