Wednesday, June 03, 2009

HUFFINGTON POST: TEN Suicide attempts in one night admitted to Carolinas Medical Center

Dear Arthur at Huffington Post:

Thanks to you and Adrianna Huffington for your comments. Love seeing her on Colbert.

Here's what is taking place in NC: since 2001, NC Mental Health Reform has been in place. What does this mean?

'Privatization' and 'competition' was viewed by the Dem controlled NC State Legislature (yes, I am a Dem, far to the left) as necessary to create a more efficient, better public mental health care system. The mental health centers were morphed into administrative centers.

Private providers came on board (this gave me an opportunity for a job as an independently practicing psychologist).

However, problems rather quickly evidenced re: this innovative mental health reform.

No one can make much of a profit re: mental health care. Why? Because people w/ mental health challenges don't have any money. What they do have is Medicare & Medicaid. So, what happened is that these Severe Persistent Mentally Ill (SPMI: a descriptor associated w/ this population) with Medicaid, utilized Community Support Services (CSS). These citizens w/ mental health challenges also received access to therapy and medication, as needed.

CSS provides weekly face-to-face support from CSS workers who work w/ the client to increase their skill level and to augment difficulties w/ creating better mental health---such as making mental health appointments, etc. (It does not help that there is not a transportation infrastructure in NC).

What were the other problems that created barriers to mental health?

For over five years, Carmen Hooker Odom, the Director of the Department of Health & Human Services (DHHS NC) was in place. She put out confusing memos that confounded the system. She was let go in 2007.

Some of the morphed community mental health centers put into place their 'favorite people' to create the mental health services.

The citizens advisory boards within the morphed community mental health centers were dissed and thrown out on the street---when they were supposed to---by law---have an advisory capacity.

As you surmise, there was a big scramble for control.

This brings us to where we are now: the NC House has just submitted a proposal to lob off 25% of the human services budget. They say its because they have to. However, this is in the face of:

*10 suicide attempt citizens being admitted to the hospital in your report this past week (there is a decrease in mental health services, particularly as BCBSNC was allowed by the State Legislature to OPT OUT of mental health reform)

*two incidents in the past two weeks where in NC citizens w/ mental health challenges were chained to hospital beds for 5 days and 8 days in the local ER's because there were no acute level beds ANYWHERE in NC

*thousands of hours of sheriffs' time tied up w/ people who are admitted to ER's and there are no inpatient beds ANYWHERE in NC

*if CSS are cut as proposed by the NC House, most of the private providers which came into play as associated w/ mental health reform will go under, thus exacerbating the already dire situation

I think you get the picture.

Marsha V. Hammond, PhD

".....ten patients attempted suicide in a single night in March, a doctor at the Carolinas Medical Center, said, "I can't believe it's not related to the economy."

The story raises questions for the rest of the country: Is this happening everywhere? And do more people kill themselves when the economy contracts?

Hard to know. The latest national data on suicides, released in April by the Centers for Disease Control and Prevention, ends in 2006, when 33,300 people committed suicide nationwide.

That's 11.2 suicides per 100,000 people, a rate increase of .2 percent over the previous year.
"Our data aren't really current enough to be able to say anything about this particular downturn," said Bob Anderson, chief of mortality statistics with the CDC's National Center for Health Statistics, in an interview with the Huffington Post.

Anderson said that the CDC is hampered in its reporting because it has to wait for each state to process death certificates, which can take up to a year. "We can only be as fast as our slowest state," Anderson said.

....Clayton stressed that 90 percent of the people who commit suicide suffer from a psychiatric disorder. However, she added, job loss can exacerbate persistent feelings of anxiety and hopelessness, which are warning signs of suicide.

There is a precedent for connecting economic trends to suicide trends, Clayton said. "If you go back to the Great Depression and you look at suicides from 1927 to 1932 there does seem to be a rise."

Even without statistics, there are clues to what might be happening. Calls to the National Suicide Prevention Lifeline, the only national 24/7 suicide prevention hotline, have increased steadily every month since April 2007, when 38,114 people called the hotline. In April 2009 the hotline received 51,465 calls......"


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