Relationships between Florida suicide, Medicaid enrollees, and involuntary examinations
The USF research team utilized archival data analyses and completed a descriptive analysis that included demographics, Medicaid enrollment patterns, and involuntary examination frequencies (e.g., Baker Act examinations, their timing related to suicides). Florida is the only state to maintain client level data on involuntary examinations. There were 7,128 deaths in Florida in the three-year period from 2004 through 2006 that were ruled suicides by a medical examiner. Of these, 1,147 individuals (16.09%) experienced at least one involuntary examination in the four years preceding their death. The number of involuntary examinations for this subset of individuals ranged from 1 to 29. There were 474 individuals (6.65% of the 7,128 people who died by suicide from 2004 through 2006) continuously enrolled in Medicaid for the year prior to their death by suicide. Of these 474 people, 231 were identified as having at least one Medicaid claim for a service related to serious mental illness (SMI) or severe emotional disturbance (SED) and 243 in the group who did not have SED or SMI related services. People in the SED/SMI group were significantly younger and more likely to be female than those in the non-SED/non-SMI group. The majority of people who died by suicide were divorced or never married (for all people, SMI/SED group, and Non-SMI/Non-SED group). The majority of deaths occurred at the person’s home. A small percentage of people who died by suicide had current or past military service. Additionally, of these 474 people, the number of involuntary examinations in the four years prior to death by suicide ranged from 1 to 17. Forty-one percent of this group who died by suicide had at least one involuntary examination in the four years prior to their death. There are two interesting groups within this forty-one percent: a) people with a long history of many involuntary examinations and b) those that had involuntary examinations quite close in time to their death. While 16.09% of the 7,128 people who died by suicide had experienced at least one involuntary examination in the four years before death, 40.15% of the subset that were continuously enrolled in Medicaid for the year before their suicide had at least one involuntary examination in the four years prior to death. This suggests that Baker Act receiving facilities are an important nexus at which issues related to suicide risk for people enrolled in Medicaid (especially those continuously enrolled in Medicaid for several years) can be addressed. Nearly 18% who were continuously enrolled in Medicaid in the year prior to their death by suicide had an involuntary examination within six months of death. These were people who had contact with at least one person (e.g., mental health professional, law enforcement officer, Baker Act Receiving staff) close in time to their death by suicide who felt they met involuntary examination criteria.