1- With the recent flood of news, announcing the two notable celebrity suicides this week, the population I have chosen to discuss is people living with mental illness and primary care practice as the setting.

Before I begin on this special population’s topic, I wanted to provide a few statistics as background. Suicide rates have increased more than 30 percent in less than two decades, and in 2016 suicide was the 10th leading cause of death in the United States according to the Substance Abuse and Mental Health Services Administration (SAMHSA). Side note; we can speculate for hours why suicide is on the rise, but that is not the point of this exercise.

Trying to link the two topics of mental illness and primary care, I started combing through countless articles online. What I found throughout this research exercise was interesting and I actually learned a lot about suicide; the warning signs, resources, etc. Importantly, on the Treatment Advocacy Center website(1) Michigan is rated a C+ for “outpatient commitment” while all other ratings (emergency evaluation and inpatient commitment) were in the A range. Additionally, the SAMHSA website(2) mentioned that almost half of individuals who die by suicide have visited a primary care provider in the month leading up to their death. These two factors got me thinking that maybe we can and should be doing more at the primary care level where physicians first encounter their patients and evaluate overall health and well-being. Potentially some key questions or conversation starters could be provided to primary care physicians in their training to utilize throughout the overall patient evaluation to aide in lowering the statistic related to recent patient/physician visits prior to a suicide. Ultimately, I think more research should be done at the primary care level to identify and/or potentially diagnose mental illness, or potentially offering up a referral to someone who can help their patient is another option.

Lastly, in December 2016, President Obama signed into law the 21st Century Cures Act(3) that focused on encouraging positive change in many aspects of health care administration, but also supported a number of mental health reforms, including millions in federal incentives for states to develop assisted outpatient treatment (AOT). This bill was to supplement prior funding for treatment of patients with mental illness and linking the necessary resource options to patients. Potentially through this recent extension of funds, accessibility to these monetary resources will encourage more research and potentially promote the quality of dialogue between patient and physician in the primary care setting to help mitigate the growing suicide rate.

1) http://www.treatmentadvocacycenter.org/browse-by-state/michigan

2) https://store.samhsa.gov/apps/suicidesafe/

3) https://en.wikipedia.org/wiki/21st_Century_Cures_Act

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