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Focusing on the reported growing use of firearms to complete suicide among African Americans, this article analyzes the 1993 National Mortality Followback Survey to examine the association of firearm suicide with race, education, geographic region, access to a firearm, depressive symptoms, and mental health service utilization on decedents aged 15 years and older. After controlling for demographic, socioeconomic, and clinical variables, the analysis indicates that African American men were twice as likely as White men to use a firearm to complete suicide. The findings suggest the importance for clinicians to screen for the presence of firearms in depressed African Americans and to reduce their access to firearms. In addition, clinicians, social workers, and public health professionals should consider racial differences in correlates of firearm suicide when designing prevention and intervention initiatives. Keywords: black suicide, firearms, risk factors, mortality

More Americans are going to an allied health professional in addition to seeing their regular doctor, according to data from the 1987 National Medical Expenditure Survey and the 1997 Medical Expenditure Panel Survey. Thirty-six percent of the patients in the survey visited an allied health professional in 1997, compared to 31% in 1987. Many were more likely to visit an allied health professional for preventive services rather than a doctor.

Introduction: Receiving a diagnosis of Alzheimer's disease or related dementias (ADRD) can be a pivotal and stressful period. We examined the risk of suicide in the first year after ADRD diagnosis relative to the general geriatric population. Methods: We identified a national cohort of Medicare fee‐for‐service beneficiaries aged ≥ 65 years with newly diagnosed ADRD (n = 2,667,987) linked to the National Death Index. Results: The suicide rate for the ADRD cohort was 26.42 per 100,000 person‐years. The overall standardized mortality ratio (SMR) for suicide was 1.53 (95% confidence interval [CI] = 1.42, 1.65) with the highest risk among adults aged 65 to 74 years (SMR = 3.40, 95% CI = 2.94, 3.86) and the first 90 days after ADRD diagnosis. Rural residence and recent mental health, substance use, or chronic pain conditions were associated with increased suicide risk. Discussion: Results highlight the importance of suicide risk screening and support at the time of newly diagnosed dementia, particularly for patients aged < 75 years. [ABSTRACT FROM AUTHOR]

The treatment of depression on an outpatient basis increased in the 1990s. This was due to a greater use of drugs versus psychotherapy, using drugs with fewer side effects, rapid methods for diagnosing depression in a doctor's office, and the existence of third-party coverage., Context: Recent advances in pharmacotherapy and changing health care environments have focused increased attention on trends in outpatient treatment of depression. Objective: To compare trends in outpatient treatment of depressive disorders in the United States in 1987 and 1997. Design and Setting: Analysis of service utilization data from 2 nationally representative surveys of the US general population, the 1987 National Medical Expenditure Survey (N=34459) and the 1997 Medical Expenditure Panel Survey (N=32636). Participants: Respondents who reported making 1 or more outpatient visits for treatment of depression during that calendar year. Main Outcome Measures: Rate of treatment, psychotropic medication use, psychotherapy, number of outpatient treatment visits, type of health care professional, and source of payment. Results: The rate of outpatient treatment for depression increased from 0.73 per 100 persons in 1987 to 2.33 in 1997 (P Conclusions: Between 1987 and 1997, there was a marked increase in the proportion of the population who received outpatient treatment for depression. Treatment became characterized by greater involvement of physicians, greater use of psychotropic medications, and expanding availability of third-party payment, but fewer outpatient visits and less use of psychotherapy. These changes coincided with the advent of better-tolerated antidepressants, increased penetration of managed care, and the development of rapid and efficient procedures for diagnosing depression in clinical practice.