The Journal of the Arkansas Medical Society Med Journal March 2019 Final 2 | Page 12

EDITORIAL PANEL: Chad T. Rodgers, MD, FAAP | Elena M. Davis, MD, MPH | William L. Mason, MD | Michael Moody, MD | J. Gary Wheeler, MD, MPS Suicide is Preventable LADEANA BELL, MS, LPE-I and MOLLY M. GATHRIGHT, MD H alf of all Americans will experience a mental health crisis during their lifetime. Most crises go unrecognized and untreated. 1 For an increasing number of people, their mental health crisis includes a suicide attempt or suicide death. While the awareness of suicide as a public health concern has increased, the suicide rate has also increased, according to the Centers for Disease Control and Prevention. 2 Arkansas ranks 14th in the nation in suicide deaths with 555 lives lost to suicide in 2016, more than double the number of homicides. 3 Suicide is the second-leading cause of death for ages 15–34; the fourth- leading cause for ages 35–44, and the seventh-leading cause for ages 45–55. On average, one Arkansan dies by suicide every 16 hours. Mental health is a key part of overall health and health maintenance visits should include mental health screening. Providers should check for mental health changes in all patients, even those with no diagnosed mental illness. One study found that suicide victims are often likely to have visited their primary care physician (PCP) in the one month prior to their death. 4 Because people have long-standing relationships with Suicide Symptoms If a person talks about: • Killing themselves • Feeling hopeless • Having no reason to live • Being a burden to others • Feeling trapped • Unbearable pain These behaviors can signal risk, especially if related to a painful event, loss or change: • Increased use of alcohol or drugs • Looking for suicide methods; searching online • Withdrawing from activities • Isolating from family and friends • Sleeping too much or too little • Visiting or calling people to say goodbye • Giving away prized possessions • Aggression • Fatigue Changes in mood to: • • • • Depression Anxiety Loss of interest Irritability • Humiliation or shame • Agitation or anger • Relief or sudden improvement in mood FOR MORE INFORMATION: www.sprc.org/settings/primary-care/toolkit • www.samsha.gov/suicide-prevention their PCP, PCPs are in an integral position to prevent suicides. Some individuals may need to be seen by a specialist or need more intensive mental health intervention. However, the reality is that primary care may be the only setting in which many patients receive health care and it should include behavioral health 204 • THE JOURNAL OF THE ARKANSAS MEDICAL SOCIETY care. For a person at risk of suicide, a visit to the PCP may be their one chance to access care. Physicians, especially in rural areas and underserved areas with limited access to mental health profession- als, must become more comfortable with being that one point of contact. This may seem daunting and is a VOLUME 115