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Crisis. 2014;35(6):415-25. doi: 10.1027/0227-5910/a000277.

Assessment and management of suicide risk in primary care.

Author information

1
<location>School of Public Health and Policy, University of Liverpool, UK</location>
2
<location>Centre for Mental Health and Risk, University of Manchester, UK</location>
3
<location>School of Social Work, University of Central Lancashire, Preston, UK</location>

Abstract

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 died by suicide.

METHOD:

Data collection from clinical proformas, case records, and semistructured face-to-face interviews with general practitioners.

RESULTS:

Primary and secondary care data were available for 198 of the 336 cases (59%). The overall agreement in the rating of risk between services was poor (overall κ = .127, p = .10). Depression, care setting (after discharge), suicidal ideation at last contact, and a history of self-harm were associated with a rating of higher risk. Suicide prevention policies were available in 25% of primary care practices, and 33% of staff received training in suicide risk assessments.

CONCLUSION:

Risk is difficult to predict, but the variation in risk assessment between professional groups may reflect poor communication. Further research is required to understand this. There appears to be a relative lack of suicide risk assessment training in primary care.

KEYWORDS:

general practitioners; primary care; risk assessment; secondary care; suicide

PMID:
25234744
DOI:
10.1027/0227-5910/a000277
[Indexed for MEDLINE]

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