By Dr. Martin Leibman, Clinical Psychologist, Department of Behavioral Health, KAHC July 31, 2014
FORT LEE, Va. (July 31, 2014) -- A recent update from the National Institute of Mental Health website highlighted a critical issue that has shaped patient screening procedures at Kenner Army Health Clinic and across the Army Medical Command. The report focused on undetected suicide risk as a critical issue in primary care settings.
In 2010, more than 38,000 Americans were lost to suicide, according to the Centers for Disease Control and Prevention. This is twice the homicide rate and higher than the annual number of traffic fatalities. According to an NIMH-funded study published in February 2014, 83 percent of the nearly 6,000 individuals they studied received health care services in the year prior to suicide death and half of those did not have a mental health diagnosis. This study showed that of the people who received health care services in the year prior to death, 50 percent made a medical visit within four weeks of their deaths. The most common visit types included primary care and medical specialty.
These findings indicate there is a key opportunity to reach individuals at risk for suicide within primary care and medical specialty settings. We know that most depressed patients will receive most or all of their care through primary care physicians. Depressed patients frequently present physical health complaints to their primary care doctor rather than report symptoms of depressed mood. Some symptoms of depression, such as fatigue, too much or too little sleep, non-specific aches and pains, loss of appetite, and decreased energy, could appear to be due to other medical conditions. In primary care settings, medical providers may be able to detect risk for suicide and begin treatment earlier to prevent suicides for depressed patients.
Currently, Kenner providers screen all enrollees for symptoms of depression, including suicidal thoughts, at each primary care visit. It is very important for individuals seeking health care services at KAHC to be honest with their medical providers regarding both their physical and behavioral health functioning.
When signs of depressed mood or suicidal thinking are detected, the providers can then make the appropriate referrals to community and/or in-house behavioral health. Treatment for depression also can be initiated in primary care settings. Mild depression can be effectively treated with medication or psychotherapy while moderate to severe depression would most likely require a combination of both.