Comparing mass killing and inpatient suicide rates

The most recent tragedy in Newtown, Connecticut may be the catalyst to bring about change in a number of ways in our society and national psyche.  I happened to be visiting about 30 miles from there the week after this horrific event and that brought the sense of magnitude of this tragedy even more clearly in focus.  Many people I talked with that week were personally affected by this Newtown tragedy; one man told me that his nephew had watched as his teacher was shot in the face.  A young mother who lives about ten miles from Newtown told me about her feelings when she dropped her ten year old daughter off at school on Tuesday morning where there were police cars parked in front of the building.

While there, I read a front page story in the USA Today paper that Wednesday (December 19, 2012) which stated that during the five year period of 2006 through 2010 there were 774 deaths in the United States from mass killings; 161 of them were children under 12 years of age.  These deaths were the result of 156 separate incidents of mass violence.  These are sobering statistics that are creating a long overdue rethinking of both gun control and psychiatric care treatment systems in this country, among other things.

This very intense environment found me struggling to do business as usual and try to find ways to convince the bean-counters of the health care world that making physical improvements to the environment of inpatient and outpatient behavioral health facilities is the right thing to do.  The American Psychological Association releases studies periodically that include the number of psychiatric inpatient suicides on an annual basis.  These vary slightly, but average around 1,500 per year.  The five-year period of 2006 through 2010, therefore, would have accounted for around 7,500 suicides by PEOPLE who happened to be admitted to inpatient psychiatric facilities in this country.  This is nearly ten times the number of deaths from mass killings, but society as a whole doesn’t seem to notice or care.  I realize that similar comparisons can be made for everything from vehicular traffic deaths to cancer and many other causes.  Somehow, society in general seems to feel that the fact that these people were “mentally ill” makes the tragedy less horrible.  At least to those not closely associated to the victims.  

The Joint Commission recently released Sentinel Event data that suggests that the inpatient suicide numbers are increasing each year in spite of this being an identified as a National Patient Safety Goal for several of those years.  Yet many hospital financial officers still say that there is no funding to pay for the needed improvements to existing facilities or their much needed replacement.

I fully realize that behavioral health care will never be a profit leader for hospitals and health care systems and that finances are very tight in these uncertain, economically tight times. I have been told that some wrongful death law suits are now bringing judgments of between $10 million and $13 million. One large provider group reportedly did a study that determined that their AVERAGE cost per inpatient suicide was $1 million. Therefore, they would not spend more than that system wide to address improving suicide resistance of patient environments. I guess they finally had answered the ago old question of the dollar value of a human life.

I also notice that AFTER there is a serious incident in a facility, that there is always enough money to spend on fixing the immediate problems as well as pay substantial attorney’s fees and settlement/judgment awards to families of the victims. Wouldn’t it be nice to occasionally spend the money we waste on attorneys and settlements to victims’ families on actually improving the living environment of the facilities?  That might actually save the organization money over time by helping to reduce the needless loss of lives.  The fact that people get to keep on living and those around them don’t need to suffer through the tragedy is just an added bonus.  We all know the financial bottom line is the only thing that REALLY matters.