Skip to main content
Top
Published in: BMC Health Services Research 1/2014

Open Access 01-12-2014 | Research article

Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists

Authors: Tine K Grimholt, Ole R Haavet, Dag Jacobsen, Leiv Sandvik, Oivind Ekeberg

Published in: BMC Health Services Research | Issue 1/2014

Login to get access

Abstract

Background

Competence and attitudes to suicidal behaviour among physicians are important to provide high-quality care for a large patient group. The aim was to study different physicians’ attitudes towards suicidal behaviour and their perceived competence to care for suicidal patients.

Methods

A random selection (n = 750) of all registered General Practitioners, Psychiatrists and Internists in Norway received a questionnaire. The response rate was 40%. The Understanding of Suicidal Patients Scale (USP; scores < 23 = positive attitude) and items about suicide in case of incurable illness from the Attitudes Towards Suicide Questionnaire were used. Five-point Likert scales were used to measure self-perceived competence, level of commitment, empathy and irritation felt towards patients with somatic and psychiatric diagnoses. Questions about training were included.

Results

The physicians held positive attitudes towards suicide attempters (USP = 20.3, 95% CI: 19.6–20.9). Internists and males were significantly less positive. There were no significant differences in the physicians in their attitudes toward suicide in case of incurable illness according to specialty. The physicians were most irritated and less committed to substance misuse patients. Self perceived competence was relatively high. Forty-three percent had participated in courses about suicide assessment and treatment.

Conclusions

The physicians reported positive attitudes and relatively high competence. They were least committed to treat patients with substance misuse. None of the professional groups thought that patients with incurable illness should be given help to commit suicide.
Further customized education with focus on substance misuse might be useful.
Appendix
Available only for authorised users
Literature
1.
go back to reference Saunders KE, Hawton K, Fortune S, Farrell S: Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review. J Affect Disord. 2012, 139: 205-216. 10.1016/j.jad.2011.08.024.CrossRefPubMed Saunders KE, Hawton K, Fortune S, Farrell S: Attitudes and knowledge of clinical staff regarding people who self-harm: a systematic review. J Affect Disord. 2012, 139: 205-216. 10.1016/j.jad.2011.08.024.CrossRefPubMed
2.
go back to reference Wolk-Wasserman D: The intensive care unit and the suicide attempt patient. Acta Psychiatr Scand. 1985, 71: 581-595. 10.1111/j.1600-0447.1985.tb02552.x.CrossRefPubMed Wolk-Wasserman D: The intensive care unit and the suicide attempt patient. Acta Psychiatr Scand. 1985, 71: 581-595. 10.1111/j.1600-0447.1985.tb02552.x.CrossRefPubMed
3.
go back to reference Wingate LR, Joiner TE, Walker RL, Rudd MD, Jobes DA: Empirically informed approaches to topics in suicide risk assessment. Behav Sci Law. 2004, 22: 651-665. 10.1002/bsl.612.CrossRefPubMed Wingate LR, Joiner TE, Walker RL, Rudd MD, Jobes DA: Empirically informed approaches to topics in suicide risk assessment. Behav Sci Law. 2004, 22: 651-665. 10.1002/bsl.612.CrossRefPubMed
4.
go back to reference Taylor TL, Hawton K, Fortune S, Kapur N: Attitudes towards clinical services among people who self-harm: systematic review. Br J Psychiatry. 2009, 194: 104-110. 10.1192/bjp.bp.107.046425.CrossRefPubMed Taylor TL, Hawton K, Fortune S, Kapur N: Attitudes towards clinical services among people who self-harm: systematic review. Br J Psychiatry. 2009, 194: 104-110. 10.1192/bjp.bp.107.046425.CrossRefPubMed
5.
go back to reference Album D, Westin S: Do diseases have a prestige hierarchy? A survey among physicians and medical students. Soc Sci Med. 2008, 66: 182-188. 10.1016/j.socscimed.2007.07.003.CrossRefPubMed Album D, Westin S: Do diseases have a prestige hierarchy? A survey among physicians and medical students. Soc Sci Med. 2008, 66: 182-188. 10.1016/j.socscimed.2007.07.003.CrossRefPubMed
7.
go back to reference Hawton K, Marsack P, Fagg J: The attitudes of psychiatrists to deliberate self-poisoning: comparison with physicians and nurses. Br J Med Psychol. 1981, 54: 341-348. 10.1111/j.2044-8341.1981.tb02572.x.CrossRefPubMed Hawton K, Marsack P, Fagg J: The attitudes of psychiatrists to deliberate self-poisoning: comparison with physicians and nurses. Br J Med Psychol. 1981, 54: 341-348. 10.1111/j.2044-8341.1981.tb02572.x.CrossRefPubMed
8.
go back to reference Samuelsson M, Asberg M, Gustavsson JP: Attitudes of psychiatric nursing personnel towards patients who have attempted suicide. Acta Psychiatr Scand. 1997, 95: 222-230. 10.1111/j.1600-0447.1997.tb09623.x.CrossRefPubMed Samuelsson M, Asberg M, Gustavsson JP: Attitudes of psychiatric nursing personnel towards patients who have attempted suicide. Acta Psychiatr Scand. 1997, 95: 222-230. 10.1111/j.1600-0447.1997.tb09623.x.CrossRefPubMed
9.
go back to reference Mackay N, Barrowclough C: Accident and emergency staff's perceptions of deliberate self-harm: attributions, emotions and willingness to help. Br J Clin Psychol. 2005, 44: 255-267. 10.1348/014466505X29620.CrossRefPubMed Mackay N, Barrowclough C: Accident and emergency staff's perceptions of deliberate self-harm: attributions, emotions and willingness to help. Br J Clin Psychol. 2005, 44: 255-267. 10.1348/014466505X29620.CrossRefPubMed
10.
go back to reference Samuelsson M, Sunbring Y, Winell I, Asberg M: Nurses' attitudes to attempted suicide patients. Scand J Caring Sci. 1997, 11: 232-237. 10.1111/j.1471-6712.1997.tb00461.x.CrossRefPubMed Samuelsson M, Sunbring Y, Winell I, Asberg M: Nurses' attitudes to attempted suicide patients. Scand J Caring Sci. 1997, 11: 232-237. 10.1111/j.1471-6712.1997.tb00461.x.CrossRefPubMed
11.
go back to reference Maitra RT, Harfst A, Bjerre LM, Kochen MM, Becker A: Do German general practitioners support euthanasia? Results of a nation-wide questionnaire survey. Eur J Gen Pract. 2005, 11: 94-100. 10.3109/13814780509178247.CrossRefPubMed Maitra RT, Harfst A, Bjerre LM, Kochen MM, Becker A: Do German general practitioners support euthanasia? Results of a nation-wide questionnaire survey. Eur J Gen Pract. 2005, 11: 94-100. 10.3109/13814780509178247.CrossRefPubMed
12.
go back to reference Onwuteaka-Philipsen BD, Brinkman-Stoppelenburg A, Penning C, de Jong-Krul GJ, van Delden JJ, van der Heide A: Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey. Lancet. 2012, 380: 908-915. 10.1016/S0140-6736(12)61034-4.CrossRefPubMed Onwuteaka-Philipsen BD, Brinkman-Stoppelenburg A, Penning C, de Jong-Krul GJ, van Delden JJ, van der Heide A: Trends in end-of-life practices before and after the enactment of the euthanasia law in the Netherlands from 1990 to 2010: a repeated cross-sectional survey. Lancet. 2012, 380: 908-915. 10.1016/S0140-6736(12)61034-4.CrossRefPubMed
13.
go back to reference Gielen J, Van den Branden S, Broeckaert B: Attitudes of European physicians toward euthanasia and physician-assisted suicide: a review of the recent literature. J Palliat Care. 2008, 24: 173-184.PubMed Gielen J, Van den Branden S, Broeckaert B: Attitudes of European physicians toward euthanasia and physician-assisted suicide: a review of the recent literature. J Palliat Care. 2008, 24: 173-184.PubMed
14.
go back to reference Suominen K, Suokas J, Lonnqvist J: Attitudes of general hospital emergency room personnel towards attempted suicide patients. Nord J Psychiatry. 2007, 61: 387-392. 10.1080/08039480701643381.CrossRefPubMed Suominen K, Suokas J, Lonnqvist J: Attitudes of general hospital emergency room personnel towards attempted suicide patients. Nord J Psychiatry. 2007, 61: 387-392. 10.1080/08039480701643381.CrossRefPubMed
15.
go back to reference Renberg ES, Hjelmeland H, Koposov R: Building models for the relationship between attitudes toward suicide and suicidal behavior: based on data from general population surveys in Sweden, Norway, and Russia. Suicide Life Threat Behav. 2008, 38: 661-675. 10.1521/suli.2008.38.6.661.CrossRefPubMed Renberg ES, Hjelmeland H, Koposov R: Building models for the relationship between attitudes toward suicide and suicidal behavior: based on data from general population surveys in Sweden, Norway, and Russia. Suicide Life Threat Behav. 2008, 38: 661-675. 10.1521/suli.2008.38.6.661.CrossRefPubMed
16.
go back to reference Bjornaas MA, Jacobsen D, Haldorsen T, Ekeberg O: Mortality and causes of death after hospital-treated self-poisoning in Oslo: a 20-year follow-up. Clin Toxicol (Phila). 2009, 47: 116-123. 10.1080/15563650701771981.CrossRef Bjornaas MA, Jacobsen D, Haldorsen T, Ekeberg O: Mortality and causes of death after hospital-treated self-poisoning in Oslo: a 20-year follow-up. Clin Toxicol (Phila). 2009, 47: 116-123. 10.1080/15563650701771981.CrossRef
17.
go back to reference Norheim AB, Grimholt TK, Ekeberg O: Attitudes towards suicidal behaviour in outpatient clinics among mental health professionals in Oslo. BMC Psychiatry. 2013, 13: 90-10.1186/1471-244X-13-90.CrossRefPubMedPubMedCentral Norheim AB, Grimholt TK, Ekeberg O: Attitudes towards suicidal behaviour in outpatient clinics among mental health professionals in Oslo. BMC Psychiatry. 2013, 13: 90-10.1186/1471-244X-13-90.CrossRefPubMedPubMedCentral
18.
go back to reference Jacobson JM, Osteen P, Jones A, Berman A: Evaluation of the recognizing and responding to suicide risk training. Suicide Life Threat Behav. 2012, 42: 471-485. 10.1111/j.1943-278X.2012.00105.x.CrossRefPubMed Jacobson JM, Osteen P, Jones A, Berman A: Evaluation of the recognizing and responding to suicide risk training. Suicide Life Threat Behav. 2012, 42: 471-485. 10.1111/j.1943-278X.2012.00105.x.CrossRefPubMed
19.
go back to reference Ougrin D, Banarsee R, Dunn-Toroosian V, Majeed A: Suicide survey in a London borough: primary care and public health perspectives. J Public Health (Oxf). 2011, 33: 385-391. 10.1093/pubmed/fdq094.CrossRef Ougrin D, Banarsee R, Dunn-Toroosian V, Majeed A: Suicide survey in a London borough: primary care and public health perspectives. J Public Health (Oxf). 2011, 33: 385-391. 10.1093/pubmed/fdq094.CrossRef
20.
go back to reference Ritter K, Stompe T, Voracek M, Etzersdorfer E: Suicide risk-related knowledge and attitudes of general practitioners. Wien Klin Wochenschr. 2002, 114: 685-690.PubMed Ritter K, Stompe T, Voracek M, Etzersdorfer E: Suicide risk-related knowledge and attitudes of general practitioners. Wien Klin Wochenschr. 2002, 114: 685-690.PubMed
21.
go back to reference Kovess-Masfety V, Boyd A, Haro JM, Bruffaerts R, Villagut G, Lepine JP, Gasquet I, Alonso J: High and low suicidality in Europe: a fine-grained comparison of France and Spain within the ESEMeD surveys. J Affect Disord. 2011, 133: 247-256. 10.1016/j.jad.2011.04.014.CrossRefPubMedPubMedCentral Kovess-Masfety V, Boyd A, Haro JM, Bruffaerts R, Villagut G, Lepine JP, Gasquet I, Alonso J: High and low suicidality in Europe: a fine-grained comparison of France and Spain within the ESEMeD surveys. J Affect Disord. 2011, 133: 247-256. 10.1016/j.jad.2011.04.014.CrossRefPubMedPubMedCentral
22.
go back to reference Poma SZ, Grossi A, Toniolo E, Baldo V, Leo DD: Self-perceived difficulties with suicidal patients in a sample of italian general practitioners. J Clin Med Res. 2011, 3: 303-308.PubMedPubMedCentral Poma SZ, Grossi A, Toniolo E, Baldo V, Leo DD: Self-perceived difficulties with suicidal patients in a sample of italian general practitioners. J Clin Med Res. 2011, 3: 303-308.PubMedPubMedCentral
23.
go back to reference McGorry PD, Goldstone S: Is this normal? Assessing mental health in young people. Aust Fam Physician. 2011, 40: 94-97.PubMed McGorry PD, Goldstone S: Is this normal? Assessing mental health in young people. Aust Fam Physician. 2011, 40: 94-97.PubMed
24.
go back to reference Kodaka M, Postuvan V, Inagaki M, Yamada M: A systematic review of scales that measure attitudes toward suicide. Int J Soc Psychiatry. 2011, 57: 338-361. 10.1177/0020764009357399.CrossRefPubMed Kodaka M, Postuvan V, Inagaki M, Yamada M: A systematic review of scales that measure attitudes toward suicide. Int J Soc Psychiatry. 2011, 57: 338-361. 10.1177/0020764009357399.CrossRefPubMed
25.
go back to reference Creed FH, Pfeffer JM: Attitudes of house-physicians towards self-poisoning patients. Med Educ. 1981, 15: 340-345. 10.1111/j.1365-2923.1981.tb02500.x.CrossRefPubMed Creed FH, Pfeffer JM: Attitudes of house-physicians towards self-poisoning patients. Med Educ. 1981, 15: 340-345. 10.1111/j.1365-2923.1981.tb02500.x.CrossRefPubMed
26.
go back to reference Colson DB, Allen JG, Coyne L, Dexter N, Jehl N, Mayer CA, Spohn H: An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients. Hosp Community Psychiatry. 1986, 37: 923-928.PubMed Colson DB, Allen JG, Coyne L, Dexter N, Jehl N, Mayer CA, Spohn H: An anatomy of countertransference: staff reactions to difficult psychiatric hospital patients. Hosp Community Psychiatry. 1986, 37: 923-928.PubMed
27.
go back to reference Kendall T, Taylor C, Bhatti H, Chan M, Kapur N: Longer term management of self harm: summary of NICE guidance. BMJ. 2011, 343: d7073-10.1136/bmj.d7073.CrossRefPubMed Kendall T, Taylor C, Bhatti H, Chan M, Kapur N: Longer term management of self harm: summary of NICE guidance. BMJ. 2011, 343: d7073-10.1136/bmj.d7073.CrossRefPubMed
28.
go back to reference Appleby L, Morriss R, Gask L, Roland M, Perry B, Lewis A, Battersby L, Colbert N, Green G, Amos T, Davies L, Faragher B: An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project). Psychol Med. 2000, 30: 805-812. 10.1017/S0033291799002494.CrossRefPubMed Appleby L, Morriss R, Gask L, Roland M, Perry B, Lewis A, Battersby L, Colbert N, Green G, Amos T, Davies L, Faragher B: An educational intervention for front-line health professionals in the assessment and management of suicidal patients (The STORM Project). Psychol Med. 2000, 30: 805-812. 10.1017/S0033291799002494.CrossRefPubMed
Metadata
Title
Perceived competence and attitudes towards patients with suicidal behaviour: a survey of general practitioners, psychiatrists and internists
Authors
Tine K Grimholt
Ole R Haavet
Dag Jacobsen
Leiv Sandvik
Oivind Ekeberg
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Health Services Research / Issue 1/2014
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/1472-6963-14-208

Other articles of this Issue 1/2014

BMC Health Services Research 1/2014 Go to the issue