Search

Community pharmacists are increasingly recognized as integral members in suicide prevention programs, as part of a multidisciplinary and multifaceted approach. However, further research is required to understand then optimize the whole pharmacy teams' role across sectors.To explore pharmacy teams' experience of, and attitudes towards, suicide prevention in England.A cross-sectional survey was purposively distributed to pharmacy staff in England before accessing an optional suicide awareness raising video, hosted by Centre for Pharmacy Postgraduate Education (CPPE), in September 2019-March 2021. Questions included demographics and experience of, attitudes towards, and preparedness for, suicide prevention. The 14-item Attitudes to Suicide Prevention (ASP) scale was used (possible range 14-70 with lower scores representing positive attitudes). Descriptive and comparative statistics were reported. Free-text comments were invited to explore respondents' experience of suicide prevention and reflexive thematic analysis used.Of 403 respondents, 82% were female; most were pharmacists (59%) or pharmacy technicians (21%), with the remainder having other roles. Eighty-five percent worked in community pharmacy. Eleven percent had prior suicide prevention training, and 71% reported interacting with at least one patient about suicide. Most often, suicidality was disclosed by the patient (40%), with 6% of pharmacy staff having directly asked a patient about suicidal behavior or plans. The aggregated ASP score was 31.51 (SD 6.23), and role did not affect experience or attitude. Pharmacy teams' experiences of suicide prevention can be summarized by three major themes i) Exposure to suicide; ii) Responsibility for action; and iii) Access to means of suicide.Pharmacy teams felt responsibility in caring for those at risk of suicide and had experience of this. Further training should include understanding of medicines means restriction and involve all roles and sectors of pharmacy. Pharmacy teams should be integrated into the 'circle of care' to access referral pathways.

BackgroundExisting evidence suggests that some individuals from ethnic minority backgrounds are at increased risk of suicide compared to their majority ethnic counterparts, whereas others are at decreased risk. We aimed to estimate the absolute and relative risk of suicide in individuals from ethnic minority backgrounds globally.MethodsDatabases (Medline, Embase, and PsycInfo) were searched for epidemiological studies between 01/01/2000 and 3/07/2020, which provided data on absolute and relative rates of suicide amongst ethnic minority groups. Studies reporting on clinical or specific populations were excluded. Pairs of reviewers independently screened titles, abstracts, and full texts. We used random effects meta-analysis to estimate overall, sex, location, migrant status, and ancestral origin, stratified pooled estimates for absolute and rate ratios. PROSPERO registration: CRD42020197940.FindingsA total of 128 studies were included with 6,026,103 suicide deaths in individuals from an ethnic minority background across 31 countries. Using data from 42 moderate-high quality studies, we estimated a pooled suicide rate of 12·1 per 100,000 (95% CIs 8·4–17·6) in people from ethnic minority backgrounds with a broad range of estimates (1·2–139·7 per 100,000). There was weak statistical evidence from 51 moderate-high quality studies that individuals from ethnic minority groups were more likely to die by suicide (RR 1·3 95% CIs 0·9–1·7) with again a broad range amongst studies (RR 0·2–18·5). In our sub-group analysis we only found evidence of elevated risk for indigenous populations (RR: 2·8 95% CIs 1·9–4·0; pooled rate: 23·2 per 100,000 95% CIs 14·7–36·6). There was very substantial heterogeneity (I2 > 98%) between studies for all pooled estimates.InterpretationThe homogeneous grouping of individuals from ethnic minority backgrounds is inappropriate. To support suicide prevention in marginalised groups, further exploration of important contextual differences in risk is required. It is possible that some ethnic minority groups (for example those from indigenous backgrounds) have higher rates of suicide than majority populations.FundingNo specific funding was provided to conduct this research. DK is funded by Wellcome Trust and Elizabeth Blackwell Institute Bristol. Matthew Spittal is a recipient of an Australian Research Council Future Fellowship (project number FT180100075) funded by the Australian Government. Rebecca Musgrove is funded by the NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC-2016-003).

Background One in four people experience a mental health problem every year and improving mental health care is an international priority. In the course of their work, pharmacists frequently encounter people with mental health problems. The experience of mental health teaching, including Mental Health First Aid (MHFA) training, in undergraduate pharmacy (MPharm) students in the UK and Ireland is not well documented. Students’ viewpoints, contextualised with curricular overviews provided by staff, were analysed to understand their experience. Methods An anonymous, online questionnaire was distributed to MPharm students and staff in the UK and Ireland. Students were asked closed questions regarding their course and exposure to MHFA, which were analysed using descriptive statistics. Open questions were included to enable explanations and these data were used to contextualise the quantitative findings. One member of staff from each university was invited to answer a modified staff version of the questionnaire, to provide a curriculum overview and staff perspective. Results 232 students and 13 staff, from 22 universities, responded. Three-quarters of students did not agree with the statement that ‘mental health was embedded throughout the MPharm’. Most students (80.6%) stated that they were taught neuropharmacology whilst 44.8% stated that their course included communicating with people about their mental health. One-third (33.2%) of students stated that their degree ‘adequately prepared them to help people with their mental health’. Twenty-six students (11.6%) had completed MHFA training of which 89% would endorse inclusion of this within the MPharm. Of those who had not completed the training, 81% expressed a desire to do so. Those who completed MHFA training self-reported greater preparedness than those who did not, but student numbers were small. Conclusions Mental health teaching for pharmacy undergraduates is more focussed on theoretical aspects rather than applied skills. MHFA was viewed by students as one way to enhance skill application. The association of the increased self-reported preparedness of those who completed MHFA could be confounded by a positive environmental cultural. MPharm programmes need sufficient focus on real-world skills such as communication and crisis response, to complement the fundamental science.

Background Specifically-designed community pharmacy-based services represent opportunities to support people with their mental health. As few such services exist worldwide, the Advancing Mental HeaLth Provision In PharmacY (AMPLIPHY) was designed with stakeholders. The purpose was to support people with their mental health when initiated on new prescription or change in drug, dose or quantity of antidepressant, through a series of consultations (up to 3 months). Objective(s) The aim was to evaluate the feasibility of the AMPLIPHY service. The objectives were to: i) pilot the service; ii) examine anonymous consultation data to understand patients' characteristics, priorities and consultation focus and iii) Evaluate pharmacists’ experiences. Methods This service evaluation involved a concurrent mixed methods design. Patient characteristics were extracted from consultation notes and descriptive statistics applied. Content analysis was used to summarise consultation foci and comparisons between patients’ priorities with consultation content were made. Pharmacists were interviewed at the start (n = 10) and end (n = 4) of the pilot with themes identified using thematic analysis. Results Seventy-six patients participated (63% of recruitment target). The median age was 39 (IQR 28–47) and 62% were female. Seventy percent of patients had one consultation, 26% had two and 4% had three. Prescription for new antidepressant was the most common reason for entry (74%) and sertraline was most prescribed (46%). Consultations commonly focussed on life experience (n = 51), medication (n = 47), health (n = 42), support (n = 36) and patients' expression of their feelings (n = 31). The pharmacists’ experiences were summarised in three themes: i) Motivation, ii) Practicalities and iii) Experience and Outcomes. Conclusions Pharmacists were motivated to deliver this novel service and some patients were willing to join the service. Analysis of patient demographics, consultation notes and interviews provide insight into the strengths and challenges of the service and provides a blueprint for future service developments.

AIMS Antihistamines are routinely taken to control allergic reactions or sedation to induce sleep. There are, however, growing concerns regarding sedating antihistamine misuse. This research aims to evaluate deaths related to antihistamines in England occurring during 2000-2019. METHODS Cases reported to the National Programme on Substance Abuse Deaths from England occurring in 2000-2019 with antihistamine detections at postmortem were extracted for analysis. RESULTS In total, 1666 antihistamine postmortem detections were identified from 1537 cases. Sedating antihistamines available for purchase under pharmacist supervision but without need for a prescription (pharmacy-only medications) were present in a significant majority of cases (85.2%, P

Every year more than 800,000 people die due to suicide, worldwide. Countries with more established suicide prevention plans often advocate for multisector, multidisciplinary, and whole community approaches to suicide prevention. The role of pharmacy teams, particularly community pharmacy teams, within this had rarely been considered but evidence is emerging. This chapter explores what is known about the role of community pharmacy teams in suicide prevention. It presents a narrative review of studies predominately from Canada, Australia, the United Kingdom, and the United States, with a focus on pharmacists’ experiences and attitudes toward suicide prevention. The chapter presents a case study which contains, for the first time, results from a survey of pharmacy staff in England and explores their experiences and perceptions of suicide awareness and prevention.

Introduction Suicide prevention is a Government priority and affects every sector of society.(1) The role of mental health nurses (MHN) in suicide prevention is more obvious than that of pharmacists. However, the requirement for suicide prevention training in community pharmacy staff has been incentivized in England through its inclusion in the Pharmacy Quality Scheme. (2) There is no standardized requirement for suicide prevention training in the MPharm degree so we curated an interprofessional education (IPE) session involving pharmacy and MHN students in order to learn about suicide prevention in a mutually beneficial way. Aim We aimed to evaluate the IPE session to understand the attitudes towards suicide and preparedness to help someone thinking about or planning suicide of both sets of students. We aimed to compare any changes in attitude before and after the session both within and between pharmacy students and MHN students. Methods We delivered two IPE sessions on suicide, 3.5 hours in length. Students attended one session. This was compulsory for pharmacy students and optional for MHN students. We evaluated the session through a duplicated, anonymous online survey, via the Qualtrics® platform, at the start and end of the session. Students were informed that this was an optional evaluation. They self-assigned a code that we used to link their answers. We invited students to answer a series of questions to assess their attitudes and preparedness to suicide prevention. We summarised these data using descriptive statistics related to individual statements and composite scores. We used Independent-samples median test and Wilcoxon-Signed Rank Tests to compare data distributions between professional groups before the session, between groups after the session and then to understand change within subject groups, using paired data only. Results 104 students completed the initial survey of which 46% (n=48) were pharmacy students. MHN students reported being more prepared to respond to suicide (median:14, IQR 12–15) than pharmacy students (median: 8, IQR 6–10). Prior to the session, there were no statistically significant differences in responses to the attitude questions between MHN and pharmacy students, barring one question (‘I don’t feel comfortable assessing someone for suicide risk’). A statistically significant increase in preparedness was reported both pharmacy students (p Conclusion We present an innovative session in suicide awareness involving two professional groups. MHN self-reported higher levels of preparedness in suicide prevention than pharmacy students both before and after the session but an improvement was seen in both groups. These results indicate that IPE between MHN and pharmacy students could improve preparedness relating to suicide. More work is needed to explore the optimal content of training and longitudinal impact of training involving more students, as well as understanding if self-reported preparedness translates to professional behaviour, all of which are limitations of the current study References 1. HM Government H. Preventing suicide in England: Third progress report on the cross-government outcomes strategy to save lives. London: HM Government; 2017. 2. NHS Business Service Authority. Drug Tariff; 2020 [cited 07 Oct 2020]. Available at: https://www.nhsbsa.nhs.uk/pharmacies-gp-practices-and-appliance-contractors/drug-tariff

Introduction Improving mental health care is an international priority, and one that is championed by the Royal Pharmaceutical Society. (1) In the course of their work, pharmacists frequently encounter people with mental health problems. The extent to which mental health is taught on the undergraduate pharmacy degree in the UK and Ireland, and the inclusion of Mental Health First Aid (MHFA) training, has not be described recently. Aim We aimed to determine how mental health teaching is embedded into the MPharm and students’ perception of their own preparedness to help people with their mental health. We explored if and how MHFA training is included, and students’ experience of, or desire to complete this. Methods We conducted an anonymous, online questionnaire of UK and Ireland MPharm students, distributed via networks and social media. Students were asked a series of closed questions about mental health teaching in the MPharm, and exposure to MHFA. We analysed answers using descriptive statistics. We included some open-ended questions to enable students to expand on their answers. We used this qualitative data to contextualize findings. We invited one member of staff from each university to answer a modified staff version of the questionnaire, in order to provide a curriculum overview and staff perspective on MHFA provision. Results 232 students and 13 staff responded, from 22 universities in total. Eighty percent of student participants were female and 70% were in the third or final year of study. Three-quarters of students felt that mental health was not embedded throughout the MPharm. Eighty-percent of students stated that they were taught about neuropharmacology and 44.8% stated that their course included communicating with people about their mental health. One third of students felt that their degree adequately prepared them to help people with their mental health. Twenty-six students (11.6%) had completed MHFA training of which 89% would endorse inclusion of this within the MPharm. Of those who had not completed the training, 81% expressed a desire to do so. Those who completed MHFA training self-reported more preparedness than those who did not, but student numbers were small. Conclusion Mental health teaching remains focused on theoretical aspects, such as pharmacology, with less emphasis on practical skills, such as communication skills that might support interactions about mental health. MHFA was viewed by students as one way to enhance this. Of the small number of students who had completed MHFA, they displayed an increased self-reported preparedness. This could, however, be linked to the environmental culture of the programme rather than the training per se. MPharm programmes need sufficient focus on skills including communication and crisis response that may be required by pharmacists, alongside the fundamental scientific knowledge relating to mental health. References 1. Royal Pharmaceutical Society. No health without mental health: How can pharmacy support people with mental health problems? London: RPS; 2018.

Introduction Antihistamines are not one of the medicine groups reported on in the Office for National Statistics drug-related death data. (1) However, there is concern that first-generation antihistamines are misused for their sedative properties. This is amplified by a recent social media challenge, which resulted in deaths due to diphenhydramine overdose. (2) The extent of the involvement of antihistamines in deaths is largely unknown. Aim We aimed to evaluate deaths related to antihistamines in England (2000–2019) by individual drug, medicine classification (POM, P, GSL), whether the drug was considered attributable to the death (known as implication rate), or incidental; and examine temporal trends. Methods Deaths are reported voluntarily by coroners to the National Programme on Substance Abuse Deaths (NPSAD) in cases where psychoactive drugs were detected at post-mortem and/or when the decedent was known to abuse drugs. NPSAD holds data on decedent demographics (gender, age, employment status, living arrangements), details pertaining to the death (cause(s) of death, manner of death, conclusion of inquest, toxicology reports) and past social and medical histories, including drugs prescribed. From this dataset, we extracted all cases where an antihistamine was detected at post-mortem between 2000 and 2019. We report descriptive statistics to describe the reporting of antihistamines in deaths. Results We identified 1666 antihistamine detections from 1537 individuals. The significant majority of these were sedative antihistamines which are classed as pharmacy medicines (P) (85.2%, p Conclusion We describe the first report regarding antihistamine-related mortality from England. From the NPSAD, we can obtain prescription source and toxicology reports, beyond those reported in national death data. Although incomplete, the response from coroners is good (89%), and provides sufficient cause for concern. The rising trend in antihistamine-related deaths may in-part be contributed to by the perceived negligible dangers associated with antihistamines, both from the general public and professionals. Awareness of the dangerous sedative properties that some antihistamines possess is however heightened in individuals who are deliberately seeking out these effects. An urgent review of sedating antihistamines currently assigned under the P classification is needed to achieve antihistamine harm reduction, balanced against the self-care they enable. References 1. Office for National Statistics. Deaths related to drug poisoning in England and Wales: 2019 registration [internet]. 2020 [cited 18 Oct 2020]. Available from: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsrelatedtodrugpoisoninginenglandandwales/2019registrations 2. US FDA. Benadryl (diphenhydramine): Drug Safety Communication - Serious Problems with High Doses of the Allergy Medicine. 2020.

Introduction Improvement of mental health is a priority in the NHS Long Term Plan (1), and pharmacists and their teams could provide enhanced support for people who take medicines for anxiety or depression, two of the most common mental health problems in the UK. However, a recent Cochrane review (2) identified no community pharmacy services focused on mental health. Aim We aimed to pilot a mental health support service, in community pharmacy: Advancing Mental Health Provision in Pharmacy (AMPLIPHY) to assess its feasibility and potential benefit Methods The AMPLIPHY service was codesigned through a workshop involving people with lived experience, pharmacists and researchers. The resultant programme is a series of consultations, beginning at the presentation of the qualifying prescription for an antidepressant, after a further 1–2 weeks and then as further prescriptions are presented, up to 3 months. People are eligible to enter the service if they are newly prescribed antidepressants for depression or anxiety, or have a change in medication, dose or quantity. Pharmacists and their teams identified people who met this criterion and invited them to participate. The service was intended to be patient-led, with the pharmacist helping the patient to define tangible aims and/or outcomes that they wanted to focus on, and providing sign-posting where required. Following brief one-day training, the pilot ran across ten pharmacies in Greater Manchester from November 2019 through March 2020. We triangulated results from: a) quantitative analysis of consultation data; b) content analysis of consultation records; and c) template analysis of semi-structured interviews with participating pharmacists at the start and end of the service. We aimed to obtain feedback from people on exit from the AMPLIPHY service, but this was curtailed due to the coronavirus pandemic. Consultations were recorded via the Pharmoutcomes system (a,b) and interviews were recorded and transcribed, with NVivo used to manage the interview dataset (c). Results Seventy-six patients participated in the service, across 9 of the 10 pharmacies. Seventy-five percent of patients had just one consultation. The median age was 39 (IQR 28–47) and 62% of patients were women. Most patients entered the service due to new prescription of antidepressant (74%), 17% due to a change in dose and the remainder due to change in medication or quantity. Sertraline was the most commonly prescribed medication (46%). The content analysis is indicating that consultations centred around one of five areas: health (n=31), lifestyle (n=62), medication (n=45), support (n=37) and patient’s descriptions of their feelings (n=31). Conclusion AMPLIPHY was accessed by a range of people, mainly on initiation of a new antidepressant. Parallels might be drawn with the New Medicines Service in England, but this does not currently extend to antidepressants. Consultations were not restricted to health and medication, but extended to other social and lifestyle aspects thus indicated that participants felt comfortable to disclose their personal situations to the pharmacist. This could support tailored interactions. However, more work is warranted to understand why most patients did not attend multiple consultations, and the immediate/ long-term impact from the patient’s perspective. References 1. NHS. NHS Long Term Plan [online]. 2019 [cited 09 October 2020]. Available at: https://www.england.nhs.uk/long-term-plan/ 2. de Barra M, Scott CL, Scott NW, Johnston M, de Bruin M, Nkansah N, Bond CM, Matheson CI, Rackow P, Williams AJ, Watson MC. Pharmacist services for non-hospitalised patients. Cochrane Database of Systematic Reviews 2018, Issue 9. Art. No.: CD013102. DOI: 10.1002/14651858.CD013102.

Objective To estimate the risk of self-harm in people with epilepsy and identify factors which influence this risk. Methods We identified people with incident epilepsy in the Clinical Practice Research Datalink, linked to hospitalization and mortality data, in England (01/01/1998–03/31/2014). In Phase 1, we estimated risk of self-harm among people with epilepsy, versus those without, in a matched cohort study using a stratified Cox proportional hazards model. In Phase 2, we delineated a nested case–control study from the incident epilepsy cohort. People who had self-harmed (cases) were matched with up to 20 controls. From conditional logistic regression models, we estimated relative risk of self-harm associated with mental and physical illness comorbidity, contact with healthcare services and antiepileptic drug (AED) use. Results Phase 1 included 11,690 people with epilepsy and 215,569 individuals without. We observed an adjusted hazard ratio of 5.31 (95% CI 4.08–6.89) for self-harm in the first year following epilepsy diagnosis and 3.31 (95% CI 2.85–3.84) in subsequent years. In Phase 2, there were 273 cases and 3790 controls. Elevated self-harm risk was associated with mental illness (OR 4.08, 95% CI 3.06–5.42), multiple general practitioner consultations, treatment with two AEDs versus monotherapy (OR 1.84, 95% CI 1.33–2.55) and AED treatment augmentation (OR 2.12, 95% CI 1.38–3.26). Conclusion People with epilepsy have elevated self-harm risk, especially in the first year following diagnosis. Clinicians should adequately monitor these individuals and be especially vigilant to self-harm risk in people with epilepsy and comorbid mental illness, frequent healthcare service contact, those taking multiple AEDs and during treatment augmentation. Electronic supplementary material The online version of this article (10.1007/s00415-018-9094-2) contains supplementary material, which is available to authorized users.

Importance People with epilepsy are at increased risk of mortality, but, to date, the cause-specific risks of all unnatural causes have not been reported. Objective To estimate cause-specific unnatural mortality risks in people with epilepsy and to identify the medication types involved in poisoning deaths. Design, Setting, and Participants This population-based cohort study used 2 electronic primary care data sets linked to hospitalization and mortality records, the Clinical Practice Research Datalink (CPRD) in England (from January 1, 1998, to March 31, 2014) and the Secure Anonymised Information Linkage (SAIL) Databank in Wales (from January 1, 2001, to December 31, 2014). Each person with epilepsy was matched on age (within 2 years), sex, and general practice with up to 20 individuals without epilepsy. Unnatural mortality was determined usingInternational Statistical Classification of Diseases and Related Health Problems, Tenth Revisioncodes V01 through Y98 in the Office for National Statistics mortality records. Hazard ratios (HRs) were estimated in each data set using a stratified Cox proportional hazards model, and meta-analyses were conducted using DerSimonian and Laird random-effects models. The analysis was performed from January 5, 2016, to November 16, 2017. Exposures People with epilepsy were identified using primary care epilepsy diagnoses and associated antiepileptic drug prescriptions. Main Outcomes and Measures Hazard ratios (HRs) for unnatural mortality and the frequency of each involved medication type estimated as a percentage of all medication poisoning deaths. Results In total, 44 678 individuals in the CPRD and 14 051 individuals in the SAIL Databank were identified in the prevalent epilepsy cohorts, and 891 429 (CPRD) and 279 365 (SAIL) individuals were identified in the comparison cohorts. In both data sets, 51% of the epilepsy and comparison cohorts were male, and the median age at entry was 40 years (interquartile range, 25-60 years) in the CPRD cohorts and 43 years (interquartile range, 24-64 years) in the SAIL cohorts. People with epilepsy were significantly more likely to die of any unnatural cause (HR, 2.77; 95% CI, 2.43-3.16), unintentional injury or poisoning (HR, 2.97; 95% CI, 2.54-3.48) or suicide (HR, 2.15; 95% CI, 1.51-3.07) than people in the comparison cohort. Particularly large risk increases were observed in the epilepsy cohorts for unintentional medication poisoning (HR, 4.99; 95% CI, 3.22-7.74) and intentional self-poisoning with medication (HR, 3.55; 95% CI, 1.01-12.53). Opioids (56.5% [95% CI, 43.3%-69.0%]) and psychotropic medication (32.3% [95% CI, 20.9%-45.3%)] were more commonly involved than antiepileptic drugs (9.7% [95% CI, 3.6%-19.9%]) in poisoning deaths in people with epilepsy. Conclusions and Relevance Compared with people without epilepsy, people with epilepsy are at increased risk of unnatural death and thus should be adequately advised about unintentional injury prevention and monitored for suicidal ideation, thoughts, and behaviors. The suitability and toxicity of concomitant medication should be considered when prescribing for comorbid conditions.

Objectives To establish which non-psychotropic medications have been assessed in relation to risk of suicide or attempted suicide in observational studies, document reported associations and consider study strengths and limitations. Design Systematic review. Methods Four databases (Embase, Medline, PsycINFO and International Pharmaceutical Abstracts) were searched from 1990 to June 2014, and reference lists of included articles were hand-searched. Case–control, cohort and case only studies which reported suicide or attempted suicide in association with any non-psychotropic medication were included. Outcome measures The outcomes eligible for inclusion were suicide and attempted suicide, as defined by the authors of the included study. Results Of 11 792 retrieved articles, 19 were eligible for inclusion. Five studies considered cardiovascular medication and antiepileptics; two considered leukotriene receptor antagonists, isotretinoin and corticosteroids; one assessed antibiotics and another assessed varenicline. An additional study compared multiple medications prescribed to suicide cases versus controls. There was marked heterogeneity in study design, outcome and exposure classification, and control for confounding factors; particularly comorbid mental and physical illness. No increased risk was associated with cardiovascular medications, but associations with other medications remained inconclusive and meta-analysis was inappropriate due to study heterogeneity. Conclusions Whether non-psychotropic medications are associated with increased risk of suicide or attempted suicide remains largely unknown. Robust identification of suicide outcomes and control of comorbidities could improve quantification of risk associated with non-psychotropic medication, beyond that conferred by underlying physical and mental illnesses.

Suicide is a leading cause of death internationally, and self-harm significantly increases the risk of suicide (Hawton et al., 2015; World Health Organization, 2014). To tackle this global health crisis a multisystem, inter-faceted, joined-up approach across health and social care, education, judicial, financial, and voluntary sectors is needed. Within this, the health setting of primary care holds unlocked potential for suicide prevention (Michail et al., 2020). In this editorial, we outline the importance of focusing on primary care for suicide prevention and introduce a new special interest group for the International Association for Suicide Prevention.