North Carolina community pharmacists' attitudes about suicide and willingness to conduct suicidal ideation assessment: A cross-sectional survey study

Background: Suicide is a major and growing public health problem. Pharmacists are one of the most accessible members of the health care team. Due to their unique place in the health care system, pharmacists may be an ideal resource for monitoring patients at risk of suicide. The objectives of this study were to: (1) investigate community pharmacists' attitudes toward suicide; (2) identify pharmacist-reported barriers to suicidal ideation assessment; and (3) evaluate facilitators and barriers to pharmacists conducting suicidal ideation assessment. Methods: An anonymous questionnaire was distributed to North Carolina (NC) community pharmacists. Measures included contact with suicide, perceived role in suicidal ideation assessment, Attitudes Towards Suicide (ATTS), and barriers in suicidal ideation assessment. Multivariable logistic regression was used to analyze the data. Results: There were usable and complete data for 225 participants (3.52% response rate). The median ATTS score was 70 (IQR = 7). Community pharmacists were significantly more likely to perform a suicidal ideation assessment at least sometimes when (s)he reported a lower number of barriers (OR = 0.70, 99.5% CI = 0.51-0.98) and when (s)he agreed or strongly agreed that they knew how to help someone who was suicidal (OR = 6.63, 99.5% CI = 1.74, 25.23). The most common barrier to suicidal ideation assessment was lack of education in mental health screening (n = 176). Conclusions: Suicide prevention education programs for pharmacists may need to address reducing barriers, increasing knowledge about suicide, and improving self-efficacy. Targeting these areas may lead more pharmacists conducting these assessments.