Role of doctors in the prevention of suicide:the final consultation

Background. It is generally assumed that people committing suicide see their doctor shortly before their death, and consequently that enhancing doctors' psychiatric knowledge and interview skills might help prevent some suicides. Aim. A study was undertaken to determine the nature and timing of final contacts with medical practitioners by people committing suicide. Method. Adults dying by suicide in Scotland during 1988-89 were identified by the General Register Office for Scotland and their primary care case notes studied. Results. Within this national sample, medical contact near to the time of the suicidal act was rare, except for those individuals who had a previous psychiatric history. Conclusion. These data suggest that medical practitioners, particularly those working in primary care, are not failing to detect and intervene in significant numbers of preventable suicides. Consequently, the likelihood of implementing successful suicide prevention strategies based within primary care is open to question. Greater awareness of the risk of eventual suicide in those with a previous history of psychiatric disorder may contribute to any future reduction in suicide rates