Photo Credit: Tero Vesalainen
The following is a summary of the study “Engaging primary care patients at risk for suicide in mental health treatment: user insights to inform implementation strategy design,” published in the October 2024 issue of Primary Care by Wolk et al.
Suicide prevention efforts often overlook the fact that many individuals who die by suicide had visited primary care in the year before their death. For a study, researchers aimed to identify the barriers and facilitators to engaging primary care patients at risk for suicide in mental health services, with the goal of designing better strategies to increase patient engagement.
The team of researchers conducted 74 semi-structured interviews with key stakeholders, including primary care patients (n=20), primary care and behavioral health clinicians (n=18 and n=12), mental health intake coordinators (n=4), and health system leaders (n=20). Patients at risk for suicide, identified through elevated scores on the Patient Health Questionnaire (PHQ-9), were included. The interviews, which lasted between 30 to 60 minutes, were conducted via video conference or phone and analyzed using a rapid qualitative method.
The majority of participants were female (64.9%), white (70.3%), and non-Hispanic/Latine (91.9%). Key barriers to engaging in mental health services included long waitlists, insurance limitations, capacity issues, and challenges related to patient characteristics, communication, and travel. On the other hand, facilitators of engagement included telehealth services, integrated care models, reminders, case management, psychoeducation, motivational support, and flexible scheduling.
Suggestions to improve engagement in mental health care included enhancing communication between providers, simplifying referral and intake processes, offering reminders and follow-ups, and advocating for better reimbursement for suicide risk assessments.
The study highlighted the significant challenges patients at risk for suicide face in accessing mental health services through primary care settings. It also helped to identify potential solutions to improve patient engagement, which could inform future strategies aimed at reducing suicide risk among primary care patients.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-024-02616-w
