• Certain populations face additional barriers to treatment that increase their vulnerability to suicide. For minors and aged adults, transportation and/or permission of family members present challenges to obtaining treatment. Barriers for incarcerated populations include lack of mental health care staff and, at times, either outright denial of care or forced treatment. Minority populations face discrimination and may refuse seeking professional care because of mistrust. Developing countries suffer severe lack of specialist care.

Efforts should be made to bridge the barriers to proper treatment in under-served, at-risk populations. Culturally appropriate strategies to increase access and utilization of mental health services should be employed.

  • Lack of adequate insurance coverage for mental health services represents a critical barrier to treatment for mental disorders, including substance use disorders, that increase suicide risk.

Insurance coverage equal to that of general health services should be extended to mental health services. Such action is projected to reduce suicide via increasing access to care for those at risk. Laws and policies mandating insurance coverage parity for mental health services are likely necessary before third-party payers will cover clinically adequate mental health services. Uninsured adults and children must be provided with effective treatment. Novel approaches to funding need to be explored, since current funding mechanisms are not adequate.

REFERENCES

AAP (American Academy of Pediatrics, Committee on Adolescence). 2000. Suicide and suicide attempts in adolescents. Pediatrics, 105(4 (Pt 1)): 871-874.

Adebimpe VR. 1981. Overview: White norms and psychiatric diagnosis of black patients. American Journal of Psychiatry, 138(3): 279-285.

Agnew R. 1998. The approval of suicide: A social-psychological model. Suicide and Life-Threatening Behavior, 28(2): 205-225.

Al-Jaddou H, Malkawi A. 1997. Prevalence, recognition and management of mental disorders in primary health care in Northern Jordan. Acta Psychiatrica Scandinavica, 96(1): 31-35.

Anno BJ. 1991. Prison Health Care: Guidelines for the Management of an Adequate Delivery System. Washington, DC: U.S. Department of Justice, Department of Corrections.

APA (American Psychiatric Association). 1994. The Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC.

Appleby L, Amos T, Doyle U, Tomenson B, Woodman M. 1996. General practitioners and young suicides: A preventive role for primary care. British Journal of Psychiatry, 168(3): 330-333.



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