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Guest opinion: Suicide bills are a game-changer

Paul Quinnett And Marny Lombard

This particular week – Christmas week – delivers the most painful days of 2013 to a certain set of Inland Northwest residents: those who have lost loved ones to suicide.

The pain that surrounds suicide, the crippling aftermath for those whose loved ones die by suicide – these are unusual topics to raise during this traditional time of family, joy, faith and community. Must we talk about something so upsetting? Impolite, even?

How many immense issues have we regarded with such entrenched silence? Suicide is one of the last issues to carry the taint of taboo in our wide-open culture. That must change. The numbers demand it. Since 1970, more than five million Americans have survived the loss of a loved one to suicide. They all plow through the heavy winds of grief and loss that blow especially strong this time of year.

Some Americans have had enough of losing lives to suicide. Some are speaking out, acting, and creating new resources to lead the way. One such resource is Forefront, the new suicide prevention group at the University of Washington. The Evergreen State is emerging as a national leader in taking vigorous legislative steps to reduce suicide. By passing two suicide-prevention bills during the 2012 legislative session – with a third in the works – lawmakers have mandated training requirements for health professionals that will save lives.

The Matt Adler Suicide Assessment, Treatment, and Management Act of 2012, HB 2366, mandates that certain licensed health professionals complete at least six hours of training every six years in how to assess, treat and manage suicidal patients. This requirement goes into effect on New Year’s Day – perfect timing for a hopeful 2014.

Why should such training be required? Don’t health professionals already know about how to prevent suicide?

No, they don’t. Here’s the problem: Health professionals can’t diagnose and treat a problem they don’t know about. Suicide is that problem.

Dozens of studies show that suicide risk is not discussed during patient visits for a variety of mental, substance abuse and medical problems. An article in the Journal of Family Medicine titled “Let’s Not Talk About It; Suicide Inquiry in Primary Care” concluded that even for people being treated for depression – which increases suicide risk 32-fold – only 36 percent of the time did doctors ask patients if they were thinking about suicide.

The Matt Adler Act is a game changer because it prepares thousands of clinicians to break the silence and start talking about suicide with their patients. A generation ago, AIDS topped the nation’s list of medical taboos. The tide changed on that epidemic once we began to talk about it. Today, health practitioners must start to talk with patients about suicide. But not all clinicians are included in the new suicide-prevention law. Despite being the de facto U.S. mental health service providers, physicians and nurses negotiated an exclusion from the Matt Adler Act. They have their reasons, but consider this:

A study of more than 7 million Swedish adults over eight years found that of more than 8,700 people who died by suicide, 57 percent of the women and 45 percent of the men sought medical care – not mental health care – within three months of ending their own lives, and 25 percent sought care within two weeks of dying.

According to the Centers for Disease Control, an estimated 250,000 adult Washington residents will seriously consider suicide next year. Thousands will make a suicide attempt or plan. As many as 1,000 will die; more than 100 of them young people.

Of thousands at risk, many will see a physician, nurse, chiropractor or other health professional before they attempt suicide. They will present depression-related problems: sleep, appetite, fatigue, mood, concentration, anxiety, vague pain. Or they will have chronic obstructive pulmonary disease, cancer, spine disorders, asthma and stroke – medical conditions that double one’s risk for suicide.

A new bill to include all licensed health care professionals in the Matt Adler Act is being introduced in 2014 by Rep. Tina Orwall (D-Des Moines). Bring hope to the New Year; explore the bill, share your views with your legislators, family, friends, and anyone willing to help break the silence.

Lives depend on it.

Paul Quinnett, Ph.D., is president of the QPR Institute and a clinical assistant professor at the University of Washington Medical School. Marny Lombard is a writer, editor, and a mother whose son died by suicide in April.
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