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Table 2 Barriers to recognition, effective management and suicide prevention

From: The failure of suicide prevention in primary care: family and GP perspectives – a qualitative study

GP (MIS) RECOGNITION
PATIENTS RECOGNITION
No prior history of mental illness  
Stigma and denial of mental illness  
Limited contact  
Somatic presentations  
Substance misuse  
GP FACTORS SUICIDE ASSESSMENT/SCREENING
Limited competence (mental health Regarded as simplistic and intrusive
Low confidence Limited time for psychological care
Negative views of mental health patients Scepticism of patient suicidal intent Barrier to therapeutic engagement
Undermines patient trust
Belief in patient stoicism (stereotyping)  
GP MANAGEMENT (PATIENT FACTORS) GP MANAGEMENT (psychiatry liaison)
Rejection of diagnosis Long waiting lists
Medication non-adherence Psychiatry focus on psychotic illness
Substance misuse Inadequate follow-up
Multiple contacts Functional split model
  Fragmentation of services
Loss of shared knowledge and expertise