Identification and monitoring of suicide risk in primary care settings

Suicide is a leading cause of death and a public health priority. In an attempt to reduce suicide rates, efforts have focused on detection and management of suicidal patients in primary care settings, given that an estimated 45% of suicide victims see their physician in the month prior to their death. Previous research suggests that limitations exist in primary care physicians' (PCPs') assessment and treatment of suicidal risk. Training programs addressing the detection of suicidal patients and management of suicidal risk in primary care settings have demonstrated significant improvement in practice. Hence, treatments are available to help PCPs assist with suicide prevention. Recent safety warnings about suicidal ideation and behavior associated with youths and young adult antidepressant treatment have led to sharp declines in prescribing, particularly by PCPs. Concern now exists about under-treatment of depression and the subsequent impact on suicide rates. This article reviews recent literature and provides an overview of suicide risk factors and assessment of suicide risk. The importance of assessing and managing suicidal ideation and behavior and risk factors is highlighted.