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Although outpatient treatment of psychiatric problems can be cost-efficient, a new study indicates that suicidal individuals treated for addiction as inpatients are significantly more likely to abstain from alcohol and drugs.
Mark Ilgen and his colleagues at the Veterans Administration Palo Alto Health Care System in California compared outcomes for addiction patients who had and had not reported suicide attempts and who were treated either as outpatients or during an extended hospital stay. All the patients had serious substance abuse problems, such as alcohol or cocaine dependence. Individuals who had reported a recent suicide attempt and were treated in the hospital did significantly better than any of the others: an 88 percent rate of abstinence from drugs six months later, compared with rates of around 60 percent for the rest.
Inpatient protocols—in this case, the average stay was 23 days—are expensive, but Ilgen notes that substance abusers who are suicidal often require several kinds of physical and mental health services again and again. “If this intensive treatment really does help them maintain abstinence over the long term, it would be cost-effective,” he says, reducing the drain they would otherwise impose on the health care system.