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Suicidal Americans Missing Out on Care

Many don't seek it in the first place, experts say

FRIDAY, July 14, 2006 (HealthDay News) -- Only half of suicidal people surveyed in a new study said they received significant mental health treatment during the previous year.

The odds of getting assistance were especially high among people who didn't think they had anything wrong with them despite having thoughts of killing themselves, the researchers said.

But even those who realized they were in trouble sometimes couldn't get care.

"It's good if you perceive a need for help, but it doesn't solve all the problems," said study co-author Ruth Klap, an assistant research sociologist at the University of California at Los Angeles (UCLA).

The problem appears to be nationwide: A second study -- a survey of more than 3,500 people in five states -- found that less than 15 percent of those with symptoms of clinical depression were getting recommended care.

In the UCLA study, Klap and her colleagues examined the results of a 2000-2001 survey of nearly 7,900 Americans. Among other things, the survey asked participants about suicidal thoughts and access to mental health care; the study was designed to include a higher than normal proportion of poor and psychologically stressed people.

The study findings appear in the July-August issue of General Hospital Psychiatry.

The UCLA team found that 3.6 percent of those surveyed had thought about suicide within the past year, but only about a quarter of that group consulted a mental health specialist.

Of all those with suicidal thoughts, the researchers estimated that three-quarters probably had a psychological disorder that could have been effectively treated. But almost 40 percent of people in that category didn't receive needed care.

Of those who thought they needed help for suicidal thoughts or addiction -- 56 percent -- only about six in 10 received adequate care as defined by the study. And of all those with suicidal thoughts, only 52 percent got treatment that consisted of more than a simple assessment.

Suicide remains a leading cause of death in the United States, and "suicidal ideation" -- thinking about suicide -- is a major warning sign. However, the study points out that some experts question the importance of suicidal thoughts because most people who have them don't try to kill themselves or actually do so.

The findings make sense to Alan Berman, executive director of the American Association of Suicidology. "Those most at risk are most unlikely to access care, partly because of their pathology -- the underlying disorders, symptoms or behavior problems," he said.

In many cases, suicidal people are male -- known to be less likely to seek help than females -- and isolated from others. "One of the best protective factors is being able to form good and meaningful nurturing relationships," Berman said. "They become suicidal in part because they have trouble doing that."

To make matters worse, doctors and mental health workers often aren't well-trained in how to assess suicidal people, he said. "That's just not being done very well," he noted.

Another survey found that depressed individuals who have limited access to free or low-cost care spend nearly triple the amount on depression treatment as people who do have less restricted access ($4,312 vs. $1,496, respectively).

The survey of 3,542 adults in California, Florida, New York, Ohio and Texas found that limited access to care is associated with dissatisfaction with jobs and/or personal relationships. And while experts recommend a combination of medication and psychotherapy as the best means of treating depression, less than 15 percent of depressed Americans surveyed were receiving this level of care. Floridians were most likely to receive psychotherapy plus an antidepressant (27 percent).

The survey was funded by the National Alliance on Mental Illness and Wyeth Pharmaceuticals.

More information:

Learn more about suicide from the U.S. Centers for Disease Control and Prevention.

SOURCES: Ruth Klap, Ph.D., assistant research sociologist, University of California at Los Angeles; Alan Berman, Ph.D., executive director, American Association of Suicidology, Washington D.C.; July 11, 2006, news release, National Alliance on Mental Illness; July-August 2006 General Hospital Psychiatry
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