PCP Opinions of Universal Suicide Risk Screening in Rural Primary Care: Current Challenges and Strategies for Successful Implementation

LeCloux, Mary; Aguinaldo, Laika D.; Lanzillo, Elizabeth C.; Horowitz, Lisa M.

doi:10.1111/jrh.12508

Cited by 10 publications

(4 citation statements)

References 68 publications

(98 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This is the first study to date to investigate HCPs' opinions on depression, SI, ISI, and suicide specifically in diabetes clinics and barriers to care. Previous studies that note mental healthcare concerns in primary care 21,22 are echoed here by diabetes HCPs, including difficulty referring to mental health providers, lack of access, and lack of confidence in asking about mental health concerns. Similar to primary care studies, the majority of diabetes HCPs found that it is important to ask about depression and suicide and want to have more training on how to ask appropriate questions, how to quickly assess risk in clinic, and what to do after an individual reports depression or SI.…”

Section: Discussionmentioning

confidence: 92%

“…Primary care studies have evaluated HCPs’ opinions of mental healthcare and specifically suicide risk screening. 21,22 These studies found that HCPs felt screening was important but were concerned about poor access to mental healthcare, disruption to clinical flow when someone screened positive, and overall concern that patients would not attend when a referral was placed. Within diabetes care, studies have shown that in those with positive mental health screening who are referred to mental healthcare, approximately 50% attend a mental healthcare appointment.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Healthcare Professional Experiences and Opinions on Depression and Suicide in People With Diabetes

Majidi

Cohen

Holt

et al. 2023

J Diabetes Sci Technol

View full text Add to dashboard Cite

Objective: People with diabetes have an increased risk of depression, intentional self-injury and self-harm (ISI), and suicide compared with the general population. This study aimed to explore experiences and awareness of health care professionals (HCPs) regarding depression, ISI, and suicide, and understand resource use and needs among HCPs who care for persons with diabetes (PWD). Methods: Health care professionals who see children and/or adults with type 1 diabetes or type 2 diabetes anonymously completed an online survey about their experiences, opinions, barriers, and needs surrounding identification and care of PWD with depression, ISI, and suicide. Results: One hundred twenty-nine HCPs participated. The majority were medical doctors (MDs) or advanced practice providers (APPs). Only a quarter of MDs and APPs felt very comfortable asking about ISI or suicidal ideation (SI), whereas 20% felt they had received appropriate training to support those with ISI or SI. The primary needs reported include more training on how to ask, respond, and support those expressing ISI and SI. Health care professionals reported wanting better access to resources for PWD. Discussion: The HCPs tend to underestimate SI in the diabetes population and rates of training were low. Areas to address include providing education and training to HCPs to improve identification and management of ISI and suicide risk. These data can inform the development of mechanisms to improve discussions of depression and suicide and of resources to help HCPs support PWD.

show abstract

Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Healthcare Professional Experiences and Opinions on Depression and Suicide in People With Diabetes

Majidi

Cohen

Holt

et al. 2023

J Diabetes Sci Technol

View full text Add to dashboard Cite

show abstract

“…Almost half of participants reported being “neutral” or disagreeing with the statement that they felt comfortable completing a risk assessment or a safety plan with a suicidal individual, indicating that this might be an additional area that needs more attention in future trainings. Covering content related to discomfort with the topic of suicide may be beneficial as well, as many primary care providers have reported discomfort to be a main barrier to suicide risk screening and assessment in primary care (LeCloux, Aguinaldo, Lanzillo, & Horowitz, 2017).…”

Section: Discussionmentioning

confidence: 99%

The development of a brief suicide screening and risk assessment training webinar for rural primary care practices.

LeCloux¹

2018

Journal of Rural Mental Health

Self Cite

View full text Add to dashboard Cite

Although primary care practices have the potential to be crucial intervention points for suicide prevention in rural areas of the United States, primary care staff are often underequipped to deal with suicide and have limited access to high-quality training opportunities on this topic. This manuscript reports on posttest data collected from a sample of primary care staff (N = 16) regarding the acceptability of a brief, online interactive training webinar designed for primary care practices in rural West Virginia. The majority of participants reported the webinar was relevant to their practices (73.3%) and that they would recommend it to a fellow professional (75.0%). Higher proportions of participants reported confidence (75.0%) and comfort (68.8%) asking patients about suicide than they did regarding their ability to complete a risk assessment (50.1%) and a safety plan (56.3%) with a suicidal individual. Only half (56.3%) thought it was important to screen all primary care patients for suicide. Future research should use tracked pre-and posttest data to evaluate the effectiveness of trainings that include a focus on risk assessment and safety planning, education about the potential benefits of universal suicide risk screening, and that can be delivered through asynchronous methods. Keywordssuicide prevention; rural mental health; primary care services Suicide is a significant global public health problem. Recent estimates indicate that over 800,000 individuals die by suicide globally each year (World Health Organization [WHO], 2015), and, in the United States, over 44,000 people died as a result of suicide in 2015 alone (Centers for Disease Control and Prevention [CDC], 2015). Suicide rates have been significantly higher in rural than in urban areas (Gamm, Stone, & Pittman, 2003;Hirsch & Cukrowicz, 2014), and recent data from the CDC (2017) regarding urban/rural suicide rates from the years 2009-2015 indicate that this disparity is increasing. According to the CDC (2017), in 2015, the suicide rate in rural areas was roughly 22 per 100,000, which was 83% higher than the suicide rates in urban areas of the United States (approximately 12 per 100,000).

show abstract

“…[24][25][26] Studies on suicide risk screening in other clinical settings (eg, emergency departments) suggest there are additional barriers for assessing suicide risk, such as care coordination challenges, and clinician and patient hesitancy to discuss mental health concerns. 21,[27][28][29][30][31] Therefore, studies are needed to identify barriers and facilitators of suicide risk screening programs in cancer care delivery.…”

Section: Original Contributionsmentioning

confidence: 99%

Oncology Providers' and Professionals' Experiences With Suicide Risk Screening Among Patients With Head and Neck Cancer: A Qualitative Study

Turner

Stover

Tometich

et al. 2023

JCO Oncology Practice

View full text Add to dashboard Cite

PURPOSE: There has been limited study of the implementation of suicide risk screening for patients with head and neck cancer (HNC) as a part of routine care. To address this gap, this study assessed oncology providers' and professionals' perspectives about barriers and facilitators of implementing a suicide risk screening among patients with HNC. MATERIALS AND METHODS: All patients with HNC with an in-person visit completed a suicide risk screening on an electronic tablet. Patients reporting passive death wish were then screened for active suicidal ideation and referred for appropriate intervention. Interviews were conducted with 25 oncology providers and professionals who played a key role in implementation including nurses, medical assistants, patient access representatives, advanced practice providers, physicians, social workers, and informatics staff. The interview guide was based on the Consolidated Framework for Implementation Research. Interviews were transcribed and analyzed for themes. RESULTS: Participants identified multilevel implementation barriers, such as intervention level (eg, patient difficulty with using a tablet), process level (eg, limited nursing engagement), organizational level (eg, limited clinic Wi-Fi connectivity), and individual level (eg, low clinician self-efficacy for interpreting and acting upon patient-reported outcome scores). Participants noted facilitators, such as effective care coordination across nursing and social work staff and the opportunity for patients to be screened multiple times. Participants recommended strengthening patient and clinician education and providing patients with other modalities for data entry (eg, desktop computer in the waiting room). CONCLUSION: Participants identified important intervention modifications that may be needed to optimize suicide risk screening in cancer care settings.

show abstract

PCP Opinions of Universal Suicide Risk Screening in Rural Primary Care: Current Challenges and Strategies for Successful Implementation

Cited by 10 publications

References 68 publications

Healthcare Professional Experiences and Opinions on Depression and Suicide in People With Diabetes

Healthcare Professional Experiences and Opinions on Depression and Suicide in People With Diabetes

The development of a brief suicide screening and risk assessment training webinar for rural primary care practices.

Oncology Providers' and Professionals' Experiences With Suicide Risk Screening Among Patients With Head and Neck Cancer: A Qualitative Study

Contact Info

Product

Resources

About