Indianapolis-based Community Health Network is part of a new group of hospitals working together to stop suicide.

Research shows half the people who took their own lives interacted with someone in health care the month before their death, proving a window of opportunity exists for intervention. Those 30 days are crucial for the new Suicide Care Collaborative Improvement and Innovation Network.

Kimble Richardson, licensed mental health counselor at Community Fairbanks Behavioral Health, said he learned early in his career as a licensed mental-health counselor the importance of sharing best practices.

"Fast forward to 2023, we also are partnering in initiatives nationwide to make sure that we are leading the best practices in the nation," Richardson explained. "We can learn from each other and partner for better health outcomes, and you know, ultimately, to save lives. "

Suicide claimed around 48,000 lives in 2021, and in Indiana, the number of suicides completed has been higher than the national average for almost a quarter-century. If you or anyone you know is struggling or in crisis, help is available 24 hours a day, seven days a week, by calling or texting 988, the Suicide and Crisis Lifeline.

Richardson stressed mental-health issues are not signs of weakness and ultimately, there is hope. He added a conversation about mental health in any kind of space brings it into the open.

"This is a way to have a conversation, initially, with a person who might be inquiring, even on the telephone for help, or in person," Richardson pointed out. "There's an initial -- I'll call it a screening -- and then later, you could call it an assessment."

Julie Goldstein Grumet, vice president for suicide prevention strategy at the Education Development Center and director of the Zero Suicide Institute, said hospitals in the initiative will test, implement, refine and scale up innovations to improve the care provided to patients at risk.

"That is standardized that everybody in the system is trained to do, recognizes that there are protocols in place," Goldstein Grumet emphasized. "So that whether you're in Indiana or Florida, or New Jersey or Iowa, you are getting evidence-based, standardized, competent, caring, compassionate care."

In the next 14 months, participating hospitals will share their experiences to accelerate learning. The Suicide Care Collaborative Improvement and Innovation Network is a collaboration by The Pew Charitable Trusts and the Education Development Center.

Support for this reporting was provided by The Pew Charitable Trusts.

The mental healthcare landscape in Nebraska is being upended by policies for reimbursing providers who see patients covered by both Medicare and Medicaid. Systems say they're losing money, resulting in access gaps for older low-income clients.

Providers say the key concern has to do with serving patients considered dual-eligible, meaning they're enrolled in Medicare and Medicaid. This year, the federal government expanded the scope of professionals who can see Medicare patients for therapy and be reimbursed.

But Jon Day, executive director of Blue Valley Behavioral Health, said because of how Nebraska policy aligns with dual-eligible situations, practitioners are now seeing rates cut in half.

"More providers are coming out and saying, 'Oh my gosh, we can't see these people cause we're losing money.' So, we either refer them out, or they're not taking on people as well," he explained.

Day estimates a $200,000 revenue loss for his system and added that it's not easy to refer clients elsewhere because of provider "deserts" in some areas. Those working with the Nebraska Assocation of Behavioral Health Organizations have been meeting with state Medicaid leaders, noting the state can cover the difference without taking on extra costs. But progress on a final solution has been slow.

Providers say they understand the federal government's desire to bring more mental health professionals to the table in seeing patients. But they add unintended consequences at the state level almost defeat the purpose.

Chase Francl, CEO and president of the Mid-Plains Center for Behavioral Healthcare Services, said this is a heartbreaking situation.

"There's such a low margin on any behavioral health services, and any small disruption really can have catastrophic effects," he said.

Even though fixes offered by these providers are described as solutions without extra costs, they acknowledge the challenging environment given the appetite among elected officials to reduce the state's budget. As for the federal change that brought this situation to light, Licensed Independent Mental Health Practitioners can now be reimbursed under Medicare, and not just those with Masters or doctoral degrees in Social Work.

'Tis the season for celebration and good cheer. However, for many Michiganders, the absence of a loved one - whether through death, divorce or another painful separation - can make this time of year feel almost unbearable. According to the National Alliance on Mental Illness, 64% of people with depression report the holidays just make them feel worse.

Dr. Ibrahim Sablaban, a psychiatrist and addiction medicine physician at Corewell Health, offers a surprising insight: he says sadness is one of the most universal human emotions, and should be embraced.

"The worst thing somebody can do is really try to suppress feeling human - really suppress feeling lonely, feeling sad, feeling a sense of loss," he explained. "It's very easy to say, 'Oh, I need to get my mind off of so-and-so who passed away,' but that's not the healthy way forward."

If you or someone you know is struggling with a mental health crisis, help is available 24/7 - call or text 988, the Suicide and Crisis Lifeline, to connect with someone for free and confidential support.

While many enjoy Michigan's snowy holiday scenes, the state's long winters and reduced daylight can also worsen depression, especially for those with Seasonal Affective Disorder, the aptly-named "SAD." Dr. Sablaban advises sharing emotions with trusted family and friends, and reflecting on happy memories of loved ones.

"To be able to embrace the traditions and the things that you shared with that individual, even if they're not in your presence. To be able to keep those things alive," he continued.

Mental health professionals also emphasize that while family traditions can provide comfort and remembrance, it's okay to let go if they become too painful. Explore new ways to celebrate, and over time, new traditions will naturally evolve.


get more stories like this via email

On this Election Day, Indiana residents may be feeling the effects of what some are calling election stress disorder, but there are several ways to cope.

If you're suffering with anxiety related to the biggest day of the year for politics, Dr. Jennifer Embree - chief wellness officer and clinical professor at the Indiana University School of Nursing in Indianapolis - encourages taking a moment to pause before reacting to election-related news, especially on social media, and focusing on what you can control.

"When we pause, it's easier to take the emotion out of that situation and then really thinking about what exactly are you afraid of," said Embree. "What's the worst thing that can happen? And then, what issue impacts you the most?"

Deep breathing exercises can lower heart rates and reduce anxiety. One popular technique is known as box breathing: inhale for four seconds, hold for four, exhale for four, and hold again for four.

Medical experts caution against using alcohol or drugs to cope, noting the substances often disrupt sleep and ultimately do little to alleviate stress.

Instead, clinicians prescribe seeking professional help if stress becomes unmanageable.

Embree suggested connecting with supportive people who help keep them calm. For those greatly stressed, she recommended meditation, exercise, or even dancing to manage emotions.

"Think about the people that keep you calm and really are your support peope," said Embree. "Those are the people you need to be connecting with - not people that are going to make you more anxious, more upset, that's one thing - is to keep the calm around you."

While election outcomes are beyond individual control, Embree said maintaining personal well-being is key to victory in navigating this high-stress period and future events.