Suicide is Never Painless

I am reposting this entry because it has been brought to my attention that the term “committed suicide” reflects negatively on people suffering from severe depression and facing untenable circumstances that leads to suicide.

The haunting melody of the song “Suicide Is Painless” filled millions of American homes as the theme song for the television seriesM*A*S*H that ran from 1972 to 1982 starring Alan Alda and Donald Sutherland as battlefield doctors serving in Vietnam.  The show was based on the 1970 motion picture of the same name.  The song’s lyrics were written by Mike Altman, the 14-year son of the film’s producer Robert Altman, after the elder Altman gave up trying to write lyrics with the desired amount of absurdity.  The mere idea of suicide being painless is patently absurd.  Every suicide has multiple victims.  In some cases, entire communities and—yes, the entire nation can be impacted.

The Center for Disease Control released its Morbidity and Mortality Weekly Report last week detailing violent deaths in the United States based on data reported to 16 states.  From these data collected in 2010, it is estimated that approximately 55,000 violent deaths occur annually in the United States.  Of these violent deaths, about 38,000 are the result of suicide.  Another 16,000 were homicides.  The 16 states reported 16,186 violent deaths in the United States in 2010.  Of these, 10,167 (62.5%) were suicides and 3,949 were homicides or caused by legal intervention.  Nearly four times as many males experienced death by suicide as females.  Native Americans and Alaskan Natives had the highest rates of suicide, followed by non-Hispanic whites.  The highest rate of suicide among age groups was among persons 45-54 years old.  Firearms were used in more than half (51.7%) of suicides and homicides (66.2%).

The CDC’s National Violent Death Reporting System (NVDRS) began collecting data on violent deaths in 2003 from seven states and collected data in 2010 from Alaska, Colorado, Georgia, Kentucky, Maryland, Massachusetts, New Jersey, New Mexico, North Carolina, Oklahoma, Oregon, Rhode Island, South Carolina, Utah, Virginia and Wisconsin.  It plans to collect data from all 50 states and the District of Columbia in the future.

Suicides have captured the public attention recently because of high rates of suicide occurring among military personnel.  The suicide rate among veterans at 30 per 100,000 is more than twice the rate of the general population at 14 per 100,000.  It is estimated 49,000 veterans experienced death by suicide between 2005 and 2011.  Nearly one in every five suicides nationally is experienced by a veteran.  As many as 22 veterans experience suicide daily in the United States.  Veterans 65 years and older experienced the majority of suicides.

Congress weighed in on the issue, passing H.R. 327—the Joshua Omvig Veteran Suicide Prevention Act—signed into law on November 5, 2007, directing the Secretary of Veteran Affairs to develop a comprehensive strategy to reduce suicides among veterans.  The military has acted to get in front of the issue with psychological assessments of military personnel before they are deployed.  However, military personnel are wary of these assessments because of the potential negative impact they may have on a soldier’s career.

To address suicides generally, Rep. Tim Murphy (R-PA18) recently introduced H.R. 3717—theHelping Families in Mental Health Crisis Act of 2013—a comprehensive bill that will address severe mental illnesses and other precursors of suicide.  The bill contains a number of policies that would boost suicide prevention efforts such as: expanding Medicaid reimbursement of inpatient psychiatric treatment, reauthorizing the Mentally Ill Offender Treatment and Crime Reduction Act (MIOTCRA), reauthorizing the Garrett Lee Smith Suicide Prevention Act, improving access to psychiatric medication in Medicaid and Medicare, and increasing resources for research at NIMH on early identification of serious mental illness in youth.  However, the bill would also transfer authority for administering the mental health and substance use Block Grants from SAMHSA to a new Assistant Secretary for Mental Health and Substance Use Disorders, reduce or eliminate funding for certain other SAMHSA programs, and eliminate the authority of state Protection and Advocacy programs to engage in lobbying and class action lawsuits.

The bill currently has 38 co-sponsors including three Democrats.  As desirable as the provisions to address mental illness and suicide are, it would do serious damage to the current system.  Social workers need to keep a keen eye on this bill.  The National Alliance for Mental Health (NAMI) is currently reviewing the bill and will make its recommendations soon.