The role of general practitioners in parasuicide: A Western Australia perspective

Is suicide prevention properly taught in medical schools?

“…It is widely reported that a great number of patients who commit suicide or attempt suicide have consulted their General Practitioner (GP) prior to doing so (Crockett 1987;Pfaff et al 1999;Smith & Scoullar 2001;Luoma et al 2002;Scoullar & Smith 2002;Marquet et al 2005). Up to 77% of patients make contact with a primary care provider within the 12 months before death, and up to 66% within 30 days before death (Andersen et al 2000).…”

Suicide Prevention: Critical Elements for Managing Suicidal Clients and Counselor Liability Without the Use of a No-Suicide Contract

“…The physician's role in identifying these individuals and preventing self-harm is crucial because primary care physicians more often are the first and most frequented professionals seen by suicidal individuals (Kelly & Knudson, 2000;Maltsberger, 1991). This applies not only to the United States but in other countries as well (Pfaff, Acres, & Wilson, 1999;Takahashi, 1993).…”

“…Limitations exist with the use of nosuicide contracts, and without formal training in their use greater difficulty is likely to be encountered by clinicians and primary care physicians. More training and guidelines should be implemented for both mental health professionals and primary care physicians (Maltsberger, 1991;Pfaff et al, 1999;Takahashi, 1993), and these professionals should be cautious about using or promoting the use of any intervention whose efficacy and utility has yet to be empirically demonstrated. Therefore, no-suicide contracting without a thorough assessment of risk is inadvisable (Goldblatt, 1994;Weiss, 2001).…”

“…A more appropriate response to a suicidal client is to use an aggressive assessment, which often includes a referral for hospitalization (Clark & Kerkhof, 1993;Goldblatt, 1994). In the absence of an aggressive assessment, the client is placed at a greater risk of suicide and the counselor for litigation (Pfaff et al, 1999).…”

Australian and New Zealand clinical practice guidelines for the management of adult deliberate self-harm

“…General practice as a setting for management has received little attention, despite our knowledge that people often visit their GP prior to self‐harm [28,78]. Counselling intervention by GPs in the UK improved patients’ problem‐solving more effectively than standard outpatient and after‐care [79].…”