Engaging primary care professionals in suicide prevention: A qualitative study

Elzinga, Elke; Kruif, Anja J. T. C. M. de; Beurs, Derek P. de; Beekman, Aartjan; Franx, Gerdien; Gilissen, Renske

doi:10.1371/journal.pone.0242540

Cited by 27 publications

(23 citation statements)

References 35 publications

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“…Since many medical professionals do not feel confident assessing suicidality [65,66], we recommend using validated, standardized instruments as much as possible. For routine screening, self-administered versions of these instruments can be used, or the questions asked by ancillary staff (e.g., medical assistants) but for more urgent situations, the healthcare professional should ask the questions themselves.…”

Section: How Should Patients Be Screened or Assessed? What Issues Should Clinicians Pay Attention To Or Ask About?mentioning

confidence: 99%

“…Educational, attitudinal, logistical, financial, and legal barriers impede optimal care. Healthcare providers readily admit they are not confident about diagnosing and managing both ME/CFS [4] and suicidality [65,66]. Hopefully, the process outlined (Figure 1) and detailed in this article advances practitioners' knowledge about suicidality and supplies them with a straightforward care plan.…”

Section: Clinical Care Barriersmentioning

confidence: 99%

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Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2021

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Adult patients affected by myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) are at an increased risk of death by suicide. Based on the scientific literature and our clinical/research experiences, we identify risk and protective factors and provide a guide to assessing and managing suicidality in an outpatient medical setting. A clinical case is used to illustrate how information from this article can be applied. Characteristics of ME/CFS that make addressing suicidality challenging include absence of any disease-modifying treatments, severe functional limitations, and symptoms which limit therapies. Decades-long misattribution of ME/CFS to physical deconditioning or psychiatric disorders have resulted in undereducated healthcare professionals, public stigma, and unsupportive social interactions. Consequently, some patients may be reluctant to engage with mental health care. Outpatient medical professionals play a vital role in mitigating these effects. By combining evidence-based interventions aimed at all suicidal patients with those adapted to individual patients’ circumstances, suffering and suicidality can be alleviated in ME/CFS. Increased access to newer virtual or asynchronous modalities of psychiatric/psychological care, especially for severely ill patients, may be a silver lining of the COVID-19 pandemic.

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Section: How Should Patients Be Screened or Assessed? What Issues Should Clinicians Pay Attention To Or Ask About?mentioning

confidence: 99%

Section: Clinical Care Barriersmentioning

confidence: 99%

Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

et al. 2021

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“…Yet research has illustrated how GPs, who remain the first point of contact for people with mental health problems, may have insufficient time, tools and resources to appropriately support people with complex psycho-social needs [ 31 ]. Educating primary care professionals on suicide prevention is beneficial [ 32 ], but improved connections between community mental health services and primary care are also key [ 33 , 34 ]. This is supported by a systematic review of the role of GPs in the management of patients who self-harm, identifying a need for GP training, enhanced communication between primary care and mental health teams and enhanced service provision [ 35 ].…”

Section: Discussionmentioning

confidence: 99%

Preventing male suicide through a psychosocial intervention that provides psychological support and tackles financial difficulties: a mixed method evaluation

et al. 2022

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Background To help resolve high suicide rates in Bristol, North Somerset and South Gloucestershire, the charity Second Step was commissioned to roll-out the Hope service offering a psychosocial intervention for men, supporting them through acute distress and addressing financial difficulties. This study evaluated the impact of the Hope service on men at risk of suicide experiencing financial and other difficulties. Methods Mixed methods study using: (i) a prospective cohort study design to compare depression, suicidal ideation and financial self-efficacy scores of men aged 30–64, referred to the service between October 2018 and July 2020, at baseline and 6 months follow-up and between low and moderate to high-intensity service users; and (ii) a qualitative interview study to evaluate the acceptability and impact of the Hope service to Hope service users. Results There was a 49% reduction in depression score (mean reduction − 10.0, 95% CI − 11.7 to − 8.3) and in the proportion of service users with suicidal ideation (percent reduction − 52.5, 95% CI − 64.1% to − 40.9%) at 6 months follow-up compared to baseline. Financial self-efficacy scores increased by 26% (mean increase 2.9, 95% CI 1.8 to 3.9). Qualitative accounts illustrated how ‘Hope saved my life’ for several men interviewed; most respondents described being able to move forward and tackle challenges with more confidence following the Hope intervention. Professional advice to tackle financial and other difficulties such as housing helped to relieve anxiety and stress and enable practical issues to be resolved. Conclusions The Hope service offered practical and emotional support to men who have experienced suicidal feelings, redundancy, homelessness and poverty and occupies an important space between mental health and social care provision. Hope demonstrates the value of an intervention which cuts across traditional boundaries between psychiatric care and social advice agencies to provide, what is, in effect, an integrated care service.

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“…Of concern is the body of literature that relating to a lack of education and support for primary care physicians in how to recognise and manage the care of patients in distress [ 15 , 47 , 48 ]. A recent qualitative evaluation of suicide prevention in primary care within the Netherlands emphasised the need for suicide prevention strategies at primary care to include improved liaison with mental health services and primary care [ 49 ]. In a second qualitative study, Leavey et al [ 50 ] also suggest that there is concern that GPs in the UK lack confidence in their recognition and management of suicidal patients, with several issues raised around the relationships and information flow between GPs and other parts of the health care system.…”

Section: Discussionmentioning

confidence: 99%

Suicide preceded by health services contact – A whole-of-population study in New Zealand 2013-2015

Chiang

Paynter²,

Edlin³

et al. 2021

PLoS ONE

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New Zealand’s rate of suicide persistently exceeds the global average. The burden of suicide in New Zealand is disproportionately borne by youth, males and Māori (NZ indigenous people). While the demographic characteristics of suicide decedents are established, there is a need to identify potential points of contact with health services where preventative action could take place. This paper aims to determine if suicide deaths in New Zealand were likely to be preceded by contact with health services, and the type and time frame in which these contacts took place. This study utilised a whole-of-population-cohort of all individuals age 15 years and over, who were alive on March 5th 2013, followed up to December 2015. Associations between the odds of suicide, demographic factors, area-based deprivation, and the timing of last contact with primary, secondary, and tertiary services were analysed using univariate and multivariate logistic regression. Contact with a health service in the 6 Months prior to death was associated with the highest odds of suicide. Over half of the suicide decedent population (59.4%) had contacted primary health services during this period. Large proportions of the suicide decedent population contacted secondary and tertiary services in the 6 Months prior to death, 46.5% and 30.4% respectively. Contact with primary, secondary and tertiary services in the prior 6 Months, were associated with an increased odds of suicide of 2.51 times [95% CI 2.19–2.88], 4.45 times [95% CI 3.69–4.66] and 6.57 times [95% CI 5.84–7.38], respectively, compared to those who had no health services contact.

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Engaging primary care professionals in suicide prevention: A qualitative study

Cited by 27 publications

References 35 publications

Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Identifying and Managing Suicidality in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome

Preventing male suicide through a psychosocial intervention that provides psychological support and tackles financial difficulties: a mixed method evaluation

Suicide preceded by health services contact – A whole-of-population study in New Zealand 2013-2015

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