Suicide Risk Assessment Toolkit for the Primary Care Setting

Abstract
Introduction: The Centers for Disease Control and Prevention reported that suicide is the 10th leading cause of death for all ages and the cost associated with lost wages and medical expenses was estimated to be $34.6 million with over 38,000 successful suicides and an additional 487,000 cases of self-inflicted wounds being treated in emergency rooms (CDC, 2012, 2013). In addition, 77 percent of U.S. counties have experienced a shortage of mental health providers and mental health prescribers (Thomas, Ellis, Konrad, Holzer & Morrissey, 2009) which can lead to many patients being seen by their primary care provider (PCP) for mental health management. Cattell & Jolley (1995) studied suicide and depression in the elderly and reported that 43% of elderly patients were being seen by their PCP prior to their suicide and mental health referrals were not done consistently.
Purpose: Develop and evaluate a Suicide Risk Assessment Toolkit based on the current evidence and clinical practice guidelines (CPG) for utilization in a primary care setting.
Method: This SRA Toolkit was submitted to a panel of six subject matter experts in various health care specialties to review and provide suggestions for improvement with possible implementation in a family practice or primary care setting as a long term goal.
Discussion: All except one panel member rated the SRA Toolkit as “Likely” or “Very Likely” to be utilized in a primary care setting. The dissenting panel member who rated it “Unlikely” for use in a primary care cited time as a major constraining factor. Suggestions to improve the SRA Toolkit included simplification and single page quick reference for easy use during patient visits.