TY - JOUR
T1 - The Perspective of Older Men with Depression on Suicide and Its Prevention in Primary Care
T2 - Implications for Primary Care Engagement Strategies
AU - Vannoy, Steven
AU - Park, Mijung
AU - Maroney, Meredith R.
AU - Unützer, Jürgen
AU - Apesoa-Varano, Ester Carolina
AU - Hinton, W Ladson
PY - 2018/4/5
Y1 - 2018/4/5
N2 - Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: »What prevents men from acting on suicidal thoughts?» Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.
AB - Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: »What prevents men from acting on suicidal thoughts?» Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.
KW - counseling
KW - late-life suicide
KW - primary care
UR - http://www.scopus.com/inward/record.url?scp=85047502643&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85047502643&partnerID=8YFLogxK
U2 - 10.1027/0227-5910/a000511
DO - 10.1027/0227-5910/a000511
M3 - Article
C2 - 29618265
AN - SCOPUS:85047502643
JO - Crisis
JF - Crisis
SN - 0227-5910
ER -