Isolation And Risk Of Suicide
Deaths by suicide can be prevented when services are in place
According to The Department of Health and Human services, a staggering 55% of counties across the US do not have a single psychiatrist, psychologist or social worker. Incredibly, every one of those counties is rural. That means that for a person who is living in one of these areas who is at a high risk of suicide, a visit to the closest psychiatrist’s office to get the help they need requires hours of travel and missing up to a day of work, something that may not be possible.
According to a recent New York Times article, the isolation and loneliness that can come from living in a rural town, combined with lower income, health problems and family issues can have a negative impact on any resident. For those who are at risk of suicide, that impact could be much greater, especially when the help they need is hours away. Some posit that this isolation could be one reason for the increase of suicides in rural areas over the last few years.
Stigma associated with mental health puts patients at risk
There is still a great deal of stigma associated with seeking help from a mental health professional, so much so that some people who need help actively won’t seek it for fear of being seen coming or going from a psychiatrist’s office. This stigma is especially strong in rural areas, where the perception is that there is little expectation of privacy.
When there aren’t any dedicated mental health professionals in their area, a person may try to find help through other means. Some rely on friends or family members. Others may turn to drugs and alcohol. But many who need help seek it from their primary care doctors, whom they know and are comfortable with. According to a 2002 analysis published in the American Journal of Psychiatry, nearly half of the people who died by suicide had visited their primary care physicians within a month of their death. Most reported minor symptoms such as trouble sleeping or headaches.
Bridging the gap with integrated care
Unfortunately, this tendency to see the primary care doctor for mental health issues is quite dangerous. Most primary care physicians are not properly trained in identifying risk factors for suicide, which means they cannot protect those patients in the ways that are most needed. If those patients who went to their doctor for headaches or sleepless nights could then see a medical heath professional on the same day, they would have access to the standard of care they need to reduce the risk of dying by suicide. Because those services are rarely available in rural areas, thousands of people are put at elevated risk.
Experts cited in the Times article have suggested adding a mental health component to primary care practices, either by having an affiliated psychiatrist practicing in the same building or by using video conferencing to get patients immediately evaluated by an off-site psychiatrist. That way, patients can seek mental health services without having to go to a building specifically dedicated to mental health – and thus avoid the weight of the social stigma.
However, with limited space and resources available, adding these services in rural areas is a challenge. Additional resources are needed to provide those essential mental health services to those who are most in need of help. Just as importantly, the public needs to be educated about the high cost of letting mental health services suffer – and the social stigma needs to be replaced with an understanding that seeking treatment for mental health is no different from seeking treatment for any other medical issue.
If you or a loved one has been effected by a death by suicide, contact Skip Simpson today. He knows that a person who is at high risk of suicide cannot seek help that isn’t there. Contact him today for a free and confidential case evaluation.