Suicide Ideation in US Nursing Homes: Institutional Freedom Versus Institutional Paternalism

Barak focuses on the suicide ideation in the US nursing homes, exploring institutional freedom and institutional paternalism. Data regarding whether being housed in a nursing home is a risk factor for suicide were scarce and inconclusive but in recent years, it has been established that the time immediately before and after the transition to LTC is a time of risk for suicide. Temkin-Greener et al. present in this issue a comprehensive assessment of suicidal ideation (SI) among more than 2 million new postacute and long-stay nursing home admissions. Despite the drawback that SI was based on responses to one item on the PHQ-9 scale, this is a laudable effort. Prevalence rates of SI were highest at admission (1.24% for postacute and 1.84% for long stay and declined thereafter.