Broken Arm? Come On In. Broken Mind? Get in Line.

By Erik Osland, CEO

Suicide by the numbers:

• 2022 had the highest number of deaths by suicide ever recorded in the U.S. – Mental Health America
• Nearly half of people who died by suicide visited their primary care provider (PCP) within months of their death. – The Joint Commission
• 94% of adults surveyed in the U.S. think suicide can be prevented – American Foundation for Suicide Prevention

Most people don’t think twice about a cracked vase. It sits on a shelf, unnoticed, quietly holding itself together until one day it shatters into pieces on the floor. The warning signs were there all along, but no one cared until it finally broke.

America turns the same blind eye depending on what’s broken – even if it’s a matter of life and death.

Not all crises are treated as emergencies by America’s healthcare system.

Physical health crises, such as broken arms, are often visible, easily understood, and receive immediate treatment, even if the bone isn’t poking through the skin.

Mental health crises, such as suicidal ideation, are often invisible, not easily understood, and treatment is delayed, even if you’re contemplating.

But here’s the kicker: Suicidal ideation doesn’t qualify as a medical emergency unless there’s explicit intent or a plan to act on it. Imagine telling someone their broken arm isn’t an emergency unless the bone is poking through their skin.

Desperate to escape their mental torment, patients with suicidal thoughts must endure further suffering: the waiting room, often for hours on end. Staff may eventually perform a self-harm risk assessment, but rarely include treatment recommendations. If they’re lucky, patients may be admitted to inpatient psychiatric units, but still wait days or weeks for a bed at the hospital or another facility.

If not emergency rooms, where can they go? Their doctor’s office.

Today, primary care is the most likely point of contact for suicidal patients. It’s easy to see why: patients trust their doctor and don’t need an emergency to visit them.

However, not all patients enjoy the same experience. Some doctors are confident in their training and will prescribe antidepressants, antipsychotics or mood stabilizers, while others, lacking sufficient training, are understandably not comfortable addressing these symptoms. Some will screen each patient for mental health issues while others neglect to incorporate screening into daily practice.

When all else fails, many patients depend on referrals, yet nearly two-thirds of PCPs struggle to find community therapists to refer their patients to. And as many as 20% of patient referrals do not make it to treatment at all. Even with a referral, patients may wait weeks or months for the first available appointment.

Once again, suicidal patients find themselves, all alone, playing the waiting game.

Delaying treatment can escalate suicidal ideation to intent, a plan, and eventually an attempt.

Wherever they go, patients contemplating suicide face outdated protocols, inconsistent treatment, and worse outcomes. Who knows, maybe the person who unsuccessfully tried getting help is no longer with us.? Maybe things would be different if they had broken their arm instead.

Nobody should have to jump through so many hoops to save their own lives, especially when the U.S. saw its highest number of deaths by suicide in 2022—the highest ever recorded. They deserve to be seen, heard, and treated, not brushed off, ignored, and turned away.

The best way forward is collaborative care. Lives depend on it.

For starters, primary care is the front door for mental health treatment. Second, people who die by suicide are more likely to have seen their doctor in the month before their death than any other healthcare provider. Finally, patients don’t need to be in a state of emergency to receive help.

A collaborative and proactive approach can mean the difference between life and death. Collaborative care, especially my company evolvedMD’s approach, is the most comprehensive and effective solution.

Ideation or intent, here’s how evolvedMD’s approach to collaborative care can help:

Screening: Some patients are more comfortable than others speaking about mental health issues, including suicidal ideation. Incorporating screenings into regular check-ups can help doctors identify risk much earlier.

Referral: When doctors identify risk, they can seamlessly and instantly refer their patients down the hall to our mental health therapist. This ensures timely help without unnecessary delays, reducing risk of suicidal ideation escalating to intent, a plan, or an attempt.

Integrated Care: Quality care requires uninterrupted collaboration. Here, the patient’s doctor and our therapist work together in one location to meet their needs, preventing patients from navigating America’s broken healthcare system alone.

Timely, Ongoing Treatment: Our mental health therapist addresses the patient’s emotional concerns while their doctor addresses physical symptoms. Together, they monitor the patient’s progress and provide continuous support, ensuring they don’t fall through the cracks.

Better Outcomes: Comprehensive, ongoing care leads to reduced suicidal ideation, depression, and anxiety in far less time than traditional care.

We’re proof that collaborative care saves lives.

At one of our partner’s primary care clinics in Utah—the state with the highest prevalence of adults experiencing serious thoughts of suicide—a patient walked in seeking help for suicidal ideation. Our mental health therapist immediately provided crisis support, developed a safety plan with the patient’s doctor, and began treatment on the spot. They weren’t turned away, told to wait, or referred out into the community with uncertainty. We took immediate action, and now, the patient routinely visits their doctor and our therapist—not because they’re struggling, but for regular wellness checks.

Emergency or not, suicidal ideation is a cry for help we can’t ignore.

I’m not saying it deserves more attention than other crises; I just want America’s healthcare system to treat mental health with the same urgency as physical health. Lives depend on it, and people depend on us to make it happen.

Through collaborative care, we can provide timely, compassionate, and comprehensive support that patients need to heal, thrive, and live long, happy lives. If you’re a primary care leader who wants to help your patients, partner with us today. They deserve comprehensive, high-quality, and efficient care, free from mental torment and the pitfalls of a broken healthcare system.