Forefront volunteers played an essential role in helping this important bill about suicide prevention pass overwhelmingly in the House of Representatives (94-3) and unanimously in the Senate (49-0). They contacted legislators both by email, told their personal stories face-to-face on Lobby Day and testified at numerous public hearings. The final step was Gov. Jay Inslee's signature on March 27, 2014. Forefront thanks Rep. Tina Orwell for her leadership and unflagging efforts on behalf of this bill and suicide prevention.
HB 2315 has three important components, each of which has the potential to expand Washington’s capacity to help suicidal persons and to save lives.
In 2012, a law was passed that requires mental health professionals to have training in the assessment, management and treatment of suicide as a condition of having a license to practice. The bill proposed in the current session would extend the training requirement to doctors and nurses working in primary care settings.
More than half of all individuals who die by suicide visit their primary care physicians less than a month before taking their own lives. Most never see a mental health professional. It is critical that frontline health care providers are aware of their role and responsibility in the prevention of suicide and are equipped with the skills to save lives.
HB 2315 proposes a novel method to pilot-test a psychiatric telephone consultation line and a system for regional care coordination that doctors and nurses can use for patients for whom they have mental health concerns.
For doctors and nurses working in primary care settings, it is critical that they have the support they need in treating common mental health disorders like depression and in identifying and referring patients who are suicidal for mental health interventions. Many doctors and nurses do not work in integrated healthcare settings and do not have mental health providers available to assist them, necessitating a form of support like the one proposed.
HB 2315 proposes that Washington’s Department of Health develop a state plan to reduce lives lost to suicide across age groups.
Washington has a youth suicide prevention plan that is outdated and is not sufficient since it does not address the fact that middle-aged men, American Indian/Alaska Native residents, and veterans of the US armed forces die by suicide at the highest rates and in the largest numbers. Most people don’t realize that almost 1000 Washington residents die by suicide each year, representing a rate 14 percent higher than the national average. Furthermore, suicide is the second leading cause of death among Washington’s youth (ages 10-24).
Key back-up materials
- Washington State Injury and Violence Prevention, Chapter on Suicide, 2013.
- Suicide Education Study. Report to the Legislature, December 2013.
- Stuber, J and Quinnett P. (2013). Making the Case for Primary Care and Mandated Suicide Prevention Education. Suicide and Life Threatening Behavior 43(2): 117-124.
- Hilt, R. et al. (2013). The Partnership Access Line: Evaluating a Child Psychiatry Consult Program in Washington State. 167(2): 162-8.
- Gliatto, M. F., & Rai, A. K. (1999). Evaluation and treatment of patients with suicidal ideation. Am Fam Physician, 59, 1500–1506. Retrieved from http://www.aafp.org/afp/1999/0315/p1500.html
- Horowitz, L. M., Ballard, E. D., & Pao, M. (2009). Suicide screening in schools, primary care and emergency departments. Curr Opin Pediatr, 21(5), 620–627. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2879582/
- Ikeda, R. M., Kresnow, J., Mercy, J. A., Powell, K. E., Simon, T. R., Potter, L. B., . . . Swahn, M. H. (2002). Medical conditions and nearly lethal suicide attempts. Suicide and Life-Threatening Behavior, 32(s1), 60-67. Retrieved from http://onlinelibrary.wiley.com/doi/10.1521/suli.18.104.22.168.24207/full
- Luoma, J. B., Martin, C. E., Pearson, & J. L. (2002). Contact with mental health and primary care providers before suicide: A review of the evidence. Am J Psychiatry, 159, 909–916.
- Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., Haas, A., . . . Hendin, H. (2005). Suicide prevention strategies: A systematic review. JAMA, 294(16), 2064–2074. Retrieved from http://jama.jamanetwork.com/article.aspx?articleid=201761
- Puntil C. et al. (2013). Competency-Based Training for PMH Nurse Generalists. Inpatient Interventions and Prevention of Suicide. Journal of the American Psychiatric Nurses Association 19(4) 205-201.
- Stovall, J., & Domino, F. J. (2003). Approaching the suicidal patient. Am Fam Physician, 68, 1814–1818. Retrieved from http://www.aafp.org/afp/2003/1101/p1814.html
- Unutzer J., Harbin, H., Schoenbaum, M. and Druss, B. (2013). The Collaborative Care Model: An Approach in Integrating Physical and Mental Health Care in Medicaid Homes. Health Home Information Resource Center.