HEA027 Mental health care or depression treatment for transgender population leading to avoided suicide deaths

Number of participants: Reported by program.

Percentage of individuals who receive mental health care due to program: [0.52]. This is the percent of transgender patients, reported in a sample survey, who showed evidence of psychological distress but had not received mental health services in the past year (Shiperd et al., 2010).

Q: Impact of program on suicide deaths: [0.01]. To calculate this, we first estimate the mean effect size using the formula:

In this formula, OR is the odds ratio showing the impact of receiving timely transgender-specific mental health on suicide attempts [3.81] (Seelman, et al., 2017).  This results in an effect size of: ln(3.81)/1.65 = 0.81.

Then, we estimate the number of impacted participants is estimated using the formula:

Where ES is the effect size estimated from Seelman, et al. (2017) [0.81] the base percentage is the estimated percent of transgender individuals with successful suicide attempts [0.0036]. We estimate this by adjusting the percent of transgender individuals with suicide attempts [10%] (Seelman, et al., 2017) by the estimated rate of successful suicide attempts [3.6%]. We estimate this rate from the number of suicide attempts in the U.S. and the number of deaths by suicide in 2017 (NIH, 2017)

$ value per life saved: We estimate the value of a life based on a [$50,000] QALY. This value varies by the age and expected years of life of each participant. Thus, we compute total benefits of a program based on specific program data on participants age and discount the annual value to present value using Constellation’s standard discounting method.

Shipherd, J. C., Green, K. E., & Abramovitz, S. (2010). Transgender clients: Identifying and minimizing barriers to mental health treatment. Journal of Gay & Lesbian Mental Health, 14(2), 94-108.

Kessler, R. C. (2000). Posttraumatic stress disorder: The burden to the individual and to society. Journal of Clinical Psychiatry, 61(5).

Seelman, K., Colón-Diaz, M., Lecroix, R., Xavier-Brier, M., & Kattari, L. (2017). Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults. Transgender Health, 2(1), 17-28.

National Institute of Mental Health (2017). https://www.nimh.nih.gov/health/statistics/suicide.shtml#part_154968

U.S. Census Bureau. (2016). American Community Survey 5-year estimates – public use microdata sample, 2012-2016. Generated using Public Use Microdata Area (PUMA) in the Seven-county Twin Cities Metropolitan Area.

Seelman, K., Colón-Diaz, M., Lecroix, R., Xavier-Brier, M., & Kattari, L. (2017). Transgender Noninclusive Healthcare and Delaying Care Because of Fear: Connections to General Health and Mental Health Among Transgender Adults. Transgender Health, 2(1), 17-28.

U.S. Census Bureau. (2016). American Community Survey 5-year estimates – public use microdata sample, 2012-2016. Generated using Public Use Microdata Area (PUMA) in the Seven-county Twin Cities Metropolitan Area.