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Title: General practitioners' attitudes to suicide prevention in older people and barriers to assessing risk : a public health psychology approach
Author: Ronald, Lisa Helena
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2010
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Background: Suicide is an important public health problem. Older people constitute the highest rate of completed suicides worldwide, with depression as the leading risk factor within this population. However older people's mental health has long been a neglected area both in terms of public policy and service provision. Research suggests that despite the fact older people visit their primary care practitioner more frequently than their younger counterparts, depressive symptoms and suicidal ideations are often not identified. Furthermore, even when psychological distress is recognised, older people are less likely to be treated or referred on to appropriate mental health services, despite the availability of efficacious treatments. Research suggests that "ageist" attitudes within society adversely affect the health-seeking behaviours of older people as well as health-care practitioners' clinical practice. Such attitudes require particular consideration when attempting to reduce suicide rates in older populations. Aim: The present research looks to enhance understanding of potential barriers to recognising and treating late-life depression and suicidal ideation by exploring GPs' attitudes and self-reported clinical practice in this area. Method: The study adopted a within-subject, questionnaire based design. 399 General Practitioners within a single health board area completed a self-administered questionnaire exploring attitudes towards suicide prevention in older people and selfreported clinical practice in terms of risk assessment with older adult populations. Results: Participants' attitudes towards suicide prevention in older people, on the whole, were marginally negative. Furthermore, there was a positive correlation between participants' attitudes and their self-reported clinical practice in terms of conducting a suicide risk assessment with this population - more negative attitudes were associated with less proactive clinical practice. There was also a relationship between age of participant and attitude where older GPs were more pessimistic regarding suicide prevention in older people. Previous training in suicide risk assessment did not appear to impact on attitudes towards suicide prevention, but did result in more pro-active clinical practice. Discussion: The present study provides a useful insight into GPs attitudes towards suicide prevention in older people and how such attitudes may impact on clinical practice. The findings have significant clinical implications in terms of multi-level approaches to reducing suicide rates within older populations. At an individual level it is important to enhance primary care practitioners' knowledge and skills regarding late-life depression and suicidality, while simultaneously highlighting factors associated with healthy ageing. At a wider strategic level it is necessary to develop sustainable mental health services for an ageing population while reducing age related discrimination and the stigma of mental illness through appropriate public policy and legislation. The potential role of clinical psychology at each of these levels was demonstrated. The strengths and limitations of the present study are also discussed along with suggestions for further research.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available