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Youth Suicides Higher With Shortage of County Mental Health Professionals
A shortage of mental health professionals working at the US county level is associated with increased youth suicide rates, according to new findings published in JAMA Pediatrics.
“Our results have relevance to policy considerations and the development of interventions to reduce youth suicides,” said lead author Jennifer A. Hoffman, MD, MS, Department of Pediatrics, Ann & Robert H. Lurie Children’s Hospital of Chicago, Northwestern University Feinberg School of Medicine, and co-authors. “Strategies to ameliorate mental health professional workforce shortages, such as workforce development programs and integration of mental health care into primary care and schools, may be considered in comprehensive youth suicide prevention programs.”
The retrospective, cross-sectional study utilized data from all US counties and all US youth suicides from January 2015 through December 31, 2016, comprising 5034 individuals. County mental health professional shortage areas were identified using the US Health Resources and Services Administration (HRSA) records that evaluate shortage areas on a scale from 0 to 25 based on factors including population, need for mental health services, and service availability.
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During the period under study, the annual countrywide suicide rate was 3.99 per 100,000 youth. Of the 3133 US counties that met study criteria, 2117 counties (67.6%) had mental health Health Professional Shortage Areas (HPSA) while 1016 counties (32.4%) had partial or no mental health HPSA designation.
The unadjusted annual suicide rate in counties experiencing a mental health professional shortage was 5.09 per 100,000 youth, compared with 3.62 per 100,000 youth in counties with partial or no shortage experienced. When adjusted for the socioeconomic and demographic profiles of each county, youth suicide rates were 1.16 times higher in counties with mental health HPSA designation compared to those with partial or no HPSA designation.
In a second model, county mental health HPSA status was linked with higher rates of youth death by firearm suicide rates. In a third model, the adjusted youth suicide rate rose by 4% for every 1-point increase in the county mental health HPSA score.
“Mental health problems are among the most common precipitating factors for youth suicide. Up to 1 in 5 children in the US has a mental health condition, but only about half of children who need mental health care receive it,” the authors noted. “Shortages of mental health professionals contribute to this unmet need, with geographic variation in workforce shortages across the US.”
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