Cambridge Health Alliance of Massachusetts is joining a new nationwide network of hospitals collaborating on suicide prevention.

Research shows nearly half the people who die by suicide interact with the health care system in the month before their death, providing a critical opportunity to save lives.

Julie Goldstein Grumet, vice president for suicide prevention strategy at the Education Development Center and director of the Zero Suicide Institute, said health care providers will use evidence-based methods to detect suicide risk and collect real-time data, as they would with other health concerns.

"We get our blood pressure and our weight just to kind of check there's not an underlying issue," Goldstein Grumet pointed out. "We need to do the same when it comes to suicide. We need to ask at every visit, every person."

Grumet pointed out when interventions are used with fidelity, hospitals can reduce suicide rates of people in their care by up to 75%. She stressed it is always important to ask people directly if they are considering suicide, and advise them to contact the nationwide Suicide and Crisis Lifeline at 988.

Over the next 14 months, participating hospitals will test and refine innovations to improve the care provided to patients at risk of suicide.

Fiona McCaughan, assistant chief nursing officer for Cambridge Health Alliance, said she hopes the new training will help build confidence and skills in her nursing staff, who ultimately spend the most time with patients.

"It's that nursing staff that is often first online and can see minor changes in somebody," McCaughan explained.

McCaughan noted many community-based supports for those at risk of suicide were lost during the pandemic, and she hopes the training will help families as those programs slowly return. The latest data reveal suicide claimed roughly 48,000 lives in 2021.

Support for this reporting was provided by The Pew Charitable Trusts.


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Gaps in mental health care are a common research topic right now and for Minnesota youth in rural areas, a new report showed their families face big obstacles in navigating the care system if their child displays symptoms.

In its analysis, the Center for Rural Policy and Development said long travel distances and a lack of information make it hard for parents in these settings to put a concrete plan together.

Marnie Werner, vice president of research and operations at the center, said other factors are at play.

"There's a desire for anonymity," Werner pointed out. "People don't necessarily want all their neighbors to know that their kids are seeing a therapist. And in rural areas, especially, there are just getting to be fewer and fewer people in the mental health field."

Because of a fragmented system, the authors say in a crisis, parents -- especially in rural areas -- often end up taking their child to the emergency room, which can create a host of other problems. As long-term solutions take shape, parents are encouraged to educate themselves about early warning signs and the basics of mental health. And if their child reaches a crisis point, the 988 Suicide and Crisis Lifeline is a resource to lean on.

Werner noted there is also an evolving approach to integrate mental health care with primary care.

"Having a therapist in the regular clinic," Werner explained. "Mental health has often been siloed off to the specialty clinic. And so, with behavioral health integration, the doctor can bring the therapist in to meet you and your child while you're there at your appointment."

The authors said it is not a perfect solution but school-linked mental health services are increasingly becoming more dynamic, which can make it easier to seek assessments and schedule treatment on campus.

Meanwhile, the American Heart Association is raising awareness about establishing healthy routines like physical activity, which help improve mental health while preventing such conditions as anxiety and depression.

A U.S. Department of Justice investigation has found Kentucky is failing to provide access to community-based mental health services for people who need them, and instead relies too heavily on psychiatric hospitals.

The report says the state is potentially in violation of the Americans with Disabilities Act, or ADA.

Licensed Psychologist Sheila Shuster, who is part of the Advocacy Action Network, said years of budget cuts have reduced or eliminated the city's crisis centers - such as the Living Room, which opened its doors in 2018 and was shut down within a year due to lack of funding.

"Three to four hundred people a month coming in and using the services, and getting referrals," said Shuster. "And then boom, it's gone. So, that was May of 2019, and we don't have anything like it back in place."

The University of Louisville Hospital provides emergency psychiatric treatment to more than 2,200 adults with serious mental illness each year.

In a separate investigation last year, the Justice Department concluded the city and the Louisville Metro Police Department violated the ADA by subjecting people with mental illness to an unnecessary police response.

While the new report raises awareness about the needs of people living with mental illness, Shuster said it doesn't capture the full picture.

She cited recent changes the city has made, such its 911 call diversion program for mental health-related incidents, as well as families' view of the role of hospitalization.

"By and large, what I hear from the family members is not that their loved ones are being kept too long in the hospital, but that they're not being kept long enough," said Shuster, "which I think is what is leading to the revolving door."

Marcie Timmerman, executive director at Mental Health America of Kentucky, said the focus should be on early intervention and treatment, so folks don't end up being involved with the police.

"We would love to have more providers available," said Timmerman. "I'm not sure that pinpointing our psychiatric hospitals is really helpful."

She added that a mobile crisis response system, and Medicaid-funded housing and support programs, could help reduce the number of people who continue to cycle through hospitalization and the criminal legal system.





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Mental health experts have released a checklist for parents of students headed back to school in Montana.

Research shows kids who need services are often go without and substance abuse and mental health experts say half of students who are clinically depressed are not getting the mental health care they need.

Caitlin Hochul, vice president of public policy for the mental health advocacy organization Inseparable, said it is important services are available to students as they return to school.

"They help improve access to care and are really one of the most effective tools we have to help
improve children's mental health well-being," Hochul explained. "We are reaching kids where they spend most of their time, and that is in schools. "

The U.S. Department of Education said young people who get school-based services are six times more likely to complete treatment than those who get their services in community settings. A program at Montana State University has shown success in reducing the teen suicide rate by increasing mental health literacy among young students.

Hochul pointed out research showed increasing mental health literacy decreases symptoms of depression, and noted there are several steps to achieving the goal.

"One is making sure that kids understand what brain health is, what mental health is, similar to physical health education," Hochul outlined. "Then there's also training up staff and teachers, too, so they're understanding warning signs and can help with suicide prevention and substance use disorder prevention."

Hochul added regular mental health check-ins with kids, even if they are just informal, can help identify students who may need support.