PREVENTION OF ELDERLY SUICIDE - PHYSICIANS ASSESSMENT OF FIREARM AVAILABILITY

Introduction: Physicians have a unique role to play in the prevention of elder suicide, yet they may not be sufficiently attentive to the pr ominence of firearms in the rising trend in suicide by elderly persons . This study sought to examine the extent to which physicians inquired about firearms with their depressed and suicidal elderly patients and further identified factors associated with physicians' likelihood of asking about firearms. Methods: A probability sample of 300 primary ca re physicians in Illinois was drawn from the American Medical Associat ion Physician Masterfile. Physicians were chosen from the specialties most likely to be involved with elderly persons: internal medicine and family practice. A mailed questionnaire yielded a 63% response rate. Results: Although they were treating depressed and suicidal older pati ents, a sizable proportion of the respondents (42%) reported that they did not ask such patients or their family members whether they had ac cess to a firearm. Several factors distinguished physicians who assess ed for firearms from those who did not. The most salient predictors we re: continuing medical education training in suicide risk assessment, expertise in geriatric mental health, confidence in diagnosing depress ion, having a patient mention suicide in the past year, and indicating patient reluctance as a barrier to mental healthy treatment. Discussi on: Physicians working with depressed and suicidal elderly persons nee d to be informed about the prevalence of elder suicide and about the l ikelihood of elderly persons using firearms as a method of suicide. Ef fective suicide prevention will require physician training that direct ly addresses geriatric mental health and firearm suicide, in particula r, at the student, residency, and continuing education levels.