The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Abstract

Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

Preventing suicide, promoting resilience: Is this achievable from a global perspective?

“…Studies show that even though older adults consult more with primary care and other health professionals than the general population, suicidal ideas are less likely to be recorded in their case records compared to the general population, either because health professionals are not asking about suicidal ideas or because older adults may find it more difficult to disclose when they are asked. Primary care clinicians should routinely ask about both suicidal ideas in the older population—especially those who are depressed, lonely, or have other psychosocial risk factors—and the impact suicide is likely to have on the people left behind (Vannoy et al, ). A study of Chinese Americans showed that older adults who reported discrimination had twice the risk of suicidal thoughts compared with older adults from this population who did not and promoting civil rights to reduce discrimination may also contribute to decreasing suicide rates (Li, Gee, & Dong, ).…”

Suicide prevention strategies for older persons—An integrative review of empirical and theoretical papers

“…Two of the studies mentioned using a smaller sample size that can increase bias (Chauliac et al, 2016;Kim & Yang, 2017) (Table 1). Two qualitative studies were included (Vannoy et al, 2018;Wong et al, 2014). Neither contained any reflections or limitations related to the use of the qualitative method.…”

“…Three quantitative (Chan et al, 2018;Ho et al, 2014;Kim & Yang, 2017), two qualitative (Vannoy et al, 2018;Wong et al, 2014) (Table 2) and one theoretical study (Arbore, 2019) revealed that older adults who died by suicide had a past history of suicidal behaviour and suffered from mental illness. Ho et al (2014) found that having received mental health treatment in the past and having antidepressant medication detected by blood toxicology screening were indicators of suicide ideation.…”

“…Kim and Yang (2017) suggest using a community-based programme for healthcare professionals to prevent suicide among older adults with early-stage dementia. Vannoy et al (2018) found that the participants struggled with inner conflicts that involved their identity and self-image. Suicidal ideation violates their self-image and what other people think and expect of them (Vannoy et al, 2018).…”

“…Vannoy et al (2018) found that the participants struggled with inner conflicts that involved their identity and self-image. Suicidal ideation violates their self-image and what other people think and expect of them (Vannoy et al, 2018). Wong et al (2014) revealed that the participants (older men) had been admitted to either a mental or general hospital about 1 month before committing suicide and were diagnosed with a depressive illness.…”