There was an interesting hearing in Olympia yesterday morning for HB 2366, which is one of those bills that at first sounds like a great idea: More training in suicide assessment, treatment, and management for health care workers most likely to come into contact with suicidal people.

The bill passed the house 92 to 5 on February 10, which means a lot of legislators in that chamber want state government to require physicians, counselors, chemical dependency specialists, and even chiropractors and naturopaths to undergo certain amounts of training in noticing—and hopefully helping—suicidal people.

Representative Tina Orwall (D-33), who spent 20 years working in the mental health field, introduced the bill and yesterday morning told Senate Committee on Health & Long-Term Care that suicide is the tenth most common cause of death in the United States (and the eighth most common cause of death in this state). Every week, she said, two young adults between the ages of 14 and 24 commit suicide. And male veterans are twice as likely to commit suicide as non-veterans. This bill, she said, is "about saying the status quo is not acceptable. We can do more.”

With her at the witness table was a woman whose husband committed suicide just over a year ago. She believes his mental health providers missed key signs that, if noticed, could have led to a different outcome. "I truly believe if this law had been in place at the time of his death, that he may still be alive today," the woman said.

The director of the Washington State Department of Veteran Affairs spoke in favor of the bill, as did a psychologist from eastern Washington and Amnon Shoenfeld, director of mental health services for King County.

And it was noted frequently that doctors in Washington State are currently required to undergo training in HIV/AIDS in order to get and keep their licenses—so why not require training in suicide detection and prevention?

Well, replied the doctors and other health care providers who showed up to testify against the bill, because this is a different situation (and has the potential for a slippery slope in terms of regulation).

Dr. Steve Albrecht, a family physician practicing in Olympia and the past president of the Washington Academy of Family Physicians, noted that the requirement for HIV/AIDS training was originally instituted to deal with an emerging epidemic that many practicing doctors hadn't been trained to respond to. Suicide is different. It has been around much—much—longer, and is something that doctors do get trained to handle. To the extent that their training is insufficient, it should be left to their professional associations to police and improve, Albrecht said. (Not to mention the universities that educate doctors and psychiatrists.)

This bill, he noted, is "asking the legislature to become the developer and the arbiter of medical education in this state."

Those testifying against the bill went out of their way to say they share the "intent" of the bill and the concern of its backers. But the implication of their testimony was clear: It's not hard to find stories in any category of medical or mental health care that could be used to marshal support for a bill demanding more training for health care providers. How far could this ultimately go in adding hours and hours of pre-licensing and continuing education requirements for already-busy health care workers?

"While we know that the legislature has excellent staff," Albrecht said, "we really don’t think that the legislature wants their staff to have to become the people who design medical education… The legislature is really not the place to do this kind of thing.”

We'll keep an eye on where this bill goes from here.