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The feasibility of preventing suicide: the results of a Dutch intervention program.

Donker, G., Elzinga, E., Gilissen, R., Beurs, D. de. The feasibility of preventing suicide: the results of a Dutch intervention program. European Journal of Public Health: 2018, 28(supl. 4) 56-57. Abstracts: 11 th European Public Health conference: Winds of change: towards new ways of improving public health in Europe, Ljubljana, Slovenia 28 November –1 December 2018.
Background
The GP is in many countries the first contact for patients with mental health problems, making them important gatekeepers to identify suicidal ideation at an early stage.

Methods
Cases of suicide or attempted suicide were registered by sentinel general practices participating in the NIVEL Primary Care Database during the period 1983-2018. Additionally, since 2016, GPs answered additional items on suicide prevention for each patient diagnosed with depression (P76).

Results
Join-point analyses revealed a rise in male suicides from 2008- 2014 and a decline since 2014. Female suicidal behaviour showed a steady decrease from 1989-2017. Before 2007, a history of depression was reported in 65% of the suicides. After the start of the recession, a depression was recognized in 44% of the patients died by suicide. Additional questions on suicide prevention within depressed patients in 2016 resulted in a total of 1034 completed questionnaires; 33.1% concerned patients experiencing a new episode and 67.9% an existing episode of 56 European Journal of Public Health, Vol. 28, Supplement 4, 2018 Downloaded from https://academic.oup.com/eurpub/article-abstract/28/suppl_4/cky260/5187184 by University Library Utrecht user on 27 November 2018 depression. Suicidality was inquired in 65.8% of the new episodes and in 33.2% of the existing episodes of depression. Suicidal thoughts were inquired in 455/1034 (44%) times. Of these 38.2% patients reported suicidal thoughts. In 579 (56%) cases, suicidal feelings were not inquired. Reasons not to inquire suicidality were ‘did not assess patient as being suicidal’ (67.5%) or ‘patient already reported not being suicidal in a previous consultation’ (22.1%).

Conclusions
Since 2008, there was a rise in the male suicide rate up till 2014 after which it declined while female suicidal behaviour continued to decline. GPs less often reported a history of depression within patients that died due to suicide after 2007 than before. Although guidelines recommend the assessment of suicidal ideation within all depressed patients, in more than half of the patients with depression, suicide ideation was not assessed.