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Hope for people who injure themselves? Health reform means help (part 1)

By Dr. Alice Chen

Journal Watch Psychiatry reported this week a pretty sobering statistic about people who injure themselves:

"A single emergency department (ED) visit for deliberately self-injurious behavior is associated with a sixfold increased lifetime risk for suicide. To examine how patients with self-injury are treated, researchers reviewed Medicaid records for adults treated in EDs for self-harm in 2006. Of 7355 visits, 4595 visits (62%; 4440 patients) involved discharge to the community, and 2760 visits (38%) involved admission to the hospital.

Of the patients who were sent home, only 48% had a mental health evaluation in the ED, and 52% received outpatient follow-up in the next 30 days."

As any doctor of any specialty knows, mental health is a major contributor to physical illness. Treat the mental illness, and it becomes far easier to take care of chronic diseases like diabetes and heart failure and to keep patients from landing in the hospital. And yet too often, patients with mental illness don't have access to the help they need (see prior Doctors for America posts by neurologist Dr. Laura Davies and psychiatrist Dr. Dora Wang). See our next post for how the Affordable Care Act will help.

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