Recognize signs for preventable public health crisis

Arizona ranks in the top half of states for adults reporting symptoms of anxiety and depression. The number of suicides in the state increased in 2021, after leveling off the two previous years. It is an upward trend that moves us backward.

National days, weeks, and months, including Suicide Prevention Awareness Month and Depression Education Awareness Month, shed light on the issues. However, elevating our awareness and vigilance in recognizing the signs and risk factors for this preventable public health crisis can be lifesaving every day of the year.

The 2021 Arizona suicide rate was 35% above the national rate of suicide that year. Suicide is the second-leading cause of death for Arizonans ages 10-34.

Understanding behavioral health

Behavioral health describes the connection between behaviors and health and well-being. It encompasses emotional, social and psychological resilience and well-being, as well as the treatment of mental health and substance use disorders.

Fleeting thoughts of suicide in moments of desperation are more common than you might think. Many people with suicidal thoughts never act on them. But risk factors that make attempts much more likely, include having one or more serious mental health conditions like depression, anxiety and/or substance use disorder. One of the strongest predictors of death by suicide is a history of a previous suicide attempt.

Factors that can decrease a person’s risk include being a parent, having strong religious beliefs and maintaining supportive social connections.

Breaking the stigma  

The Covid pandemic added another layer of stress and uncertainty to an already increasing trend in suicide rates. A spotlight has been shone on behavioral health and wellness, offering an opportunity to reduce the stigma that can be attached to asking for help. The pandemic highlighted that no one is immune from having a behavioral health condition, but we need to do more to eliminate stigma and reduce the risk of suicide to zero.

Making strides 

It is important to note the progress we have made.

The Mental Health Parity and Addiction Equity Act, otherwise known as the Federal Parity Law, requires insurance coverage for mental health conditions, including substance use disorders, to be no more restrictive than insurance coverage for other medical conditions.

In Arizona, Jake’s Law, enacted in 2020, requires health care insurers to cover mental health without additional barriers, just like they would cover annual physicals.

Connecting the dots 

Behavioral health and physical health are equally important and can impact one another. Integrating behavioral health care with primary care and taking a more holistic approach to all individuals with chronic health conditions reduces stigma by making the discussion of behavioral health a routine part of primary care visits. Integrated practices are growing in Maricopa County, which will hopefully make mental health specialists available for more complex conditions that need a specialist and increase access to behavioral health care.

Be a part of the solution  

You do not need to be a medical professional to help someone who is struggling. Anyone can sign up for Mental Health First Aid (MHFA), an eight-hour, evidence-based training course that gives you the tools to assist and provide initial support to someone experiencing a mental health or substance use concern or crisis until they can get professional help. Blue Cross Blue Shield of Arizona offers MHFA training to Arizona businesses and their employees.

Continuing the conversation 

Suicide is a tragedy and public health crisis. Let’s keep the momentum going year-round by continuing the conversations, focusing on primary care prevention, making access to behavioral health services easy and increasing community support.

If you or someone you know needs immediate help, there are resources that provide confidential crisis support 24/7. Call, text, or chat 988. Dialing 988 will reach the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline) from anywhere in the U.S.

Dr. Sandra Zebrowski is corporate medical director of behavioral health at Blue Cross Blue Shield of Arizona.