Ethics & Religion
Column #1,989
September 26. 2019
How Doctors Might Reduce Suicides
By Mike McManus

The major reason American life expectancy has fallen for three years is the steady increase of suicides. This terrible trend can be reversed.

In 2017 there were 47,123 recorded suicides - up from 42,773 in 2014 - according to the National Center for Health Statistics. The suicide rate has increased by 24% between 1999 and 2014.

What can be done to reduce the suicide rate?

Consider this fact, reported by The Washington Post in an article on Tuesday by Steven Petrow: According to Kelly Posner Gerstenhaber, a Columbia University psychiatry professor, half of all people who take their own lives met with their primary care doctors within the month before they die.

"We need to ask about suicide the way we monitor blood pressure," Dr. Posner Gerstenhaber asserts. The LIghthouse Project, which has a tag line: "Identify risk. Prevent suicide." It recommends that physicians ask six questions of anyone they see for routine appointments:

1, "Have you wished you were dead or wished you could go to sleep and not wake
up?"

2. "Have you actually had any thoughts about killing yourself?"

3. "Have you thought about how you might do this?"

4. "Have you had any intention of acting on these thoughts of killing yourself?

5. "Have you started to work out the details of how to kill yourself? Do you intend to carry out this plan?"

6. "Have you done anything, started to do anything, or prepared to do anything to end your life?"

A Yes answer to any of these questions indicates the need for medical care. Experts suggest that if the answer to any of the last three questions is "Yes." Immediately escort your friend to emergency people for care. For help, call 1-800 273-8256.

Then in capital letters, comes this call to action: "DON'T LEAVE THE PERSON ALONE. STAY WITH THEM UNTIL THEY ARE IN THE CARE OF PROFESSIONAL HELP."

Dr. Posner Gerstenhaber says she "hopes every teacher, parent, peer and coach can be equipped with these simple questions to help those at risk to connect to the care they need."

I called Kaiser Permanente, my health care provider, to see what its physicians are doing along this line, and came away very discouraged. My group serves 750,000 people in Metro Washington where I live - and 12 million people across the country. It is the largest Health Maintenance Organization in the country.

When I asked Washington area KP leaders if physicians regularly ask patients any of the six suicide questions above, no one would speak to me. Therefore, I called Kaiser Permanente's national office and spoke to Keith Montgomery, who handles press. He could not get anyone in authority to call back either.

Instead he sent a press release which said, "Kaiser Permanente is dedicated to care innovations, clinical research, health education, and the support of community health."

Pure blather.

(I hasten to add that I have been pleased with the health care I have received from Kaiser.)

You may have seen many stories on network TV about how "vaping" is killing young people - 10 so far. Obviously, that is a minor issue compared to the 47,000 suicides in 2017.

People plagued by mental health issues "continue to be plagued by stigma and misconceptions," wrote Steven Petrow in The Washington Post. "Their friends- our friends - need our loved ones to step up and reach out at the signs of danger. Yes, it feels scary to do this, but then again you might save a life."

However, the biggest need is for the medical profession to ask suicide questions of all patients, even their apparently normal ones.

I asked a chief nurse at a hospital group based in Virginia if suicide questions are part of a normal screening process of those who come to hospitals for emergency care.

She replied, "Those who come to the hospital for emergency care are asked, `Have you thought about suicide or tried to kill yourself?' If the answer is yes, "that triggers a psychiatric consultation."

Good. That should be a routine question that physicians ask every patient - even those who do not seem to be depressed.

Let's set a goal to cut suicide deaths in America.

Our physicians must see their role as crucial.

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Copyright (c) 2019 Michael J. McManus, President of Marriage Savers and a syndicated columnist. To read past columns, go to www.ethicsandreligion.com. Hit Search for any topic.