Suicide-related attitudes of pharmacy teams in primary care in England in response to a video intervention

Problem

Two-thirds of people who die by suicide are not seen in specialist mental health services. These people must either be known to primary care, or not engaged with health services at all. Suicide prevention strategies have been established to better develop roles and responsibilities for primary and specialist care providers in suicide risk management. Pharmacists and their teams are well placed to contribute to this vital, multi-professional effort, in community pharmacy and general practice settings. There is emerging evidence and recognition of this role. However, we need to better understand the experiences and attitudes of pharmacy teams in suicide prevention activities and how to optimise roles. Our aim was to examine changes in attitudes and preparedness following a suicide awareness e-learning video produced for pharmacy teams.

Approach

A cross-sectional study including a video intervention for pharmacy teams in England with pre- and post- surveys of the 14-item Attitudes to Suicide Prevention (ASP) scale (possible range 14-70 with lower scores representing positive attitudes) and the exploration of experience, was conducted. Pharmacy staff in England could access a suicide awareness video via the Centre for Pharmacy Postgraduate Education (CPPE). This video was an on-the-sofa conversation involving experts, including those with lived experience, and tailored to a pharmacy audience. Between September 2019 and March 2021, people accessing the video were invited to complete anonymous pre- and post-viewing assessments of attitudes and to share their prior experience. Data were analysed using SPSS®. Descriptive statistics and t-tests used to compare the paired analyses, are reported.

Findings

Of 354 survey respondents working in primary care, 93% worked in community pharmacy, 2% in General Practice and 5% in both sectors. Most were pharmacists (61%) and the remainder had other roles (e.g., pharmacy technicians (18%)). 71% reported interacting with a patient about suicide at least once and were mostly prompted by patient disclosure (39%), with just 5% directly asking a patient. 10% reported participation in suicide prevention training. In the paired analysis (n=127), attitude towards suicide significantly improved immediately following the video (ASP pre: 31.43, S.D.6.12; ASP post: 28.67, S.D.6.73).

Consequences

Pharmacy staff working in primary care speak with people about suicide. Until recently, this has mostly been without formal training on suicide prevention best practices. Using a video intervention demonstrated an improved in attitudes of pharmacy team members towards suicide and demonstrates support for training and upskilling pharmacy team members. Our study highlights the need to continue to explore the role and appropriate training for GP pharmacists to complement the Zero Suicide Alliance training which has since been completed by community pharmacy staff.