76 These deaths came at a total lifetime cost of 304 billion or 91 percent of

76 these deaths came at a total lifetime cost of 304

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medically treated self-inflicted injuries of which over 29,000 (9 percent) were suicide deaths. 76 These deaths came at a total lifetime cost of $30.4 billion, or 91 percent of the total cost of all self-inflicted injuries. The vast majority of these costs are attributed to lost productivity. In this same year, the economic burden of depression was estimated at $83.1 billion of which $5.4 billion were suicide-related mortality costs. 74 Hospital readmissions for suicide attempts and repetition in general are quite common. 23, 24, 77 Fewer than 15 percent of individuals making suicide attempts account for over 50 percent of the medical expenses ascribed to all suicide attempts, according to one study. 78 Some important conclusions come from these many investigations: First, individuals making suicide attempts are at considerable risk for repeat attempts and eventual suicide death. Second, this risk may last many, many years. Third, suicide attempts produce significant morbidity and multiply associated costs. Fourth, being discharged from an emergency department or a psychiatry inpatient unit after being treated for suicidal behaviors should link patients with certain and effec- tive treatments. Another conclusion has paramount implications for public policy: The lethal and powerful re- lationships between suicide and suicide attempts prescribe one essential means for effective suicide prevention. Targeting high risk individuals that attempt suicide and providing them with anti-suicide therapeutics is a suicide prevention strategy that has great potential for saving large numbers of lives. Access to care and clinical interventions are critical elements for the prevention of suicide. 79 The effectiveness of this strategy crucially depends on motivating patients discharged from emergency departments and psychiatry inpatient units to follow up with the recommended treatment plan. In turn, this motivation depends on fundamentally sound continuity of care, coor- dination of care and high-quality clinical practices and procedures. This report explores the under- pinnings and benefits of this overall approach to suicide prevention. In so doing, this report will summarize the relevant evidence base, make recommendations for clinical practice and for new directions in public policy based on the extant research, identify the most critical gaps in knowl- edge, and suggest direction for new research to fill those gaps. The intended primary audience for this report is policymakers who govern systems of care and research programs.
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Continuity of Care for Suicide Prevention and Research 22 About the subsequent text: All sections have an ending synopsis called “ Section-at-a-Glance .” Similarly, “ Section Commentary ” is used in this report’s Part Eight that reviews specific suicide prevention programs in the United States and other countries. “Section-related Recommendations” are found at the end of each section as well. These recommendations tend to pertain most to the subject matter of that section. All recommendations are mentioned in the Summary found at the beginning of this report. Many of these recommendations are deliberately broad and intended to
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