September 10th is World Suicide Prevention Day, a day designed to reduce stigma about suicide, create compassion, and inspire action to prevent suicide and suicide attempts around the globe.¹
The American Foundation for Suicide Prevention identifies suicide as the 10th leading cause of death in the United States.² This is a dire problem in many communities, one that requires extensive support from health care professionals. Do these professionals have sufficient tools to help patients with suicidal ideations and urges?
A pair of recent studies suggest primary care physicians (PCPs) need more help in assisting patients struggling with their mental health. What do these researchers believe has stifled PCPs’ ability to help suicide prevention, and what do they suggest should be done about it?
Working With Mental Health Services
A 2020 study in PLOS One examined attempts to engage PCPs in suicide prevention education as part of the Suicide Prevention Action Network (SUPRANET) program in the Netherlands.³ The PCPs interviewed and evaluated in this study were mostly general practitioners and mental health support staff. The researchers found that without specific education on suicide prevention, PCPs often found it difficult to detect suicidal ideation and assess risk. The PCPs were concerned about their ability to effectively prevent harm, and those who had experience with patients’ suicidal behavior often had feelings of self-doubt.
Nearly all PCPs responded positively to SUPRANET. They felt it made them better equipped to assess suicide risk, increased their knowledge of prevention, and enhanced their communication skills. They did, however, believe they would benefit from more scientific insights, which speaks to a need for specialized mental health education. One of the PCPs’ largest complaints was difficulty collaborating with mental health care facilities. They felt these facilities were difficult to access — particularly if a patient wasn’t deemed to be in severe crisis — and that the processes could be time-consuming. This lack of communication is detrimental to patients, as it makes it more likely that there will be inconsistencies in their treatment plans and quality of care. The researchers concluded that while programs like SUPRANET are helpful, it’s more important that PCPs and mental health facilities develop better communication.
Access to Behavioral Health Services
Access to behavioral health services is lacking in some areas of the world. A 2021 study in The Journal of Behavioral Health Services & Research examined the perspective of family medicine physicians on behavioral health care in rural areas.⁴ The researchers found that rural areas have a shortage of mental health care professionals, despite patients being more likely to report depression, substance abuse, domestic violence, and suicide.
Rural physicians reported working longer hours and seeing more patients. Many said they were concerned about the lack of available behavioral health care for patients, and believe that existing structures in their locales are limited and fail to provide a high quality of care. They worried that some patients’ stigma toward mental health care and the lack of anonymity in small communities may prevent them from seeking care, but that lack of insurance and inability to make time for appointments also played a large role. The physicians said that in rural areas they have to take on unique duties as patients’ primary source of medical communication, including assessing behavioral health.
These studies suggest that PCPs are eager to help patients address their mental health concerns. However, PCPs need improved access to and collaboration with behavioral health care services to receive the proper knowledge and develop more effective treatment plans.
1. World Suicide Prevention Day 2021. International Association for Suicide Prevention. https://www.iasp.info/wspd2021/. Accessed September 7, 2021.
2. Suicide statistics. American Foundation for Suicide Prevention. https://afsp.org/suicide-statistics/. Accessed September 7, 2021.
3. Elzinga E, de Kruif AJTCM, de Beurs DP, Beekman ATF, Franx G, Gilissen R. Engaging primary care professionals in suicide prevention: A qualitative study. PLoS One. 2020;15(11):e0242540. Published 2020 Nov 30. doi:10.1371/journal.pone.0242540
4. Jensen EJ, Mendenhall T, Futoransky C, Clark K. Family medicine physicians’ perspectives regarding rural behavioral health care: Informing ideas for increasing access to high-quality services [published online ahead of print, 2021 Apr 6]. J Behav Health Serv Res. 2021;1-12. doi:10.1007/s11414-021-09752-6