It is interesting to look at the progress made in behavioral health since the unprecedented passing of the Kennedy-Johnson Community Mental Health legislation of 1963. The fragmented old system of treatment consisting of private-practice psychiatrists, mental hygiene clinics and regional state hospitals has been replaced by a comprehensive community-based system of care.

This community-based system provides emergency and acute care services, counseling, alcohol and drug treatment, day hospital, and rehabilitation services for severe and persistent mental illness that focus on recovery. More work remains to get all of the severely mentally ill into adequate housing and to lower the excessively high unemployment rate among these seriously ill but potentially productive people.

While there has been a slight decline in national and local suicide rates, self-inflicted death remains a predominately white male phenomenon. Age is a factor in that the greatest potential for suicide exists between the ages of 25 and 55. Women account for fewer than 25% of these deaths and African Americans account for less than 10%.

No one season or time of year seems to be a factor. Holiday blues don’t seem to be significant. The person contemplating suicide most often chooses firearms, but hanging and asphyxiation are the second and third most frequent methods of suicide. Women attempt suicide more often than men, but men complete suicide much more frequently; women generally utilize less violent means.

We need a national scholarly effort to research causes, treatment and prevention of suicide. While current access to emergency psychiatric care is available, few individuals seriously contemplating ending their lives seek care.

All of us can learn more about suicide, events and factors that lead to an attempt on one’s life. Since suicide is rarely a brief impulse matter, loved ones can learn to recognize warning signs and try to intervene.

Often a person talks of suicide, makes threats and plans to acquire the means; they get personal affairs in order while distributing prized possessions. Persons who talk or hint about suicide actually make the attempt.

Unemployment, loss of financial stability, loss of significant love relationships, and loss of good health, access to weapons, and having another family member complete suicide are all important factors in determining who actually makes an attempt on their own life.

Three psychiatric illnesses are closely associated with increased suicide risk: major depression, bi-polar mood disorder, and schizophrenia. Studies confirm that alcohol and drugs complicate mood and thought disorders, which can then cause increases in suicidal thoughts, suicide attempts and suicide rates.

Even though suicide rates across the nation have remained relatively constant over the last three decades, there are still things that can be done to reduce the likelihood that a loved one or friend would take his/her life.

We need to heighten awareness of who is at greater risk for attempting suicide, such as Caucasian males between the ages of 25 and 55, those who have experienced loss of health, unemployment, love relationships, those with previous suicidal attempts or those who verbalize suicidal thoughts. There is also new thinking that agitation, irritability and anxiety may also play a role in who actually completes suicide.

Family members who suspect that a loved one is contemplating suicide should move quickly to get a psychological evaluation. Family members and trusted friends are often the most effective in persuading the troubled person to be evaluated. In very high-risk situations, law enforcement and the courts can facilitate a psychological assessment.

Often the person at risk for a suicide attempt fears “being kept at a facility.” Yet there are treatment resources in addition to inpatient care, such as day hospitals, outpatient psychotherapy and medication.

I urge all of us to be aware of the risk factors associated with self-inflicted death. The need to get a mental health assessment for any person at risk is paramount.