The Perspective of Older Men with Depression on Suicide and Its Prevention in Primary Care

Implications for Primary Care Engagement Strategies

Steven Vannoy, Mijung Park, Meredith R. Maroney, Jürgen Unützer, Ester Carolina Apesoa-Varano, W Ladson Hinton

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish (US)
JournalCrisis
DOIs
StateAccepted/In press - Apr 5 2018

Fingerprint

Suicide
Primary Health Care
Depression
Mental Health Services
Social Class
Interviews

Keywords

  • counseling
  • late-life suicide
  • primary care

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

The Perspective of Older Men with Depression on Suicide and Its Prevention in Primary Care : Implications for Primary Care Engagement Strategies. / Vannoy, Steven; Park, Mijung; Maroney, Meredith R.; Unützer, Jürgen; Apesoa-Varano, Ester Carolina; Hinton, W Ladson.

In: Crisis, 05.04.2018.

Research output: Contribution to journalArticle

@article{aaaac674f7144471b6d22e8956ebdad3,
title = "The Perspective of Older Men with Depression on Suicide and Its Prevention in Primary Care: Implications for Primary Care Engagement Strategies",
abstract = "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.",
keywords = "counseling, late-life suicide, primary care",
author = "Steven Vannoy and Mijung Park and Maroney, {Meredith R.} and J{\"u}rgen Un{\"u}tzer and Apesoa-Varano, {Ester Carolina} and Hinton, {W Ladson}",
year = "2018",
month = "4",
day = "5",
doi = "10.1027/0227-5910/a000511",
language = "English (US)",
journal = "Crisis",
issn = "0227-5910",
publisher = "Hogrefe Publishing",

}

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

JO - Crisis

JF - Crisis

SN - 0227-5910

ER -