Background: Individuals who do not adhere to their treatment regimens may be at greater risk of suicide but these issues are relatively unexplored in primary care services.
Aim: To explore GPs' views and perspectives on the reasons why patients who were in contact with mental health services in the year prior to suicide was non-adherent to treatment prior to their death.
Method: In total, 198 semi-structured face-to-face interviews with GPs of people who had died by suicide. Interviews were transcribed verbatim and analyzed using a thematic approach.
Results: The following themes were conceptualized from GP interviews: (i) "Lack of insight or denial?" relates to what GPs perceived as their patients lack of insight into their psychiatric illness; (ii) "Lack of treatment choices" discusses GPs' understanding of patient treatment choices; (iii) "Services for comorbidity and dual diagnosis" refers to treatment availability for suicidal patients with two or more mental health diagnoses.
Conclusions: For suicide prevention, it is crucial for health professionals to assess patients and manage the possible causes of non-adherence. Policies for increasing treatment adherence, improving services for dual diagnosis, or providing alternative treatments to meet individual patient needs may help to achieve the best health outcomes and could potentially prevent suicide.
Keywords: Suicide; mental health; non-adherence; primary care; secondary care.