Proposed legislation that aims to prevent suicide among older Americans and
establish a suicide-prevention program for veterans are among several
suicide-reduction measures making their way through Congress.
Senate Majority Leader Harry Reid (D-Nev.) introduced the Stop Senior
Suicide Act (S 1854) in July. The bill is targeted at older adults, an age
group with the highest suicide rate in the United States. Nearly 7,000 older
adults died by suicide in 2004, the most recent statistics available from the
Centers for Disease Control and Prevention.
The bill would authorize formation of the Interagency Geriatric Mental
Health Planning Council to make recommendations on the integration of services
for mental health, suicide prevention, physical health, and aging. Funding
would be through government grants and go to public or private organizations
that plan and implement elderly suicide intervention and prevention
The bill also would improve Medicare's mental health benefits by lowering
patients' copayment rate for outpatient mental health services to equal the
rate for other outpatient services.
Jerry Reed, executive director of the Suicide Prevention Action Network
(SPAN USA), said the bill is an important step forward in addressing some of
the challenges facing older adults, which include depression, mental illness,
loneliness, and isolation. A critical part of any suicide-prevention effort is
expanded access to mental health care, he told Psychiatric News. The
bill's critical feature would correct the discriminatory copayments the
government requires for outpatient mental health services in Medicare.
Reid, who lost his father to suicide in 1972, said the vulnerability of
older adults to suicide is not well known and that the unacceptably high
suicide rates among the elderly must be addressed.
"These findings do not just constitute a serious public health
problem," Reid said in a Senate floor speech. "They also conflict
with America's belief in living our golden years in dignity."
Another new initiative is legislation to establish the first comprehensive
suicide-prevention program for veterans. The Senate Veterans Affairs Committee
approved a bill (S 479) in late June that would direct the secretary of
Veterans Affairs (VA) to develop a comprehensive program to reduce the number
of suicides among veterans.
The legislation, passed by the House in March (HR 327), would create a
program that provides mandatory training for "appropriate" VA
staff and contractors, including medical personnel, who interact with
veterans; screen veterans for suicide risk when they receive medical care;
refer at-risk veterans for counseling and treatment; require
suicide-prevention counselors at medical facilities; require veterans' mental
health care to be available 24 hours a day; and provide outreach and education
for veterans and their families.
The House bill, called the Joshua Omvig Veterans Suicide Prevention Act,
was named for a 22-year-old combat veteran from Iowa who committed suicide
after an 11-month tour in Iraq.
The Senate bill's sponsor, Sen. Tom Harkin (D-Iowa), told
suicide-prevention advocates at a Capitol Hill luncheon in July that the Omvig
family told him that Joshua avoided mental health care when he needed it
because he was concerned its presence on his medical record would hurt his job
"That's the kind of stigma we are up against," Harkin said.
He urged supporters of the measure to keep up pressure on members of
Congress to get the bill enacted to benefit the one-third of returning
veterans who seek mental health care and the many others who also need it but
don't seek it.
Among the other legislative priorities for suicide-prevention advocates are
mental health insurance parity bills (S 558, HR 1424), which are progressing
separately in the House and Senate. The Senate reached a broad compromise
agreement among mental health advocates and insurance industry and business
representatives on language for the bill, while the House bill received its
first committee approval in July (Psychiatric News, July 20).
The parity measures would provide similar expanded coverage to the majority
of privately insured Americans as advocated for Medicare beneficiaries in
"Without mental health, you don't have total health," Reid
said, about SPAN USA's support of parity insurance coverage.
Sen. Gordon Smith (R-Ore.) urged support for renewal of the Garrett Lee
Smith Memorial Act, which was the first federal law to provide funding for
programs to prevent youth suicide. It will expire in 2007 without renewal
(Psychiatric News, November 19, 2004). The law was named for Smith's
son, who was diagnosed with bipolar disorder and eventually committed
"Hardly a week goes by that I don't get a letter from a parent who
says the funding in that bill helped save the lives of their children,"
Smith told prevention advocates in July.
SPAN USA also is urging a $1.5 million expansion of the National Violent
Death Reporting System (NVDRS), which collects data from medical examiners,
coroners, police, crime labs, and death certificates to understand the
circumstances around violent deaths, including suicides.
Although the NVDRS operates in only 17 states, suicide-prevention advocates
have found its data crucial to developing and evaluating suicide-prevention
programs. Six states have used NVDRS data to develop statewide
The suicide-prevention and other mental health bills can be accessed
by searching on their respective bill number at<http://thomas.loc.gov>.▪