Survey of Americans who attempted suicide finds many aren’t getting care

The number of people who try suicide has risen steadily in the U.S. But despite gains in health coverage, nearly half are not getting mental health treatment.

Suicide attempts in the United States showed a “substantial and alarming increase” over the last decade, but one number remained the same, a new study has found: Year in and year out, about 40% of people who had recently tried suicide said they were not receiving mental health services.

The study, published in JAMA Psychiatry, traces a rise in the incidence of suicide attempts, defined as “self-reported attempts to kill one’s self in the last 12 months,” from 2008 to 2019. During that period, the incidence rose to 564 in every 100,000 adults from 481.

The researchers drew on data from 484,732 responses to the federal government’s annual National Survey on Drug Use and Health, which includes people who lack insurance and have little contact with the health care system. They found the largest increase in suicide attempts among women; young adults between 18 and 25; unmarried people; people with less education; and people who regularly use substances like alcohol or cannabis. Only one group, adults 50 to 64 years old, saw a significant decrease in suicide attempts during that time.

Among the major findings was that there was no significant change in the use of mental health services by people who had tried suicide, despite the passage of the Affordable Care Act in 2010 and receding stigma around mental health care.

Over the 11-year period, a steady rate of about 40%t of people who tried suicide in the previous year said they were not receiving mental health care, said Greg Rhee, an assistant professor of psychiatry at the Yale School of Medicine and one of the authors of the study.

The Affordable Care Act, which took effect fully in 2014, required all health plans to cover mental health and substance abuse services, and also sharply reduced the number of uninsured people in the U.S. However, many respondents to the survey in the new report said the cost of mental health care was prohibitive; others said they were uncertain where to go for treatment or had no transportation.

“It is a huge public health problem,” Dr. Rhee said. “We know that mental health care in the U.S. is really fragmented and complicated, and we also know not everybody has equal access to mental health care. So, it’s somewhat not surprising.”

Read full story (paywalled)

Source: New York Times,19 January 2022