High-risk management guidelines for elderly suicidal patients in primary care settings

Older adults, especially older white men, are more likely to commit suicide than other age-groups. The assessment and management of suicide ideation a nd behavior for the elderly is especially relevant for primary care physici ans because many patients visit their physician shortly before committing s uicide. In 1993, the Agency for Health Care Policy and Research (AHCPR) rel eased clinical practice guidelines for the treatment of depression in prima ry care settings. The AHCPR guidelines offered some assistance with respect to detecting and treating patients who are suicidal. However, these guidel ines lacked detailed and specific instructions for managing high-risk patie nts within the context of intervention research. The current set of guideli nes builds upon this previous work by describing (1) a general approach for interacting with suicidal patients; (2) structured assessments for determi ning the degree of risk for suicide; (3) crisis intervention strategies; an d (4) ongoing management procedures for working with suicidal patients in p rimary care settings. Copyright (C) 2001 John Wiley & Sons, Ltd.