Assessing and managing suicidal behaviour in the primary care setting: A model for an integrated regional suicide...

Although suicide rates are decreasing in most countries, suicide is still a major health concern. Our aim was to introduce a complex, integrative, regional suicide prevention strategy. Based on reviewing the literature and on our previous studies we developed a suicide prevention model, which includes recognition, risk assessment and intervention. The main steps of the model are the recognition of warning signs (communicative or behavioural), exploration of crisis situation and/or psychopathologic symptoms, assessment of protective and risk factors, estimation of suicide risk and a plan for management of suicidal patients through different levels of interventions. In the management of suicidal behaviour, the complex stress-diathesis model has to be adjusted by considering biological markers and psycho-social factors. Only after the assessment of these factors can primary care professionals, as gatekeepers, manage suicidal patients effectively by using adequate psychopharmacotherapeutic and psychotherapeutic interventions in the recognition, treatment and prevention of suicidal behaviour.