Primary care provider knowledge and confidence about suicide screening and prevention: The role of practicing in integrated behavioral health-primary care

Document Type

Article

Publication Date

3-30-2026

Publication Title

Families, systems & health : the journal of collaborative family healthcare

Abstract

BACKGROUND: In nearly half of suicide deaths, the decedent had a primary care provider (PCP) visit within the prior month, which highlights the opportunity for suicide prevention in primary care. We determined if on-site behavioral health integration (BHI) in primary care was associated with increased PCP suicide risk reduction knowledge and confidence.

METHOD: From July 2022 to November 2022, a cross-sectional, web-based survey was e-mailed to PCPs nationwide. Eligible PCPs (n = 233) answered survey questions about suicide screening and prevention knowledge, confidence, and training. The primary outcomes were suicide risk reduction, knowledge, and confidence. The exposure of interest was presence versus absence of BHI. Multivariate logistic regression models were used to measure the association between BHI and the odds of higher suicide risk reduction knowledge and confidence.

RESULTS: In adjusted models, BHI was not significantly associated with knowledge and confidence. Use of ≥2 suicide risk management tools (OR = 1.91; 95% CI: 1.07-3.43) and having lived experience of patient death by suicide were positively associated with higher knowledge (OR = 2.31; 95% CI: 1.11-4.83). One covariate, access to a licensed professional counselor, was significantly associated with greater confidence (OR = 2.64; 95% CI: 1.08-6.48).

DISCUSSION: BHI was not significantly associated with PCP risk reduction knowledge and confidence, but some BHI elements, for example, presence of behavioral health, were significantly associated with greater provider confidence that could enable suicide detection. Further research is needed to improve health care delivery models that enhance suicide detection and management.

PubMed ID

41910558

ePublication

ePub ahead of print

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