Primary Care Providers’ Views Regarding Assessing and Treating Suicidal Patients

Abstract

Primary care providers (PCPs) usually do not explore patient suicidality during routine visits. Factors that predict PCP attitudes toward the assessment and treatment of suicidality were examined via an online survey of 195 practicing PCPs affiliated with medical schools in the United States. PCPs who perceived themselves as competent to work with suicidal patients were more willing to assess and more willing to treat suicidal patients, with the perception of competency fully explaining the relationship between training and willingness to treat. Female gender predicted lower self-perceived competency, while in-office access to professional mental health (MH) consultation predicted greater self-perceived competency. Higher self-perceived general competence predicted lower subjective valuation of access to MH consultation. Multiple linear regression analysis indicated a three-way interaction between training, gender, and valuation of MH consultation as predictors of perceived competency, with training generally being associated with greater perceived competency to treat suicidality. Relative to their male counterparts, female PCPs have lower confidence in assessing and treating suicidality. Perceived competence in risk assessment should be given more attention in medical training because of its role in PCPs' willingness to treat suicidality.

Comorbidity-independent risk for suicidality increases with bulimia nervosa but not with anorexia nervosa

“…These findings are important because the majority of individuals with eating disorders do not seek treatment for their eating disorder (Fairburn et al, 2000; Mond et al, 2007; Hart et al, 2011), and those who do, often receive treatment from a general practitioner (Mond et al, 2007). Importantly, several studies suggest that suicide risk assessments are often conducted by general practitioners only when patients appear depressed or inquire about medication for depressive symptoms (Hooper et al, 2012; Graham et al, 2011; Feldman, et al 2007; Williams, et al 1999). As such, the current study highlights that suicidality may be overlooked in individuals with BN who do not present with comorbid disorders and may be underestimated in those with depression and/or substance use and BN.…”

Health Care Contacts in the Year Before Suicide Death

“…48 One problem may be the low level of competence and training in suicidality that medical providers report. 49 Nonetheless, research shows that physicians who receive training feel more competent working with individuals at risk for suicide and are more likely to screen for and treat suicidality. 49,50 Training should include information on use of screening tools and appropriate processes for positive screens, including the best care pathways given the level of risk.…”

“…49 Nonetheless, research shows that physicians who receive training feel more competent working with individuals at risk for suicide and are more likely to screen for and treat suicidality. 49,50 Training should include information on use of screening tools and appropriate processes for positive screens, including the best care pathways given the level of risk. Other factors that limit expanded suicide assessment include the complexity of patients' symptoms and conditions, competing demands for providers, and lack of engagement in treatment among patients.…”

National Pathways for Suicide Prevention and Health Services Research

“…21 As discussed in this supplement and elsewhere, one concern is that general medical providers often lack the training and knowledge needed to identify and treat mental health and suicide risk, as well as limited time to discuss these issues with patients. 22,23 Thus, the current healthcare system relies on the limited number of referrals that make it to specialty mental health care and emergency services, where the skill levels of providers may also be limited with regard to suicide risk management.…”