Suicide remains a leading cause of death in the United States, with more than 49,000 lives lost in 2023. While suicide prevention has traditionally been viewed as the responsibility of behavioral health providers, many individuals at risk are seen in primary care: up to 80% of people who die by suicide saw a primary care provider in the year before their death, and as many as 40% did so within the last month. These figures highlight primary care as a key setting for timely intervention.
While many providers in primary care encounter patients at risk of suicide, they may not feel equipped to respond. A new topic brief from AHRQ’s Academy for Integrating Behavioral Health and Primary Care aims to help. Emerging Best Practices for Addressing Suicidality in Primary Care outlines strategies that can be integrated into routine care and is designed to meet practices where they are. Whether a clinic has embedded behavioral health staff or not, the brief offers flexible, actionable approaches that teams can tailor to their structure, resources, and capacity.
The brief highlights a range of implementation options, beginning with foundational strategies that can be applied in any primary care setting, including:
- Safety Planning Interventions
- Crisis Response Planning
- Caring Contacts
- Motivational Interviewing, and
- Integration of the 988 Suicide & Crisis Lifeline into routine care
These approaches are designed to fit within the realities of busy clinical workflows. Some require coordination or additional training, while others are low-lift and broadly applicable. Even small steps, such as asking directly about suicidal thoughts; validating a patient’s experience; or sending brief, supportive, follow-up messages can foster connection, reduce isolation, and offer meaningful support. The brief also introduces structured, collaborative frameworks, like the Collaborative Assessment and Management of Suicidality (CAMS) model, that promote shared decision-making, help build therapeutic trust, and may contribute to reductions in suicidal ideation.
For clinics with integrated behavioral health resources, the brief offers additional suggestions such as warm handoffs, team huddles, and cross-training to promote shared responsibility across the care team.
The brief also speaks to the challenge of balancing safety and autonomy, an issue many providers struggle with when suicide risk is present. While hospitalization may be necessary in some situations, the resource outlines scenarios where outpatient care may be equally, if not more, appropriate. This guidance can help teams navigate risk without defaulting to emergency responses that may disrupt continuity of care or undermine patient trust.
To support real-world implementation, the brief includes sample language, curated training resources, and actionable tips for integrating these strategies into daily practice. It acknowledges the time and capacity constraints primary care teams face and offers tools that can help make space for these conversations, even in busy settings.
Suicide prevention doesn’t have to be complex or out of reach. With the right tools and a thoughtful approach, primary care teams can make a meaningful difference, one conversation at a time.
Photo by Matthew Waring on Unsplash
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