How Saving Lives Can Save Money

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A study published by Journal of Suicide and Life-Threatening Behavior set out to examine the true and updated cost of suicide by looking at reported suicides and also accounting for unreported attempts and calculated both the direct and indirect costs associated with such suicidal acts. In 2013, the cost of reported suicide and suicide attempts was $58 billion and the study found that after adjusting for underreporting the true cost was instead $93 billion.

The direct costs are those that were directly related to the treatment of the injury and the indirect costs are the productivity losses of premature death such as the net value of future salaries or the productivity that is lost as a result of the injury. After examining these costs, the study determined that indirect costs made up 97% of the total cost suicide acts.

The article also notes that “1 in 10 deaths by suicide were by people who had been seen in the emergency department within 2 month of their death” highlighting the need to fund and implement early intervention programs.

The study conducted interviews about tertiary care that is supposed to happen after the first incident focusing on the existing care process, barriers to effective care delivery, how they could improve care delivery. The findings identified a lack of capacity and expertise to screen for suicidal behavior in emergency departments, difficulties securing community based behavioral health resources, challenges in communicating with therapists, and a poor system for following up with referrals.

Some of the recommendations that they provide for improving care after suicidal acts are:

  • Requiring every patient in emergency or trauma units get a comprehensive suicide assessment and be connected to the appropriate services such as hospitalization or brief treatment before being discharged as well as providing referrals to community based behavioral health providers
  • Collaboration from emergency departments, inpatient services, and the community to come up with a comprehensive list of services and providers
  • Development of a good network to establish comprehensive support services
  • Develop better ways to keep track and make sure patients follow through with referrals to those continued services

Although providing more extensive services would increase the medical (direct) costs of suicide by $2.7 billion, the study projects that psychotherapeutic and other interventions would lower overall suicides by 10% resulting in savings of $9.4 billion leaving a benefit-cost ratio of 6 to 1.

 

By Nixi-Cruz Sanchez, Mental Health Intern, Office of Diversity and Equity