USE OF THE CRITICAL INCIDENT TECHNIQUE IN PRIMARY-CARE IN THE AUDIT OF DEATHS BY SUICIDE

Objective-To explore the usefulness of the critical incident technique in primary care to improve policy and practice to prevent cases of su icide. Design-Inviting all primary care teams in County Durham with a patient who committed suicide between 1 June 1993 and 31 May 1994 to t ake part in a critical incident audit with an external facilitator. Re sults-49 cases of suicide were available for study, registered with 31 practices. 19 (61%) practices accounting for 27 (55%) cases agreed to take part. Case discussions showed areas where practice could be impr oved, but no substantive preventive measures were identified within pr imary care, which would reduce the number of people committing suicide . The wider social and economic context was thought to be more importa nt. Conclusions-The use of the critical incident technique in primary care may have only a limited role in improving the management of peopl e at risk from suicide. However, one of the potential strengths of thi s approach is to encourage reflection on practice in a difficult emoti onal area.