General practitioner consultations for mental health reasons prior to and following bereavement by suicide

Purpose Prior research has shown that the majority of those bereaved by suicide express a need for mental health care services. However, there is a lack of knowledge about these individuals’ use of primary health care. The objective of our study was to estimate the association between suicide bereavement and general practitioner (GP) consultations for […]

Experiences of general practice care for self-harm: A qualitative study of young people’s perspectives

Background: Self-harm is a growing concern and rates of self-harm in young people (aged 12-25 years) presenting to general practice are rising. There is, however, little evidence about young people’s experiences of GP care and on accessing general practice. Aim: To explore the help-seeking behaviours, experiences of GP care, and access to general practice of young people […]

Treating individuals with suicidal ideation in primary care: Patient-level characteristics associated with follow-up in the Collaborative Care Model

Introduction The Collaborative Care Model (CoCM) is an evidence-based approach which embeds behavioral health providers (BHPs) into primary care. Whether patients with suicidal ideation (SI) are willing to engage in CoCM is unclear. Methods Using Patient Health Questionnaire-9 (PHQ-9) administrative data from primary care practices within an urban academic health system, we identified patients with […]

Prototyping the implementation of a suicide prevention protocol in primary care settings using PDSA cycles: A mixed method study

Introduction: In Canada, approximately 4,500 individuals die by suicide annually. Approximately 45% of suicide decedents had contact with their primary care provider within the month prior to their death. Current versus never smokers have an 81% increased risk of death by suicide. Those who smoke have additional risks for suicide such as depression, chronic pain, alcohol, […]

Racial and gender disparities in suicide and mental health care utilization in a pediatric primary care setting

Purpose: We examined racial and gender disparities in the underrecognition of mental health disorders in adolescents and young adults as defined by a suicide-related diagnosis without a previous mental or behavioral health diagnosis. Methods: We employed a series of adjusted mixed multilevel logistic regression models to determine the odds of specific mental health diagnoses (anxiety, […]

External validation and updating of a statistical civilian-based suicide risk model in US Naval primary care

Importance  Suicide remains an ongoing concern in the US military. Statistical models have not been broadly disseminated for US Navy service members. Objective  To externally validate and update a statistical suicide risk model initially developed in a civilian setting with an emphasis on primary care. Design, Setting, and Participants  This retrospective cohort study used data collected from 2007 […]

The social life of self-harm in general practice

Research engaging qualitatively with clinical practitioners’ understanding of, and response to, self-harm has been limited. Self-harm offers a particularly compelling case through which to examine the enduring challenges faced by practitioners in treating patients whose presenting symptoms are not clearly biomedical in nature. In this paper, we present an analysis of 30 General Practitioners’ (GPs’) […]

Trajectories of perinatal suicidal ideation from early pregnancy to six weeks postpartum and their influencing factors: A prospective longitudinal study

Few studies focused on the trajectory of perinatal suicidal ideation from early pregnancy and covered whole routine perinatal periods. This study aimed to investigate the prevalence of suicidal ideation from early pregnancy to six weeks postpartum, and further explore the trajectories of perinatal suicidal ideation and their risk factors. A prospective longitudinal study was conducted […]

Does suicide risk screening improve the identification of primary care patients who will attempt suicide versus depressing screening alone?

Objective The effectiveness of suicide risk screening relative to depression screening alone among primary care patients has not been tested rigorously. This study compared the performance of multiple depression screening methods (Patient Health Questionnaire [PHQ]-2, PHQ-8, and PHQ-9) and multiple suicide risk screening methods (PHQ-9 item 9 and suicide-focused screening of “thoughts of killing yourself” during the […]

Suicide risk screening in primary care

Objective: The purpose of this research was to determine the general risk of suicide in the scope of primary health care services and to evaluate its relationship with hopelessness, depression, and psychological resilience. Methods: Seven hundred twenty-five individuals presenting to primary health care services were included in this descriptive, cross-sectional study. The research data were collected using […]

Recent GP consultation before death by suicide in middle-aged males: A national consecutive case series study

Background: Reducing suicide risk in middle-aged males (40-54 years) is a national priority. People have often presented to their GP within 3 months before suicide thus highlighting an opportunity for early intervention. Aim: To describe the sociodemographic characteristics and identify antecedents in middle-aged males who recently consulted a GP before dying by suicide. Design and setting: This study […]

Comparative effectiveness of safety planning intervention with instrumental support calls (ISC) versus safety planning intervention with two-way text message caring contacts (CC) in adolescents and adults screening positive for suicide risk in emergency departments and primary care clinics: Protocol for a pragmatic randomized controlled trial

Background: Suicide is a leading cause of death in adolescents and adults in the US. Follow-up support delivered when patients return home after an emergency department (ED) or primary care encounter can significantly reduce suicidal ideation and attempts. Two follow-up models to augment usual care including the Safety Planning Intervention have high efficacy: Instrumental Support Calls […]

Bullying, depression, and suicide risk in a pediatric primary care sample

Background: Suicide is a serious public health concern for US youth. Research has established an association between bullying and suicide risk. However, several questions remain regarding this relationship. Aims: The present study examined (a) whether experiences of verbal, physical, and cyber bullying were uniquely associated with general suicide risk; (b) whether each specific form of bullying was […]

Recent GP consultation before death by suicide in middle-aged males: A national consecutive case series study

Background Reducing suicide risk in middle-aged males (40–54 years) is a national priority. People have often presented to their GP within 3 months before suicide thus highlighting an opportunity for early intervention. Aim To describe the sociodemographic characteristics and identify antecedents in middle-aged males who recently consulted a GP before dying by suicide. Design and […]

Assessment and management of suicide risk in primary care

Background: Risk assessment and management of suicidal patients is emphasized as a key component of care in specialist mental health services, but these issues are relatively unexplored in primary care services. Aims: To examine risk assessment and management in primary and secondary care in a clinical sample of individuals who were in contact with mental health services and […]

Identifying common and unique barriers and facilitators to implementing evidence-based practices for suicide prevention across primary care and specialty mental health settings

Objective: We identified common and unique barriers and facilitators of evidence-based suicide prevention practices across primary care practices with integrated behavioral health services and specialty mental health settings to identify generalizable strategies for enhancing future implementation efforts. Method: Twenty-six clinicians and practice leaders from behavioral health (n = 2 programs) and primary care (n = 4 clinics) settings participated. […]

Saving lives by asking questions: Nurses’ experiences of suicide risk assessment in telephone counselling in primary health care

Aim: To explore nurses’ experiences of suicide risk assessment in telephone counselling (TC) in primary health care (PHC). Background: Globally, priority is given to developing suicide prevention work in PHC. However, suicide risk assessments in TC are not included in these interventions even though these are a common duty of nurses in PHC. More expertise […]

Capturing patients’ satisfaction and experiences with suicide prevention in general practice: A bridge too far?

Background Active exploration of suicidal thoughts in the general practice has the potential to prevent suicides. Yet, little is known about patients’ experiences with suicide exploration during consultations with General Practitioners (GPs). This study aimed to gain insights into their experiences of these consultations. Methods Between March 2019 and March 2020, primary care professionals from […]

Effective suicide prevention strategies in primary healthcare settings: A systematic review

Background There is a fundamental need for health systems, health managers, and policymakers to identify effective components of suicide prevention strategies (SPS) and programs in primary healthcare (PHC) settings. Accordingly, this systematic review aimed to identify and summarize effective and significant evidence on suicide prevention in PHC setting. We systematically searched the published literature in […]

Raising suicide in medical appointments–Barriers and facilitators experienced by young adults and GPs: A mixed-methods systematic review

The aim of this review was to understand the barriers and facilitators facing GPs and young adults in raising and addressing suicide in medical appointments. A mixed-methods systematic review was conducted of qualitative and quantitative studies. The focus was papers that explored barriers and facilitators experienced by young adults aged 18 to 26, and GPs […]

Invariance-based causal prediction to identify the direct causes of suicidal behavior

Despite decades of research, the direct causes of suicide remain unknown. Some researchers have proposed that suicide is sufficiently complex that no single variable or set of variables can be determined causal. The invariance-based causal prediction (ICP) is a contemporary data analytic method developed to identify the direct causal relationships, but the method has not […]

Suicide among Veterans receiving Veterans Health Administration home based primary care and following discharge from Community Living Centers

Introduction Veterans who receive Veterans Health Administration (VHA) Home Based Primary Care (HBPC) services and those discharged from VHA Community Living Centers (CLC) may be at increased risk of suicide. No studies to date have assessed suicide risks among HBPC patients. This study examined suicide risks among recipients of VHA HBPC services and following discharge […]

Measurement of primary care providers’ suicide prevention skills following didactic education

Objective Almost half of individuals who die by suicide have had contact with primary care (PC) services within 1 month of their death. PC providers must be able to assess and manage patients’ suicidal ideation, intent, and behaviors. When didactic training is provided to providers, it is assumed that their requisite skills are well developed. The […]