Suicide prevention in primary care: General practitioners' views on service availability

Abstract

BackgroundPrimary care may be a key setting for suicide prevention. However, comparatively little is known about the services available in primary care for suicide prevention. The aims of the current study were to describe services available in general practices for the management of suicidal patients and to examine GPs views on these services. We carried out a questionnaire and interview study in the North West of England. We collected data on GPs views of suicide prevention generally as well as local mental health service provision.FindingsDuring the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care servicesConclusionsHealth professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care.

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GPs’ views and perspectives on patient non-adherence to treatment in primary care prior to suicide

“…Research suggests that broad spectrum diagnosis and concurrent therapy will lead to more positive outcomes for patients with comorbid conditions. Steady progress is being made on new and existing treatment options for comorbidity in a variety of settings, however access to these services is limited (Saini et al, 2010). This area warrants further research to investigate and understand the engagement and treatment differences in patients who are non-adherent to treatment to improve practice.…”

An Electronic Clinical Decision Support System for the Assessment and Management of Suicidality in Primary Care: Protocol for a Mixed-Methods Study (Preprint)

“…In a typical morning or afternoon primary care surgery in the United Kingdom, involving 20 patients, at least one new case of depression requiring suicide risk assessment might be encountered [9]. Organisational barriers including time constraints and a heavy workload coupled with lack of specialist clinical skills and insufficient mental health training have been identified by GPs as significant barriers to the assessment and management of suicidal presentations [10,11,12]. A recent study by Michail et al [11] has identified significant variability in how GPs understand and operationalise risk which subsequently has an impact on clinical decision making.…”