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J Affect Disord. 2017 Mar 1;210:294-302. doi: 10.1016/j.jad.2016.12.035. Epub 2016 Dec 24.

The effectiveness of suicide prevention delivered by GPs: A systematic review and meta-analysis.

Author information

Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia; Work, Health and Wellbeing Unit, Population Health Research Centre, School of Health & Social Development, Deakin University, Melbourne, Australia. Electronic address:
Turning Point, Monash University, Melbourne, Australia.
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia.
Orygen National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, Australia.
Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia.
Centre for Brain and Mental Health Research, Faculty of Health and Medicine, University of Newcastle, Newcastle, Australia.



The aim of this review was to assess whether suicide prevention provided in the primary health care setting and delivered by GPs results in fewer suicide deaths, episodes of self-harm, attempts and lower frequency of thoughts about suicide.


We conducted a systematic review and meta-analysis using PRIMSA guidelines. Eligible studies: 1) evaluated an intervention provided by GPs; 2) assessed suicide, self-harm, attempted suicide or suicide ideation as outcomes, and; 3) used a quasi-experimental observational or trial design. Study specific effect sizes were combined using the random effects meta-analysis, with effects transformed into relative risk (RR).


We extracted data from 14 studies for quantitative meta-analysis. The RR for suicide death in quasi-experimental observational studies comparing an intervention region against another region acting as a "control" was 1.26 (95% CI 0.58, 2.74). When suicide in the intervention region was compared before and after the GP program, the RR was 0.78 (95% CI 0.62, 0.97). There was no evidence of a treatment effect for GP training on rates of suicide death in one cRCT (RR 1.07, 95% CI 0.79, 1.45). There was no evidence of effect for the most other outcomes studied.


All of the studies included in this review are likely to have a high level of bias. It is also possible that we excluded or missed relevant studies in our review process CONCLUSIONS: Interventions have produced equivocal results, which varied by study design and outcome. Given these results, we cannot recommend the roll out of GP suicide prevention initiatives.


Doctor suicide prevention; General practice; Self-harm; Suicide attempt; Suicide ideation; Suicide prevention

[Indexed for MEDLINE]

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