The Commonwealth Fund has released it 2009 report titled: “Aiming Higher – Results from A State Scorecard on Health System Performance” and the evidence is irrefutable where suicide prevention is concerned. States that demonstrate improved access to mental health care, especially among the most vulnerable populations, show a dramatic decrease in the rate of suicide. Access to care saves lives. The Commonwealth Fund is a non-partisan health care and policy “think-tank” and foundation that conducts research and development efforts aimed at improving access and quality of care particularly for the most vulnerable. Authors included Douglas McCarthy, Sabrina K. H. How, and Cathy Schoen as well as Joel C. Cantor and Dina Belloff of Rutgers University Center for State Health Policy.
The Commonwealth Fund’s State Scorecard assesses states’ performance relative to benchmarks across 38 indicators of access, quality, costs, and outcomes. This year’s report illustrates how our health care systems are in distress, the erosion of insurance coverage for adults, and rising health care costs.
Access to & Use of Mental Health Care: Suicide Prevention 101
After more than a decade of improvement, the report states that the national suicide rate has once again risen. That’s the bad news. Regionally, suicides were more common in states from the Mountain region while they were lowest in the Northeast. Their research suggests that lower suicide rates are related to “positive indicators” of access to and use of mental health services. That’s the good news. The five states ranked highest for access have a combined average suicide rate that is almost 40 percent lower than the combined average of the five lowest-ranked states.
Clearly, it’s not enough that generic “people” have access to some nebulous “mental health care”. The pursuit of Parity – helped along by the Surgeon General’s Report on Mental Health and the President Bush’s New Freedom Commission – has demonstrated that diverse populations in frontier, rural and urban parts of this country representing a wide range of socio-economic strata require a range of services and access to a continuum of care that reflects the variety of brain disorders, mental health disorders, substance use disorders, and serious emotional disturbances that lead tragically to suicide when left untreated.
Stigma
The Northeast has tackled stigma in ways that the Mountain region of this country has not. Parity has had a foot-hold at the State-level in the Northeast for some time and the culture is generally more accepting of the medical and scientific reality of mental health and substance use disorders. Having lived in the Mountain region for more than 20 years, I can attest to the phenomenon of the “rugged individualism”, “boot-straps” and “moral fiber” of the mythic West. Sadly, the conservative cowboy culture and character-building credo can and often do produce conditions that serve as barriers and obstacles to treatment rather than access. And where access might exist, social stigma makes it difficult at best for people to follow through and leverage what they have to recover.
Perhaps someday, lives lost to suicide will be seen as absolutely unacceptable everywhere in this great country. Until then, we have to fully exploit (and learn from) success where we find it.
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