Holding the Lifeline
A Guide to Suicide Prevention

Module 3: Substance Abuse as a Major Contributor to Suicide - Page 12 of 17

Systemic Barriers

Up to two-thirds of people who die by suicide are not receiving mental health or substance abuse treatment at the time of their death. ref

Another major barrier for individuals is the fact that typically services for mental health disorders and those for substance abuse disorders have been kept in separate streams. For example, a mental health therapist would refer an individual with a substance abuse problem to treatment at a substance abuse treatment facility or center, thus prematurely stopping the mental health treatment.

It has not been unusual for people seeking treatment for substance abuse issues to be told to get clean and sober before receiving mental health treatment. It has also been commonplace for 12-step abstinence programs to discourage the use of all medications, including anti-depressants, anti-anxiety medications, and other similar drugs.

Only recently have experts identified the need for a holistic approach toward treatment so that co-occurring conditions are addressed together.ref However, a significant shift in the mindset of both mental health and substance abuse treatment providers is still required to unify the treatment of both kinds of disorders together.

A common emergency room scenario, as described by Dr. Richard McKeon, who is heading the Substance Abuse and Mental Health Services Administration's efforts to incorporate a unified approach toward mental health and substance abuse treatment and prevention, features an intoxicated, suicidal patient who is held in the emergency room until his blood alcohol level drops. He may be discharged if the suicidal behavior is no longer presented once the alcohol wears off. Yet, although research shows that substance abuse may result in impulsive suicide attempts, there is rarely follow-up after discharge. ref

Obstacles to Care for Persons With Mental Illness:

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