Predictors of Primary Care Physicians’ Self-reported Intention to Conduct Suicide Risk Assessments

Primary care physicians play a significant role in depression care, suicide assessment, and suicide prevention. However, little
is known about what factors relate to and predict quality of depression care (assessment, diagnosis, and treatment), including
suicide assessment. The authors explored the extent to which select patient and physician factors increase the probability
of one element of quality of care: namely, intention to conduct suicide assessment. Data were collected from 404 randomly
selected primary care physicians after their interaction with CD-ROM vignettes of actors portraying major depression with
moderate levels of severity. The authors examined which patient factors and physician factors increase the likelihood of physicians’
intention to conduct a suicide assessment. Data from the study revealed that physician-participants inquired about suicide
36% of the time. A random effects logistic model indicated that several factors were predictive of physicians’ intention to
conduct a suicide assessment: patient’s comorbidity status (odds ratio (OR) = 0.61; 95% confidence interval (CI) = 0.37–1.00),
physicians’ age (OR = 0.67; 95% CI = 0.49–0.92), physicians’ race (OR = 1.84; 95% CI = 1.08–3.13), and how depressed the physician
perceived the virtual patient to be (OR = 0.58; 95% CI = 0.39–0.87). A substantial number of primary care physicians in this
study indicated they would not assess for suicide, even though most physicians perceived the virtual patient to be depressed
or very depressed. Further study is needed to establish factors that may be modified and targeted to increase the likelihood
of physicians’ providing one element of quality of care—suicide assessment—for depressed patients.