Abstract：
The cost of one suicide is estimated to be £1.67 million (2 million euros) to the UK economy. Most people who die by suicide have seen a primary care practitioner (PCP) in the year prior to death. PCPs could aim to intervene before suicidal behaviours arise by addressing suicide-risk factors noted in primary care consultations, thereby preventing suicide and promoting health and wellbeing. This study aimed to conduct a rapid, systematic scoping review to explore how PCPs can effectively recognise and respond to suicide-risk factors. MedLine, CINAHL, PsycINFO, Web of Science and Cochrane Library databases were searched for three key concepts: suicide prevention, mental health and primary care. Two reviewers screened titles, abstracts and full papers independently against the eligibility criteria. Data synthesis was achieved by extracting and analysing study characteristics and findings. Forty-two studies met the eligibility criteria and were cited in this scoping review. Studies were published between 1990 and 2020 and were of good methodological quality. Six themes regarding suicide risk assessment in primary care were identified: Primary care consultations prior to suicide; Reasons for non-disclosure of suicidal behaviour; Screening for suicide risk; Training for primary care staff; Use of language by primary care staff; and, Difference in referral pathways from general practitioners or primary care practitioners. This review focused on better recognition and response to specific suicide-risk factors more widely such as poor mental health, substance misuse and long-term physical health conditions. Primary care is well placed to address the range of suicide-risk factors including biological, physical-health, psychological and socio-economic factors and therefore these findings could inform the development of person-centred approaches to be used in primary care.
摘要：
一次自杀的成本估计为英国经济167万英镑（200万欧元）。大多数死于自杀的人在死前一年见过初级保健医生（PCP）。PCP可以通过解决初级保健咨询中提到的自杀风险因素，在自杀行为出现之前进行干预。从而防止自杀，促进健康和福祉。这项研究旨在进行快速，系统范围审查，以探讨PCP如何有效识别和应对自杀风险因素。MedLine,CINAHL,PsycINFO,搜索了WebofScience和CochraneLibrary数据库中的三个关键概念：预防自杀，心理健康和初级保健。两名审稿人筛选了标题，独立对照资格标准的摘要和完整论文。通过提取和分析研究特征和发现来实现数据综合。42项研究符合资格标准，并在本次范围审查中被引用。研究发表于1990年至2020年之间，具有良好的方法学质量。确定了有关初级保健中自杀风险评估的六个主题：自杀前的初级保健咨询；未披露自杀行为的原因；自杀风险筛查；初级保健人员的培训；初级保健人员使用语言；和，全科医生或初级保健医生转诊途径的差异。这篇综述的重点是更好地识别和应对更广泛的特定自杀风险因素，如心理健康差。物质滥用和长期身体健康状况。初级保健可以很好地解决自杀风险因素的范围，包括生物，身体健康,心理和社会经济因素，因此这些发现可以为在初级保健中使用以人为本的方法的发展提供信息。
