Suicide prevention in primary care

This is a brief summary of tools to help the clinician assess suicide risk, to inform clinicians how to get help and to provide links for both clinician and patient to obtain more information about support.

1. Risk factors
2. Assessments
3. Local help
4. Resources for clinician and patient

Risk Factors:

Anyone may present in a crisis with suicidal ideation. Those at most risk of completed suicide are men, especially men over 40, people with a psychiatric diagnosis, frequent attenders, people on multiple medications, people who have drug or alcohol issues. High risk times are leaving hospital and transition between mental health services.

Assessments:

Evidence says- ask directly about suicidal thoughts including plans and intent. Document protective factors. Consider safety plans. Always take seriously and get help where needed. Ensure the patient has multiple routes to access self help locally. Do not rely only on standard questionnaires for anxiety/depression- do a psychosocial assessment. Ensure booked follow up with the same doctor- consistency is important. Reduce access to means of suicide attempt- so only issue small amounts of medication, and only if indicated.

Local help:

• Crisis line for clinician and self referral for immediate crisis help
• Crisis café and SUN – self referral for ongoing support
• James Place- suicide prevention support for men
• Samaritans
• MIND
• NEL Suicide Prevention Training

Resources:

For clinicians:

• RCGP Suicide in children and young people: tips for GPs
• Suicide mitigation: a compassionate approach to suicide prevention
• NICE self-harm pathway
• NICE Self-harm in over 8s: short-term management and prevention of recurrence
• Suicide prevention training from the Zero Suicide Alliance
• Key Messages: Safer care for patients with personality disorder
• Infographic about factors associated with suicide in young people
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For patients:

• Staying Safe: Making a Safety Plan with Jonny Benjamin
• Staying Safe from suicidal thoughts
• Mind: Side by Side online community
• Mind: How to cope when supporting someone else