Dr Grant Blashki1, Associate Professor Jane Pirkis2, Professor Jane Gunn3, Mr Jon Kroschel4, Miss Jill Day5, Professor Robert Goldney6, Dr Penny Mitchell2, Ms Donna Southern1, Dr Richard Moulding1
1 Department of General Practice, The University of Melbourne
2 School of Population Health, The University of Melbourne
3 Department of General Practice, The University of Melbourne
4 Alfred Psychiatry Research Centre, Alfred Psychiatry
5 Southcity GP Services, The Alfred Hospital
6 Department of Psychiatry, The University of Adelaide
beyondblue Victorian Centre of Excellence
Project completion year
Managing suicidal ideation in men is a crucial health issue in Australia, and additional training for GPs is one potential avenue for reducing suicide rates. The Suicide in Men (SIM) study involved designing, utilising and evaluating a training package for GPs titled, Reducing Suicide in Men through General Practice, which would assist them in detecting and managing suicidal ideation in men. The intervention involved a predisposing activity (SIM Pack), an enabling activity (a SIM DVD and small group face-to-face training over a single three-hour session) and a reinforcing activity (SIM CD-ROM). All intervention resources were specially developed for the project. Effectiveness of the training was evaluated using a self-report survey of attitudes and confidence from GPs plus a blinded rating of GP skills (by experienced researchers) using video-taped consultations with simulated patients in the GPs’ practices. Ninety-three Victorian GPs were randomly allocated to training or the control group, and 13 underwent video assessment.
GPs were interested in undertaking the SIM study but reluctant to be videotaped, even when offered significant incentives. Compared to the control group, GPs in the intervention group had increased confidence in their ability to access specialist services and improved their attitudes to managing suicidality. No significant effects on skills in managing suicide were seen in the video-taped assessments; however, the sample size was small and perhaps a single training session is insufficient to bring about changes in clinical practice that are large enough to be observable to blind raters.
Implications for policy, practice and further research
The SIM training resources and research instruments will be made available to GP educators, primary care researchers and other health professionals involved in suicide prevention. The success of this pilot study warrants a larger randomised controlled trial. However, future research may require a less intrusive and more acceptable method of assessing GP skills in suicide assessment (for example, direct feedback from actors or audio-taping general consultations) and/or greater incentives for GPs to participate in primary care research.