Suicidality and Mismanaged Care

Abstract

The numbers speak for themselves and seem to cry out for increased outreach and provision of services. Yet, the reality of healthcare in the U.S. is that it is access to policy benefits is difficult, placing those who are perhaps least able to negotiate the bureaucratic maze of the healthcare industry in the unenviable position of having to fend for themselves. Rather than listening to the concerns of treating clinicians, determinations are made by individuals with rather clear conflicts of interest—the latter’s mandate is to limit care and they have the power to do so. That adverse decisions are rationalized not as denials of care, but as denials of reimbursement to providers and institutions for medically unnecessary services strains credulity. While the escalation of medical costs and its containment is a legitimate concern, let’s not place the burden of cost-cutting on our most vulnerable and needy citizens. Suicidality is not only an urgent concern, it is an ultimate concern. Proper evaluation and treatment by highly-trained mental health professionals is essential and often can be provided only in an inpatient setting where patient safety is a priority. It is an ethical obligation of those involved to insure that those most in need receive proper care.