The understanding and proper management of mental health in the US is far from perfect and in recent years deficiencies have become increasingly apparent. An article in JAMA Psychiatry explored the association between suicide rates and the number of psychiatric hospital beds in mental care facilities.
A Center for Disease Control (CDC) communication published in 2017 shows that there has been a 22% increase in national suicide rates over the past 15 years. A separate study published in 2016 found that there has also been a decrease in psychiatric hospital beds and posited that this could be another one of the many suicide risk factors.
This article explored this relationship by analyzing patient data from the period of 1999-2013. Researchers collected data on the number of psychiatric hospital beds, number of beds in substance abuse programs, mental health spending and suicide rates. The data was compared within and between-states.
Researchers found that the inverse association between suicide rates and psychiatric hospital beds was mainly produced by differences in the availability of psychiatric hospital beds and that this was only observed between states. According to the study, this accounted for a 1.32% increase in the annual suicide rate per 1 fewer psychiatric hospital bed per 100,000 residents. They also found a weak but still significant inverse relationship between mental health spending and suicide rates, specifically a 0.01% decrease in suicide rate for every 1 dollar spent on mental health.
The researchers concluded that the availability of psychiatric hospital beds was not causally related to suicide rates. Even the between-state results that were mentioned previously were confounded by other in-state level differences. This study’s analysis was mainly weakened by the lack of long term data from psychiatric care facilities. Further, it focused on the total number of beds and not how available beds were being used. For example, are high risk patients being admitted or treated as outpatients? Since major depression plays a role in suicidality, the effectiveness of treatment should also be taken into consideration in future studies. Although this study did not produce a clear answer to the question it set out to assess, it is still a step in the direction toward a better understanding of the relationship between suicide rates and certain resources.
References: Larsen JR, Vedtofte L, Jakobsen MSL, Jespersen HR, Jakobsen MI, Svensson CK, Koyuncu K, Schjerning O, Oturai PS, Kjaer A, Nielsen J, Holst JJ, Ekstrøm CT, Correll CU, Vilsbøll T, Fink-Jensen A. Effect of Liraglutide Treatment on Prediabetes and Overweight or Obesity in Clozapine- or Olanzapine-Treated Patients With Schizophrenia Spectrum DisorderA Randomized Clinical Trial. JAMA Psychiatry. Published online June 10, 2017. doi:10.1001/jamapsychiatry.2017.1220
Written by Clifton Lewis