The role of general practitioners in parasuicide: A Western Australia perspective

Abstract

To determine the role of general practice in parasuicidal patients, a non-randomised survey of parasuicidal patients' general practitioners was conducted. The study population consisted of 233 patients who presented to a public hospital casualty department, due to engaging in parasuicidal behaviour. Of interest was the time between patient presentation to hospital and last GP visit, nature of the patient's chief complaint during the last GP consultation, and the proportion of GPs prescribing medication used by overdose patients. Approximately 38% of the patients had visited a GP in the week prior to hospital presentation, 63.5% within a month. Females less than 35 years of age had a significantly shorter duration between seeing their GP and the parasuicidal act, compared to older females. No significant differences were found between males and females or younger and older males. During their last visit to the GP, patients more often presented with somatic complaints. However, in the week before engaging in suicidal behaviour they were 2.3 times more likely to manifest psychological symptoms. Of the 150 patients engaging in overdosing behaviour, one-third used medications obtained from their GP. Our findings indicate that individuals who engage in non-fatal suicidal behaviour do access general practice, particularly young females. Unfortunately, their manifestation of psychological distress may be presented in the form of somatic complaints, making it difficult for the GP to recognise. Training initiatives for GPs appear warranted and should lead to a reduction in the morbidity and mortality associated with suicidal behaviour.