Coping with suicide loss: a qualitative study in primary health care.

AIM: To analyze how people cope with suicide loss and the implications for primary health care. BACKGROUND: Previous studies have shown that primary health care will often be an initial source of support for those bereaved by suicide. METHODS: We included adult persons who were ready to talk about a suicide completed by a person they knew well (family member or close friend). Participants were recruited via mixed media (television, radio, print, social media, etc.). Altogether, we conducted 37 individual interviews, which were recorded using a dictaphone and lasted from 46 to 158 min. The interviews were transcribed verbatim and analyzed using a content analysis method. The interviewees were mostly women (n = 27) and family members (n = 28) of a person who had died by suicide during the years 2012-2018. FINDINGS: We identified two main themes in the data: supporters and barriers in support. Coping with suicide takes time, and support was mostly found among friends and family. Support from GPs was mentioned in the context of diagnosing medical problems and prescribing medicines. Respondents indicated that feeling ashamed and a lack of trust impeded their willingness to seek help from their GP. Unmet needs among the bereaved may increase their risk of diminished mental health outcomes. Thus, primary health care practitioners may have a substantial opportunity to support those who are bereaved by suicide. CONCLUSION: Primary care providers have an opportunity to provide bereavement support among their patients. Continuing medical education regarding the needs of the bereaved and a coordinated approach among primary care practitioners may be useful to proactively identifying and supporting those in need.

Geographical variations in hospital use in Estonia.

The purpose of this study was to analyse the utilisation of inpatient care in Estonia. Using small-area analysis the age and sex of municipality residents and travel time to the nearest hospital were linked to the frequency of use and length of stay of respective inpatients. Adjusted hospitalisation and readmission rates decreased with increasing travel time to the hospital. The travel time effect on the length of stay was inconsistent. Despite differences in hospital utilisation among municipalities, geographical access to inpatient care was substantially diminished only for 3% of the population living further than 30 min from hospital.