Saturday, July 24, 2010

We're Not Fixing The Suicide Problem

Suicide is painless,
It brings on many changes,
And I can take or leave it if I please...

Such is the refrain from the Johnny Mandel/Mike Altman song best known as the theme used by M*A*S*H. It appears that our response to suicide prevention has proven woefully ineffective since the song was first released in 1970.

Brendan Koerner, in his Atlantic essay The Suicide Conundrum, notes thusly:

Despite all we've learned about human psychology over the past several decades, we seem unable to make much of a dent in America's overall suicide rate, which has remained remarkably stable over the past half-century. In fact, the rate of suicide attempts seems to have gone up over that time period; the rate of successful attempts has most likely held steady due to advances in emergency-room medicine.

Think about that for a moment. While there has been a plodding removal of stigmata associated with mental health issues in general, we still we have more suicide attempts, the success rate tempered only by advances in medical care and advanced life support. That's failure, plain and simple.

Says Koerner:

And so the mystery remains: How do we reduce America's suicide rate, which has barely budged for 50 years? The natural answer is to address the underlying causes, such as desperate economic circumstances and poor mental health. But if we were intent on launching a 10-year crusade to reduce the national suicide rate by, say, 30 percent, what sorts of (relatively) quick, affordable fixes could we marshal? Will bridge barrier and signs work, for example, despite some recent evidence to the contrary?

That's an excellent question, and the fact that we're still asking it calls into question current approaches to prevention. The socio-economic causes of suicide are well known, yet they never enter into the debate when pompous windbags pontificate about deficit reduction on the backs on our neediest citizens while preserving the ability of those who have the most to accumulate even more.

How many poor citizens who attempt suicide but are saved by dedicated emergency room staff have private insurance? My guess is that not many. Medicaid is paying the tab, or hospitals are absorbing the expenses, both of which have been identified as part of the overall health care problem in this country. 

Experts agree that preventative medicine can lower overall medical costs, as issues are identified early and treatment can cure or effectively manage conditions before they become more significant in severity and require more invasive - and more expensive - treatment options.

Yet there seems to be little support for channeling a portion of available resources toward correcting the root causes of hopelessness and despair, or providing avenues for the desperate to cope with the crushing circumstances that have lead them to individual tipping points.

Have we become a society so cold-hearted that it's now acceptable to turn our backs on the suffering of others so that a small percentage of people who have accumulated the largest share of our combined wealth can continue to amass huge fortunes and increase the gap between the haves and the have-nots? Or is the system so stacked against anyone not part of that protected class that hopelessness is the new reality, and Americans are witnessing the beginning of a downward spiral that will only accelerate as we cowardly accede to a mental health caste system where those deemed worth saving are the very same people who are responsible for making the life and death decisions?

If so, it's time to start pumping Paxil into the water supply, because that sounds like a very unhappy existence.

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