Improving identification of suicidal patients in primary care through routine screening

Aim: To compare patients' rates of endorsement of suicidal ideation during routine medical appointments with their primary care provider (PCP) versus rates of endorsement on a self-report symptom screening measure. Methods: PCPs referred 338 patients with identified psychosocial health-related issues to a behavioral health consultant (BHC) service fully integrated in a family medicine clinic. All referred patients completed the Behavioral Health Measure-20 (BHM) as part of routine clinical practice. Results: Of the 338 patients referred to the BHC service, 42 (12.4%) screened positive for suicidal ideation, of which only 7 (2.1%) disclosed suicidal ideation to their PCP during the medical appointment immediately preceding referral to the BHC. Use of the BHM to screen primary care patients referred to the BHC improved detection of patients with suicidal ideation by 600%. Conclusions: Routine suicide screening of primary care patients using a brief self-report measure can substantially improve the ability to identify at-risk patients in primary care, which can contribute to early detection and enhanced clinical decision-making.