Barriers to suicide prevention in primary care: A qualitative study among general practitioners in Germany

Suicide is a global public health issue and general practitioners (GPs) are important frontline responders to ensure treatment for persons experiencing suicidality. Although valid assessment tools and guidelines for managing suicidality in primary care are available, previous studies suggest that these are not yet sufficiently adhered to. Knowledge about the challenges experienced by GPs in identifying and managing suicidality among their patients is needed for the development of interventions to improve suicide prevention within primary care. The current study seeks to examine the challenges GPs in Germany encounter when managing suicidality among patients in primary care. We conducted qualitative online interviews with 15 GPs practising in Germany. Data were analysed using qualitative content analysis. We included a diverse sample of mainly early-practise GPs (mean age: 42 years; f = 9, m = 6). GPs in our study reported 1) difficulties in identifying suicidality, 2) uncertainty and insufficient knowledge, 3) responsibility and discomfort and 4) challenges due to the health care system. Our findings suggest that GPs in Germany would benefit from specialised trainings to increase their knowledge and reduce uncertainties in handling suicidality among their patients. Reported challenges could be an important focus of successful suicide prevention.