Skip to Content

Arnold School of Public Health

Facility ownership matters in the provision of suicide prevention programs, study shows

March 24, 2021 | Erin Bluvas,

Researchers at the Arnold School’s Rural and Minority Health Research Center have completed a study on the differences of facility ownership in suicide prevention programs in outpatient mental healthcare settings across the United States. Their findings, which were published in Psychiatric Services, revealed that the type of facility ownership (i.e., public, private non-profit, private for profit) significantly influences decisions concerning outpatient suicide prevention programs, including its availability, accessibility, and insurance coverage.

“Suicide is the second leading cause of death among youths and the 10th leading cause of death among all age groups in the United States, claiming over 45,000 lives annually,” says lead author Peiyin Hung, an investigator with the Rural and Minority Health Research Center and an assistant professor in the Department of Health Services Policy and Management. “Most mental health services are delivered in outpatient settings, which evidently mitigate detrimental outcomes for patients with suicidal ideation, suicidal attempts, and those who later die from suicide, but we have limited information about the availability of suicide prevention programs at these facilities.”

For this study, the researchers analyzed data from the 2019 Substance Abuse and Mental Health Services Administration Behavioral Health Treatment Services Locator. They examined the self-reported suicide prevention programs at nearly 7,600 mental health facilities with outpatient settings, comparing by ownership type (public, private non-profit, private for profit), rural versus urban location, facility type (e.g., hospital, residential, community), payment accepted (cash/self-payment, Medicare, Medicaid, private insurance), and age group treated.

Hung and her team found that only 61.2 percent of the outpatient mental health care settings nationwide offered comprehensive suicide prevention programs. “While two-thirds of publicly-owned facilities deployed these programs, only about half of private for-profit facilities did,” Hung said. “It’s encouraging that, as the study shows, those serving young adults and seniors, and facilities that accept Medicare were most likely to provide suicide prevention programs, given their higher demands.” However, the study also shows that facilities accepting Medicaid or uninsured patients are behind in suicide prevention program provision.

The researchers also found differences across ownership type by rurality of locations. Rural non-profit facilities were more likely than urban facilities to offer suicide prevention programs – a finding that encouraged the researchers as rural residents experience higher suicide rates, greater access to lethal means, and lower access to mental health and other general and specialized healthcare services. However, private for-profit facilities in more isolated rural communities were less likely to offer suicide prevention programs, likely exacerbating limited access to healthcare services. 

“Given the nationwide efforts to prevent suicide and the recent increases in mental health needs due to social isolation, unemployment, and financial distress, the maldistribution of suicide prevention programs should raise concerns,” Hung says. “Based on these findings, our next steps should be to understand the barriers and facilitators for deployment of suicide prevention programs that may improve access to these services for all, especially for high-risk patients in rural America.” 


Assistant professor Peiyin Hung, Rural and Minority Health Research Center contribute to Rural Action Plan

Peiyin Hung (HSPM) joins National Rural Health Association’s 2019 Rural Health Fellows Program

Challenge the conventional. Create the exceptional. No Limits.