CONTACTS OF SUICIDE ATTEMPTERS WITH GPS PRIOR TO THE EVENT - A COMPARISON BETWEEN STOCKHOLM AND BERN

The aim of this study was to investigate patterns of contact made with GPs by subjects in two cities prior to attempting suicide, in order t o determine whether differences in the health care systems could be a possible factor influencing the help-seeking behaviour of people exper iencing suicidal crises. Structured interviews were conducted with sui cide attempters from geographically defined catchment areas in two cou ntries with private and national health care systems, respectively. Th e subjects were suicide attempters, admitted consecutively, aged great er than or equal to 15 years and living either in Stockholm (n = 202) or in Bern (n = 66). Patients living in Bern had seen their GPs more r egularly and more frequently throughout the year. There was an increas e in the number of visits to the GP prior to the suicide attempt in bo th cities, but it was greater in Stockholm than in Bern. However, in S tockholm fewer patients who saw their GP in the week before the attemp t talked about their suicidal thoughts. The differences in help-seekin g behaviour between the two patient samples may be related to the high er number of practising GPs and a more personal and consistent patient -doctor relationship in Bern. It is possible that the private medical care system in Switzerland lowers the threshold enabling patients to t alk to their GP about their suicidal plans. The results suggest that i n both cities there is scope for improving communication of the suicid al patient with his or her doctor.