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Brief interventions for suicidal ideation in primary care: a systematic review
Puya Younesi1,2, Carolin Haas1,2,3, Tobias Dreischulte1,2
1Institute of General Practice and Family Medicine, University Hospital, LMU Munich, Nussbaumstrasse 5, Munich, 80336, Germany.
Background:
General practitioners (GPs) play a crucial role in assessing and diagnosing suicidal ideation, often acting as the first person of contact for individuals with mental health concerns. Given the time constraints faced by primary care providers, interventions need to be brief and easily implemented. This systematic review seeks to identify, compare, and critically evaluate effective brief interventions for managing suicidality in primary care, offering a comprehensive overview and discussion of key findings.
Methods:
A systematic literature review was conducted using databases including MEDLINE, EMBASE, The Cochrane Library, PSYNDEX, and PsychINFO, supplemented by manual searches. Our search strategy focused on studies from 2000 to 2023. Risk of bias was assessed using the Cochrane RoB 2 Tool, and evidence quality was evaluated using GRADE, with adherence to the PRISMA-DTA checklist. A protocol was published in PROSPERO.
Results:
The search yielded 1248 publications. Of those, 44 were assessed for eligibility after screening, ultimately resulting in five included studies addressing four brief interventions for suicidality in primary care. Motivational interviews, safety planning, structured follow-ups, and collaborative care models were identified as key elements for future interventions to enhance the role of primary care in suicide prevention.
Conclusion:
This review highlights the need for further research to adapt brief interventions for primary care suicide prevention. Given their central role in patient care, GPs are well-positioned to identify and support individuals at risk. While initial promising approaches have emerged, further research in primary care suicide prevention is needed, and interventions tailored to the GP setting must be developed.
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