WASHINGTON -- Every 90 minutes in the United States, a person 65 or older commits suicide.
It's a disturbing statistic. But behind it are other troubling numbers. Many of these patients visited their doctor before their suicide -- 20 percent within 24 hours of the act, 41 percent within a week and 75 percent within the previous month.
Therefore, raising physicians' awareness about their role in stopping suicide plays a central part in the "National Strategy for Suicide Prevention," released in May by U.S. Surgeon General David Satcher, M.D. The document establishes 11 clear goals and 68 measurable objectives for the public and private sector to work on together to prevent suicides and attempts.
"Only recently have we had the knowledge and the tools to approach suicide as a public health problem," said Satcher. And one of the most important aspects is the early recognition of depression and other mental health problems, he said.
Overall, suicide takes the lives of more than 30,000 Americans a year -- making it the eighth leading cause of death. More than 650,000 Americans attempt suicide annually. The problem also cuts across all ages and walks of life. Though older Americans are significantly at risk, suicide is also among the three leading causes of death for young people.
"Suicide is complex," said Bernard S. Arons, M.D., director of the U.S. Department of Health and Human Services Center for Mental Health Services. "And suicide is preventable.... The recommendations do not set out a cookbook approach but rather a framework to allow us to see where we all fit" into the effort.
The to-do list for physicians and other health professionals is far-reaching. The strategy focuses significant attention on the need to develop and promote more effective clinical practices. For instance, it seeks to better incorporate suicide-risk screening into primary care and increase the number of people with mood disorders who receive and maintain treatment.
"The country needs to recognize suicide as a preventable problem -- a public health problem," said Warren Jones, M.D., in an interview. He is a family physician who lives in Potomac, Md., and is president-elect of the American Academy of Family Physicians.
Jones echoed the surgeon general's emphasis on the critical link that primary-care doctors play in identifying those who are most at risk and in need.
"Family physicians and primary-care physicians play an extremely important role in prevention," Jones added. "We have continuity of contact -- longitudinal contact."
But Jones also is well aware of the challenges the doctors face in trying to help those at risk. One of his patients committed suicide.
The victim was relatively new to his care. Although Jones identified some of the signs, the patient dismissed his attempts to intervene. The experience reminds Jones of the level of trust necessary to make it possible for patients to tell their doctors the things they don't necessarily feel comfortable sharing.
"We've got to make it a part of what we do in every visit," he said.
