Changes in community mental health services availability and suicide mortality in the US: a retrospective study.
BMC Psychiatry
; 20(1): 188, 2020 04 25.
Article
em En
| MEDLINE
| ID: mdl-32334552
ABSTRACT
BACKGROUND:
Despite the fact that the overwhelming majority of mental health services are delivered in outpatient settings, the effect of changes in non-hospital-based mental health care on increased suicide rates is largely unknown. This study examines the association between changes in community mental health center (CMHC) supply and suicide mortality in the United States.METHODS:
Retrospective analysis was performed using data from National Mental Health Services Survey (N-MHSS) and the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (WONDER) (2014-2017). Population-weighted multiple linear regressions were used to examine within-state associations between CMHCs per capita and suicide mortality. Models controlled for state-level characteristics (i.e., number of hospital psychiatric units per capita, number of mental health professionals per capita, age, race, and percent low-income), year and state.RESULTS:
From 2014 to 2017, the number of CMHCs decreased by 14% nationally (from 3406 to 2920). Suicide increased by 9.7% (from 15.4 to 16.9 per 100,000) in the same time period. We find a small but negative association between the number of CMHCs and suicide deaths (- 0.52, 95% CI - 1.08 to 0.03; p = 0.066). Declines in the number of CMHCs from 2014 to 2017 may be associated with approximately 6% of the national increase in suicide, representing 263 additional suicide deaths.CONCLUSIONS:
State governments should avoid the declining number of CMHCs and the services these facilities provide, which may be an important component of suicide prevention efforts.Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Suicídio
/
Serviços Comunitários de Saúde Mental
/
Acessibilidade aos Serviços de Saúde
Tipo de estudo:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Humans
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
BMC Psychiatry
Assunto da revista:
PSIQUIATRIA
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Estados Unidos