Two thirds of all persons, who comit suicide have an appointment with their family physician (FP) in the preceding month. One third of them reports depressive thoughts and less than a fifth talks about his suicidal ideations and plans. FP are basically aware on the association of suicidality with psychiatric disorders i.e. deression. However, they hesitate to communicate about this topic mainly for insecurity. Additional factors might be that physicians themselves are prone to burnout or suicide more often than the general population.

Problem-centered semistructured interview following the grounded theory. Complete transcription of the interview tapes for analysis. Recording of demographic and practice data.

N=24 physicians were interviewed. They saw problems regarding time consuming contacts, stigma of compulsory admission, acceptance of suicidality especially in the older population. More problems would occur in non-depressed patients, especially in those suffering from chronic pain and/or addiction. Interview training was regarded as helpful.

This is the first qualitative study on the primary care management of suicidal patients. It shows e.g., that stigma of psychiatry also influences crisis management.