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THEIRS: Rising suicide rate raises new concerns

The Rapid City Journal - 6/22/2018

New federal report shows the importance of increasing access to mental health services and reducing access to firearms

If Iowa leaders needed another reason to follow through with improving mental health services, it arrived in a recent report from the Centers for Disease Control and Prevention.

Suicide rates among Americans age 10 or older have risen significantly in nearly every state, making it the 10th-leading cause of death in the country. Iowa's rate increased 36.2 percent since the late 1990s. Last year, 433 of our neighbors died by suicide.

Federal researchers used information from medical examiners and law enforcement reports to determine that about half of people who died by suicide had a known or diagnosed mental health condition. Yet the struggles of many people may never be formally documented. The fact that they took their own lives is clear evidence they needed help they did not receive.

The CDC report offers a reminder of the importance of overcoming stigmas associated with conditions such as depression and anxiety. That means talking about mental illness the same way we talk about diabetes, heart disease or other health conditions.

It also means ensuring help is actually available for people who need it. A new mental health facility in Clive or legislatively created "access centers" won't help much if there aren't enough professionals to staff them. There will be no net gain if the workers migrate from other facilities where they're also needed.

Unfortunately, qualified mental health workers are in short supply in this state. Iowa has only 278 health professionals who specialize in psychiatry and can prescribe medication, according to the National Alliance on Mental Illness Greater Des Moines. These include 123 psychiatrists in practices where people can access them, 122 nurse practitioners and 33 physician assistants.

That is one trained professional for every 11,151 Iowans.

Though this state needs more mental health workers, an influx of them is unlikely, particularly in rural areas. Facing that reality requires rethinking how care is delivered.

Iowa leaders should consider allowing some therapists to receive additional training allowing them to prescribe medication. Family physicians, who can write prescriptions, may need to do more to coordinate care with counselors who cannot.

And Iowans need health insurance to pay for care. The expansion of Medicaid in Iowa under the Affordable Care Act provided coverage to about 150,000 Iowans. Health providers are now paid to treat previously uninsured patients. That provides more resources to invest in infrastructure, including mental health services. It's why politicians must stop seeking to reduce access to Medicaid for Iowans.

The CDC report also offers a wake-up call on the accessibility of firearms, which were used in about half of suicides. Iowa should consider allowing gun violence restraining orders. Family members concerned about an unstable loved one could petition a court for temporary removal of firearms from someone in crisis who demonstrates a risk to self or others. An analysis of the effects of a similar law in Connecticut found one life was saved for every 10 to 20 orders issued.

There is no easy fix for preventing suicides. Having resources and access to the best professionals may not be enough, as the recent suicides of fashion designer Kate Spade and celebrity chef Anthony Bourdain show. But Iowa can do more to try to prevent these tragedies.

 
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