Maine’s reassessment of its involuntary commitment practices is compassionately centered on the goal of protecting from future harm those who live with serious mental health challenges (“Bill Nemitz: Where should Maine draw the line on involuntary commitment?” April 25, Page B1). Still, it is important to consider in this assessment the scientific evidence about how psychiatric hospitalizations affect the lifespans of those hospitalized.
A recent research review found involuntary psychiatric hospitalization is associated, with higher risk of suicide in the year subsequent to hospitalization, even after controlling for such factors as prior suicide attempts. Suicide risk is 100 times greater overall in the first three months post-hospitalization – 200 times greater for those admitted after describing suicidal ideas or making attempts. That is to say: Psychiatric hospitalization increases the odds of a suicide attempt even among those who were not suicidal before admission.
Also, and perhaps most surprising, receiving mental health care after hospitalization can be associated with greater suicide risk after discharge. The science confounds our common sense. We want to help people be safe and well, but well-intended hospitalization strategies that focus on protecting people from harm in the short term have just the opposite effect over time.
I would urge compassionate Mainers to consider how the global community has decreased suicide rates while the U.S. suicide rate has risen. International evidence-based approaches may be more helpful than expanding our use of hospitalizations that, the evidence shows, do not help.
Carlene Hill Byron