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Cited by 40Suicide and Self-Harm StudiesPsychiatric care and mental health servicesOpioid Use Disorder Treatment

Improving Suicide Prevention in Primary Care for Differing Levels of Behavioral Health Integration: A Review

Open access
Spottswood, Margaret, Lim, Christopher T., Davydow, Dimitry, Huang, Hsiang·2022·Frontiers in Medicine
DOI 10.3389/fmed.2022.892205PMC PMC9196265
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Abstract

Importance: Suicide prevention implementation in primary care is needed due to the increasing rate of suicide in the past few decades, particularly for young and marginalized people. Primary care is the most likely point of contact for suicidal patients in the healthcare system. Attention to the level of medical integration with behavioral health is vital to suicide prevention and is applied throughout this review. Methods: A narrative review was performed. Observations: Many interventions help improve suicide prevention care. PCP education, screening, safety planning/lethal means reduction, care transitions, psychotherapy, and medication management are all evidence-based strategies. Additionally, the pragmatic topics of financing suicide prevention, supporting providers, enacting suicide postvention, and preparing for future directions in the field at each level of primary care/behavioral health integration are discussed. Conclusions and Relevance: The findings are clinically relevant for practices interested in implementing evidence-based suicide prevention strategies by attending to the behavioral health/medical interface. Leveraging the patient/provider relationship to allow for optimal suicide prevention care requires clinics to structure provider time to allow for emotionally present care. Defining clear roles for staff and giving attention to provider well being are also critical factors to supporting primary care-based suicide prevention efforts.

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Crossref · 10.3389/fmed.2022.892205

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  • Safety planning is now routinely used as a standalone treatment for adolescents in a variety of contexts including emergency departments, inpatient psychiatric units, outpatient and trauma treatment centers, and crisis hotlines.

    “is now routinely used as a standalone treatment for adolescents13 in a variety of contexts including emergency departments, inpatient psychiatric units, outpatient and trauma treatment centers, and crisis hotlines.14”

    From Safety Planning Interventions for Suicide Prevention in Children and Adolescents (2025) · cites this paper as [13]

    The Safety Planning Intervention section describes safety planning separate from ongoing psychotherapy as a brief intervention recommended in primary care. It does not establish routine use across the listed settings; its Care Transitions section mentions emergency rooms and inpatient units as points in a care pathway, not as evidence of routine safety-planning use there. The adolescent qualifier has a separate citation in the citing sentence and is not established by this source. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

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Related

Authors
Spottswood, M., Lim, C. T., Davydow, D., & Huang, H.
Affiliations
  • University of Vermont (US)
  • Cambridge Health Alliance (US)
Corresponding author
Spottswood, Margaret
ORCID
Venue
Frontiers in Medicine
Publisher
Frontiers Media SA
Published
2022-05-27
Volume
9
Pages
892205-892205
ISSN
2296-858X (ISSN-L)
DOI
10.3389/fmed.2022.892205
PMC
PMC9196265
OpenAlex
W4281654852
Cited by
40
References
153
Citations by year
2026: 4 · 2025: 14 · 2024: 13 · 2023: 9
FWCI
1.50
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Medicine (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords
suicide prevention, primary care, behavioral health integration, medical integration, suicide risk screening, safety planning, care transitions, psychotherapy, medication management, suicide postvention, provider well-being, provider education, marginalized communities

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