Confidence of primary care physicians in assessing the suicidality of geriatric patients

Abstract

This study examined the confidence levels of physicians in assessing the risk of suicide among older adults in clinical settings. Of the 300 physicians who were selected from a population of 4980 family practice, internal medicine, and geriatric physicians in Illinois, 63% responded to the mail survey. Several categorical items inquired about specific assessment and treatment approaches, referral resources used, barriers to meeting the mental health needs of older patients, and sources of training in suicide risk assessment. All the training items (suicide assessment in medical school, residency, and CME courses; rating of medical school training; and insufficient training in geriatric mental health) were significantly (p < 0.01) associated with confidence in assessing suicidality. The overall model consisting of six variables explained 57% of the variation in confidence scores [F (6, 130) = 28.48, p < 0.001]. Three variables accounted for 50% of the explained variance: confidence in diagnosing depression, residency training in the assessment of suicide risk, and assessment of the intentional misuse of medication. Confidence in diagnosing depression (beta = 0.38, p < 0.001) was the strongest predictor. More effective mental health care will require specific preparation in treating geriatric patients through the full spectrum of medical training, including medical school, residency, and CME courses. Improved prevention of elderly suicide hinges on the enhancement of clinical skills in diagnosing and treating geriatric depression.

Differences in suicide behaviour in the elderly: a study in two provinces of Northern Italy

“…Actually, as the international literature demonstrates (Conwell, 1997;Conwell and Duberstein, 2001;Kaplan et al, 2001;De Leo et al, 2002;Luoma et al, 2002;Suominen et al, 2004), they often are the first ones to examine the older patients with social or psychiatric troubles, because the elderly seldom ask for help from specialists.…”

Counselors and Physicians Providing Mental Health Services: An Integrated Approach

“…The most common means (93%) of attempt was medication overdose, and in 66% of these cases, prescription medication was used (Lamprecht, Pakrasi, Gash, & Swann, 2005). Even more astonishing is that 90% of the time, depression is diagnosable in suicidal older adults; yet medical doctors lack training in recognizing and diagnosing the symptoms of depression with this population (Kaplan, Adamek, & Martin, 2001).…”

Recent research on suicide in the elderly

“…If depression and suicidality are seen as normal aspects of the aging process or expected to occur with physical conditions, they may be less likely seen as worthy of treatment [58,59]. However, providers who have confidence in diagnosing depression and have had training in assessing suicide risk, do report having confidence in assessing and treating suicidality [60]. Therefore, a major research challenge facing those engaged in late-life suicide prevention is to consider how to modify attitudes about mental illness in later life, support help-seeking behavior, and train health care professionals to provide adequate treatment.…”