I’ll start out with a question: How many of you who are reading this know someone who has attempted or died by suicide? I suspect there was a lot of head nodding, some anguish, some tears, much grief, constant worry and whole lot of questioning why this happened.
Why did 1,175 Coloradans die from suicide in 2017? A simple question with many complicated answers.
The gut-wrenching statistic in our state is that suicide is the leading cause of death among 10-24 year olds, and we have one of the highest suicide rates in the nation.
It is estimated that up to 50 percent of those who die by suicide have seen a primary care provider within the previous month. Thirty percent have seen a behavior health provider within the previous month.
In 1999, The Henry Ford Medical Group in Detroit implemented a Zero Suicide prevention system of care within their Department of Behavior Health Services named the “Blues Busters.”
The plan had lofty goals — screen everyone using an evidence-based screening tool, then determine who is at risk for self-harm or suffering from other behavioral issues, such as depression or anxiety. Their protocols also included an integrated and coordinated system of care which also emphasized evidence-based care. The results were astounding, and within a few years the system was implemented within their primary care departments.
From 1999-2009, they had an 80 percent reduction in suicides including zero suicides in 2009.
The North Central Health Care System in Wisconsin, which cares for 10,000 lives, saw zero suicides in 2015 after implementation of a similar system.
In 2016, Colorado Senate Bill 16-147 passed, which allowed for the creation of a Colorado Suicide Prevention Model based on the Zero Suicide care model. Regretfully, there were no funds appropriated for this bill.
In the next two weeks, the Joint Budget Committee will vote on funding $861,000 for the zero suicide bill. Although this sounds like a small amount of money, it moves us in the right direction and will help us learn what we’ll need for the next steps.
A large part of what this legislation entails is a culture shift. Many of us never give a second thought about the importance of screening for colon cancer with a colonoscopy or checking our blood pressure to ensure we don’t have high blood pressure which, if untreated, can lead to serious heart disease including heart attacks and strokes.
Now we have to start thinking and believing in the importance of mental health screening.
The evidence-based tools exist, and many of these screening tools (such as the PHQ-9) are being utilized throughout the country. Not only has this proven to save lives but will undoubtedly improve the quality of life for many, many people.
The is not a simple task as it will require commitment from health care providers in almost all settings (including our schools), an intact and accessible network of mental health providers and a system that integrates and coordinates care. It’s about a passionate systemwide buy-in to make this a priority.
Zero Suicide is more than just a hope. I urge all of you to call or e-mail our Joint Budget Committee members and ask them to approve funding for this important first step.
Jonathan Gordon, MD is the retired regional department chief of family medicine at Kaiser Permanente Colorado.