Training general practitioners to recognise and respond to psychological distress and suicidal ideation in young people

Objective: To determine the effectiveness of a training program for general practitioners in recognising and responding to psychological distress and suicidal ideation in young people. Design and setting: The study, conducted in general practice surgeries in T asmania, Victoria and Western Australia in 1996 and 1997, used a pre-/post- test design to audit consecutive young patients presenting in the six weeks before and the six weeks after the GPs' participation in the training prog ram. Participants: Consisted of 23 GPs who attended a youth suicide prevention w orkshop and 423 patients aged 15-24 years who presented to the GPs' surgeri es (203 pre-workshop and 220 post-workshop). Intervention: GPs attended a one-day training workshop designed to enhance their ability to recognise, assess and manage young patients at risk of sui cide. Main outcome measures: Scores on three patient self-report inventories (Gen eral Health Questionnaire-12 [GHQ-12], Center for Epidemiological Studies D epression Scale [CES-D] and Depressive Symptom Inventory - Suicidality Subs cale [DSI-SSI]); a BP-completed form for each patient summarising presentin g complaint(s), psychological assessment and proposed management plan. Results: After training, GPs demonstrated increased recognition rates of ps ychologically distressed patients scoring above the cut-offs of the GHQ-12 (48% increase; odds ratio [OR], 1.748; 95% Cl, 0.904-03.381) and CES-D (39. 5% increase; OR, 2.067; 95% Cl, 1.031-4.143); enquiry about suicidal ideati on increased by 32.5% (OR, 1.483; 95% Cl, 0.929-2.366); and identification of suicidal patients (determined by DSI-SS score) Increased by 130% (OR, 3. 949; 95% Cl, 1.577-9.888). Training did not lead to any significant change in GPs' patient management strategies. Conclusions: A one-day training course can significantly enhance GP detecti on rates of psychological distress and suicidal ideation in young patients, but higher recognition rates do not necessarily lead to changes in patient management.