Improving Care To Prevent Suicide Among People With Serious Mental Illness

Suicide prevention initiatives are part of much broader systems connected to activities such as the diagnosis of mental illness, the recognition of clinical risk, improving access to care, and coordinating with a broad range of outside agencies and entities around both prevention and public health efforts. Yet suicide is also an intensely personal issue that continues to be surrounded by stigma. On September 11-12, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, to discuss preventing suicide among people with serious mental illness. The workshop was designed to illustrate and discuss what is known, what is currently being done, and what needs to be done to identify and reduce suicide risk. Improving Care to Prevent Suicide Among People with Serious Mental Illness summarizes presentations and discussions of the workshop.

Suicide prevention initiatives are part of much broader systems connected to activities such as the diagnosis of mental illness, the recognition of clinical risk, improving access to care, and coordinating with a broad range of outside agencies and entities around both prevention and public health efforts. Yet suicide is also an intensely personal issue that continues to be surrounded by stigma. On September 11-12, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, to discuss preventing suicide among people with serious mental illness. The workshop was designed to illustrate and discuss what is known, what is currently being done, and what needs to be done to identify and reduce suicide risk. Improving Care to Prevent Suicide Among People with Serious Mental Illness summarizes presentations and discussions of the workshop.

Every year, about 30,000 people die by suicide in the U.S., and some 650,000 receive emergency treatment after a suicide attempt. Often, those most at risk are the least able to access professional help. Reducing Suicide provides a blueprint for addressing this tragic and costly problem: how we can build an appropriate infrastructure, conduct needed research, and improve our ability to recognize suicide risk and effectively intervene. Rich in data, the book also strikes an intensely personal chord, featuring compelling quotes about people's experience with suicide. The book explores the factors that raise a person's risk of suicide: psychological and biological factors including substance abuse, the link between childhood trauma and later suicide, and the impact of family life, economic status, religion, and other social and cultural conditions. The authors review the effectiveness of existing interventions, including mental health practitioners' ability to assess suicide risk among patients. They present lessons learned from the Air Force suicide prevention program and other prevention initiatives. And they identify barriers to effective research and treatment. This new volume will be of special interest to policy makers, administrators, researchers, practitioners, and journalists working in the field of mental health.

Behavioral health and substance use disorders affect approximately 20 percent of the U.S. population. Of those with a substance use disorder, approximately 60 percent also have a mental health disorder. Together, these disorders account for a substantial burden of disability, have been associated with an increased risk of morbidity and mortality from other chronic illnesses, and can be risk factors for incarceration, homelessness, and death by suicide. In addition, they can compromise a person's ability to seek out and afford health care and adhere to treatment recommendations. To explore data, policies, practices, and systems that affect the diagnosis and provision of care for mental health and substance use disorders, the Health and Medicine Division of the National Academies of Sciences, Engineering, and Medicine created the Forum on Mental Health and Substance Use Disorders. The forum activities are expected to advance the discussion and generate potential ideas on ways to address many of the most persistent problems in delivering mental health and substance use services. The inaugural workshop, held October 15-16, 2019, in Washington, DC, explored the key policy challenges that impede efforts to improve care for those individuals with mental health and substance use disorders. This publication summarizes the presentations and discussion of the workshop.

Perhaps never before has an objective, evidence-based review of the intersection between gun violence and mental illness been more sorely needed or more timely. Gun Violence and Mental Illness, written by a multidisciplinary roster of authors who are leaders in the fields of mental health, public health, and public policy, is a practical guide to the issues surrounding the relation between firearms deaths and mental illness. Tragic mass shootings that capture headlines reinforce the mistaken beliefs that people with mental illness are violent and responsible for much of the gun violence in the United States. This misconception stigmatizes individuals with mental illness and distracts us from the awareness that approximately 65% of all firearm deaths each year are suicides. This book is an apolitical exploration of the misperceptions and realities that attend gun violence and mental illness. The authors frame both pressing social issues as public health problems subject to a variety of interventions on individual and collective levels, including utilization of a novel perspective: evidence-based interventions focusing on assessments and indicators of dangerousness, with or without indications of mental illness. Reader-friendly, well-structured, and accessible to professional and lay audiences, the book: * Reviews the epidemiology of gun violence and its relationship to mental illness, exploring what we know about those who perpetrate mass shootings and school shootings. * Examines the current legal provisions for prohibiting access to firearms for those with mental illness and whether these provisions and new mandated reporting interventions are effective or whether they reinforce negative stereotypes associated with mental illness. * Discusses the issues raised in accessing mental health treatment in regard to diminished treatment resources, barriers to access, and involuntary commitment.* Explores novel interventions for addressing these issues from a multilevel and multidisciplinary public health perspective that does not stigmatize people with mental illness. This includes reviews of suicide risk assessment; increasing treatment engagement; legal, social, and psychiatric means of restricting access to firearms when people are in crisis; and, when appropriate, restoration of firearm rights. Mental health clinicians and trainees will especially appreciate the risk assessment strategies presented here, and mental health, public health, and public policy researchers will find Gun Violence and Mental Illness a thoughtful and thought-provoking volume that eschews sensationalism and embraces serious scholarship.

A concise review of current research into suicide providing a guide to understanding this disease and its increasing incidence globally.

The Social Determinants of Mental Health aims to fill the gap that exists in the psychiatric, scholarly, and policy-related literature on the social determinants of mental health: those factors stemming from where we learn, play, live, work, and age that impact our overall mental health and well-being. The editors and an impressive roster of chapter authors from diverse scholarly backgrounds provide detailed information on topics such as discrimination and social exclusion; adverse early life experiences; poor education; unemployment, underemployment, and job insecurity; income inequality, poverty, and neighborhood deprivation; food insecurity; poor housing quality and housing instability; adverse features of the built environment; and poor access to mental health care. This thought-provoking book offers many beneficial features for clinicians and public health professionals: Clinical vignettes are included, designed to make the content accessible to readers who are primarily clinicians and also to demonstrate the practical, individual-level applicability of the subject matter for those who typically work at the public health, population, and/or policy level. Policy implications are discussed throughout, designed to make the content accessible to readers who work primarily at the public health or population level and also to demonstrate the policy relevance of the subject matter for those who typically work at the clinical level. All chapters include five to six key points that focus on the most important content, helping to both prepare the reader with a brief overview of the chapter's main points and reinforce the "take-away" messages afterward. In addition to the main body of the book, which focuses on selected individual social determinants of mental health, the volume includes an in-depth overview that summarizes the editors' and their colleagues' conceptualization, as well as a final chapter coauthored by Dr. David Satcher, 16th Surgeon General of the United States, that serves as a "Call to Action," offering specific actions that can be taken by both clinicians and policymakers to address the social determinants of mental health. The editors have succeeded in the difficult task of balancing the individual/clinical/patient perspective and the population/public health/community point of view, while underscoring the need for both groups to work in a unified way to address the inequities in twenty-first century America. The Social Determinants of Mental Health gives readers the tools to understand and act to improve mental health and reduce risk for mental illnesses for individuals and communities. Students preparing for the Medical College Admission Test (MCAT) will also benefit from this book, as the MCAT in 2015 will test applicants' knowledge of social determinants of health. The social determinants of mental health are not distinct from the social determinants of physical health, although they deserve special emphasis given the prevalence and burden of poor mental health.

Promoting Behavioral Health and Reducing Risk Among College Students synthesizes the large body of research on college students’ behavioral health and offers guidance on applying evidence-based prevention and early intervention strategies using a comprehensive public health framework. Chapters authored by leading researchers and practitioners address a broad spectrum of important behavioral health issues, interventions, and challenges. Moving beyond a theoretical discussion to strategies for implementation, this book addresses the special issues and potential barriers faced by practitioners as they translate research to practice, such as resource limitations, organizational resistance, challenges to program sustainability, and the unique needs of special populations. This cutting-edge compendium will appeal to both practitioners and researchers involved in providing prevention, early intervention, and treatment services for college students.