There is still not enough evidence to recommend either for or against patients getting routinely screened for suicide risk by their primary care doctors, an influential panel of experts said.
The ruling applies to when doctors are dealing with teens, adults and older adults without a mental health disorder or symptoms of mental illness, according to a final recommendation from the US Preventive Services Task Force (USPSTF).
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However, primary care doctors should screen teens and adults for depression, the panel said. If a patient is depressed and potentially at risk for suicide, they should also be given immediate help.
The government-appointed USPSTF also said that further research is needed to determine the best ways to identify and help people at risk for suicide.
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Suicide remains a major public health issue in the United States, accounting for about 37 000 deaths a year. In 2010, suicide was the 10th leading cause of death in the US.
Having a mental health disorder is the greatest risk factor for suicide. For example, adults with a lifetime history of depression have a more than two-fold increased risk of suicide, the panelists noted, and between 50 to 70% of youths who attempt suicide are depressed.
Immediate help for suicidal patients
However, depression often goes undiagnosed in patients, which is why it is important for doctors to screen patients for the condition, according to the task force recommendation, which is published online May 19 in the journal Annals of Internal Medicine.
"Primary care clinicians should remain alert to patients who are suicidal or who have existing mental health disorders and ensure that they get immediate help. The task force looked to see if primary care clinicians could identify people at risk of suicide who do not have signs or symptoms of mental health concerns," task force co-vice chair Dr Al Siu said in the news release.
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However, "while there has been some promising early research, there is currently not enough evidence to determine the effectiveness of screening tools for suicide risk," he added.
"The lives of too many people, both young and old, including those who have served our country in the military, have been lost to suicide," task force member Linda Baumann said in the news release. "It is critical to find the best ways to identify those at risk and support them with effective treatment. More research is needed to better understand current screening tests, to develop new ones that can better identify people without symptoms who are at risk for suicide, and to create effective treatment programs for those who are identified as high risk."
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