Improving Suicide Prevention in Primary Care for Differing Levels of Behavioral Health Integration: A Review

Spottswood, Margaret; Lim, Christopher T; Davydow, Dimitry S.; Huang, Hsiang

doi:10.3389/fmed.2022.892205

Cited by 19 publications

(10 citation statements)

References 145 publications

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“…The 5 suicide profiles based on postmortem data can also inform clinicians to screen for each suicide risk subtype for personalized suicide prevention strategies. For class 4, integrated care coordinating physical and mental health services is crucial, especially in primary care/internal medicine settings, where a significant proportion of patients experience at least 1 (60%) or 2 (40%) chronic diseases, including diabetes (37.3 million people), Alzheimer disease (5.8 million people), and cancer (1.6 million people).…”

Section: Discussionmentioning

confidence: 99%

Decoding Suicide Decedent Profiles and Signs of Suicidal Intent Using Latent Class Analysis

Xiao,

Bi,

Yip

et al. 2024

JAMA Psychiatry

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ImportanceSuicide rates in the US increased by 35.6% from 2001 to 2021. Given that most individuals die on their first attempt, earlier detection and intervention are crucial. Understanding modifiable risk factors is key to effective prevention strategies.ObjectiveTo identify distinct suicide profiles or classes, associated signs of suicidal intent, and patterns of modifiable risks for targeted prevention efforts.Design, Setting, and ParticipantsThis cross-sectional study used data from the 2003-2020 National Violent Death Reporting System Restricted Access Database for 306 800 suicide decedents. Statistical analysis was performed from July 2022 to June 2023.ExposuresSuicide decedent profiles were determined using latent class analyses of available data on suicide circumstances, toxicology, and methods.Main Outcomes and MeasuresDisclosure of recent intent, suicide note presence, and known psychotropic usage.ResultsAmong 306 800 suicide decedents (mean [SD] age, 46.3 [18.4] years; 239 627 males [78.1%] and 67 108 females [21.9%]), 5 profiles or classes were identified. The largest class, class 4 (97 175 [31.7%]), predominantly faced physical health challenges, followed by polysubstance problems in class 5 (58 803 [19.2%]), and crisis, alcohol-related, and intimate partner problems in class 3 (55 367 [18.0%]), mental health problems (class 2, 53 928 [17.6%]), and comorbid mental health and substance use disorders (class 1, 41 527 [13.5%]). Class 4 had the lowest rates of disclosing suicidal intent (13 952 [14.4%]) and leaving a suicide note (24 351 [25.1%]). Adjusting for covariates, compared with class 1, class 4 had the highest odds of not disclosing suicide intent (odds ratio [OR], 2.58; 95% CI, 2.51-2.66) and not leaving a suicide note (OR, 1.45; 95% CI, 1.41-1.49). Class 4 also had the lowest rates of all known psychiatric illnesses and psychotropic medications among all suicide profiles. Class 4 had more older adults (23 794 were aged 55-70 years [24.5%]; 20 100 aged ≥71 years [20.7%]), veterans (22 220 [22.9%]), widows (8633 [8.9%]), individuals with less than high school education (15 690 [16.1%]), and rural residents (23 966 [24.7%]).Conclusions and RelevanceThis study identified 5 distinct suicide profiles, highlighting a need for tailored prevention strategies. Improving the detection and treatment of coexisting mental health conditions, substance and alcohol use disorders, and physical illnesses is paramount. The implementation of means restriction strategies plays a vital role in reducing suicide risks across most of the profiles, reinforcing the need for a multifaceted approach to suicide prevention.

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Section: Discussionmentioning

confidence: 99%

Decoding Suicide Decedent Profiles and Signs of Suicidal Intent Using Latent Class Analysis

Xiao,

Bi,

Yip

et al. 2024

JAMA Psychiatry

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“…Healthcare professionals can better understand an individual's degree of susceptibility and design appropriate intervention strategies by obtaining information on these aspects through effective screening approaches. It is important to note that the effectiveness of suicide prevention measures may differ across regions or countries due to social or cultural factors influencing opinions and views towards mental health disorders, including suicide [48]. Indeed, several screening and assessment instruments have been developed and implemented in the United Kingdom to support healthcare professionals in identifying those at risk of suicide.…”

Section: Screening and Assessment Toolsmentioning

confidence: 99%

Suicide Risk Assessment and Prevention Tools in the UK: Current Landscape and Future Directions

Arowosegbe,

Oyelade

2023

Psychiatry International

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Suicide is a major global public health problem, with profound implications for individuals, families, and communities. In the United Kingdom (UK), despite efforts to detect and manage suicidal ideas, suicide rates persist, especially among middle-aged men and women, particularly those aged 45 to 54 years. Recent global challenges, such as the COVID-19 pandemic, climate change, conflict, and the environmental crisis, have raised concerns about an increase in suicide rates, particularly among young people. As a result, a population-wide preventive approach based on evidence is imperative to mitigate the projected increase in suicides. To evaluate the effectiveness of suicide prevention strategies, there is a need for an objective and universally accepted risk assessment approach that does not currently exist. This review examines the current landscape of suicide prevention in the United Kingdom and evaluates the strengths and limitations of existing suicide risk assessments tools. The current suicide prevention tools used, including machine learning and mobile applications are discussed. Also, the epidemiological trends in the various regions of the UK, risk factors including age, sex, and socio-economic status are assessed to provide context. Through this discourse, we hope to provide valuable insight for clinicians, researchers, and policy makers about the current landscape of suicide, especially within the United Kingdom, while presenting recommendations regarding areas that require further research and improvement. Accordingly, suicide prevention is and will continue to be a major focus of both the national health service and research in the UK in the strive to reduce the rate of suicide across all regions. Indeed, headways have been made in the use of technology in preventing suicide both locally and globally. However, research should in the future investigate the value of personalized interventions tailored to the various risk factors of suicide and based on appropriate screening and assessment tools.

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“…Since primary care health professionals are a likely contact, therefore, it is imperative to implement necessary skills and training measures at a primary care level. [ 9 10 ] A 2017 study found that the role of primary health care can be crucial as a year prior to the suicide there is contact with the primary health care provider. Furthermore, the study found that contact with primary health care professionals was maintained even in the final month.…”

Section: Introductionmentioning

confidence: 99%

Perceptions of key stakeholders on peer led strength building program for suicide prevention among young adolescents: A qualitative study from Karnataka, India

Meena,

Kapanee,

Cherian

et al. 2024

Journal of Family Medicine and Primary Care

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Context: Adolescent suicides are a significant public health concern in India and understanding the intersecting perspectives becomes imperative for the prevention of various mental health concerns. Aim: Assessing perceptions of various key stakeholders, that is, mental health experts, school and college teachers, and District Mental Health Program staff about peer-led strength building programs for suicide prevention. Settings and Design: A cross-sectional qualitative design using two Focus Group Discussions (FGDs) with mental health experts and teachers and one FGD with DMHP staff was conducted. The sample comprised 45 participants from Bengaluru urban district. Materials and Methods: The data were analyzed manually by the method of direct content analysis, and themes were determined using existing literature. Results: The teachers and the DMHP highlighted the need for an intensive training program/module that is necessary to be developed in order to train the peer leaders first. The mental health experts opined that creating a network will help in easy identification of the cases and appropriate treatment could be provided without delays. Conclusions: This study indicated that suicide is a preventable public health emergency and inaccessibility to existing as well as proper support systems was perceived as a major concern. Therefore, peer-led programs are beneficial in steering and improving help seeking behavior in suicidal adolescents.

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Improving Suicide Prevention in Primary Care for Differing Levels of Behavioral Health Integration: A Review

Cited by 19 publications

References 145 publications

Decoding Suicide Decedent Profiles and Signs of Suicidal Intent Using Latent Class Analysis

Decoding Suicide Decedent Profiles and Signs of Suicidal Intent Using Latent Class Analysis

Suicide Risk Assessment and Prevention Tools in the UK: Current Landscape and Future Directions

Perceptions of key stakeholders on peer led strength building program for suicide prevention among young adolescents: A qualitative study from Karnataka, India

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