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General practitioners' perspectives on suicide prevention in primary care: a qualitative study
Jack Marshall1, Joe Hulin2, Phillip Oliver1
1School of Medicine and Population Health, University of Sheffield, Sheffield, UK.
Background:
Suicide is the leading cause of death among adults aged 20-34 in England and Wales. Around 80% of those who die by suicide have consulted a GP within the previous year, making primary care a critical setting for prevention. Rates in Yorkshire and the Humber (YH) exceed the national average (12-13 deaths per 100 000 population).
Aim:
To explore GPs' perspectives on suicide prevention in primary care across YH.
Design & Setting:
Qualitative study with GPs from diverse practices in YH.
Method:
Purposive sampling ensured variation in demographics and patient populations. Semi-structured interviews were conducted until data saturation. Transcripts were analysed using Thematic Analysis.
Results:
Fourteen interviews were completed (10 female, 4 male). Participants served varied populations, including asylum seekers and Roma patients. Four themes emerged: "Integration with mental health and third sector services" highlighted inconsistent mental health service organisation and the role of third sector support. "Challenges of assessing and managing risk" highlighted perceived barriers to responding to suicide risk within time and resource constraints. "Continuity of care" describes the importance of developing ongoing relationships to support suicide prevention in primary care and the risks and threats to achieving this. "Building on knowledge" describes the absence of systematic case review in general practice after suicide.
Conclusion:
An integrated, resourced system with equitable access to primary care mental health workers and third sector support may enhance suicide prevention. Continuity of care was valued but undermined by inflexible models prioritising same-day triage over personalised mental health primary care.
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