Community pharmacist encounters with patients displaying suicide warning signs: a cross-sectional survey

Mental health is a prominent public health issue exacerbated by the coronavirus disease 2019 pandemic. Community pharmacists are positioned to contribute.

This study aimed to describe Iowa community pharmacists' encounters, confidence, behaviors, and training needs related to patients with suicide warning signs and explore relationships between demographics and previous training with encounter frequency, confidence, and behaviors.

A cross-sectional survey was mailed to a sample of community pharmacists in Iowa. Three contacts were made between May and June 2022 including a prenotification letter, survey with a paid return envelope, and reminder postcard, each with a QR code for optional online completion. The survey included demographics, suicide warning sign encounter types, confidence, suicide prevention behaviors, and suicide prevention training history and needs. Analysis of variance and t tests compared differences between demographics and previous training with encounter frequency, confidence, and behaviors.

The response rate was 18.3% with 161 survey completions. Pharmacists reported encounters with patients who appeared distressed (96.3%), made concerning statements related to suicide (23.8%), and disclosed suicidal thoughts (8.8%). A minority of pharmacists had asked patients about suicide (21.1%) or referred them to crisis resources in the past year (17.4%). A third had previous suicide prevention training (37.9%), which was associated with higher levels of confidence (P < 0.001) and intervention behaviors (P < 0.05). Respondents expressed interest in training, particularly on intervention and referral.

This sample of community pharmacists encountered patients with suicide warning signs. Providing more pharmacists with training and support in understanding local mental health resources and referrals may increase their confidence and engagement in suicide prevention.