Suicide prevention in primary care: General practitioners' views on service availability

During the study period (2003-2005) we used the National Confidential Inquiry Suicide database to identify 286 general practitioners (GPs) who had registered patients who had died by suicide. Data were collected from GPs and practice managers in 167 practices. Responses suggested that there was greater availability of services and training for general mental health issues than for suicide prevention specifically. The three key themes which emerged from GP interviews were: barriers accessing primary or secondary mental health services; obstacles faced when referring a patient to mental health services; managing change within mental health care servicesHealth professionals have an important role to play in preventing suicide. However, GPs expressed concerns about the quality of primary care mental health service provision and difficulties with access to secondary mental health services. Addressing these issues could facilitate future suicide prevention in primary care.Suicide is a leading cause of death in England and Wales, accounting for approximately 5000 deaths annually [1,2]. Approximately one-quarter of individuals who complete suicide have been in contact with mental health services [3]. While suicide prevention is clearly important within mental health services, it is not exclusively the remit of any one service [1]. There is good evidence to suggest that initiatives within primary care may contribute to suicide prevention [4-8]. Further, appropriate training for GPs in the identification and treatment of mental health problems has been shown to be effective [9] as has training in suicide prevention [10] (although this has not been found consistently) [11]. As such, it is important to have appropriate services within primary care to effectively manage patients with suicidal behaviour and to ensure access to specialist mental health services when required.To date, studies on suicide prevention in primary care have focused on the identification, management and a