title: Educational interventions for general practitioners to identify and manage depression as a suicide risk factor in young people: a systematic review and meta-analysis protocol.
abstract: BACKGROUND
  Suicide is a major public health problem and globally is the second leading cause of death in young adults. Globally, there are 164,000 suicides per year in young people under 25 years. Depression is a strong risk factor for suicide. Evidence shows that 45% of those completing suicide, including young adults, contact their general practitioner rather than a mental health professional in the month before their death. Further evidence indicates that risk factors or early warning signs of suicide in young people go undetected and untreated by general practitioners. Healthcare-based suicide prevention interventions targeted at general practitioners are designed to increase identification of at-risk young people. The rationale of this type of intervention is that early identification and improved clinical management of at-risk individuals will reduce morbidity and mortality. This systematic review will synthesise evidence on the effectiveness of education interventions for general practitioners in identifying and managing depression as a suicide risk factor in young people.
  
  
  METHODS
  We shall conduct a systematic review and meta-analysis following the Cochrane Handbook for Systematic Reviews of Interventions guidelines and conform to the reporting guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. Electronic databases will be systematically searched for randomised controlled trials and quasi-experimental studies investigating the effectiveness of interventions for general practitioners in identifying and managing depression as a suicide risk factor in young people in comparison to any other intervention, no intervention, usual care or waiting list. Grey literature will be searched by screening trial registers. Only studies published in English will be included. No date restrictions will be applied. Two authors will independently screen titles and abstracts of potential studies. The primary outcome is identification and management of depression. Secondary outcomes are suicidal ideation, suicide attempts, deliberate self-harm, knowledge of suicide risk factors and suicide-related behaviours, attitudes towards suicide risk and suicide-related behaviours, confidence in dealing with suicide risk factors and suicide-related behaviour.
  
  
  CONCLUSIONS
  Our study will inform the development of future education interventions and provide feasibility and acceptability evidence, to help general practitioners identify and manage suicidal behaviour in young people.
  
  
  BACKGROUND
  PROSPERO registration number: CRD42014009110.
authors.affiliation: School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK. Lynda.Tait@nottingham.ac.uk.
authors.forename: Lynda
authors.initials: L
authors.lastname: Tait
authors.forename: Maria
authors.initials: M
authors.lastname: Michail
mesh_terms: D000293:Adolescent; D000328:Adult; D003863:Depression / Q000175:diagnosis* / Q000517:prevention & control*; D005260:Female; D058006:General Practice; D006801:Humans; D008297:Male; D010819:Physician's Role; D000297:Psychology, Adolescent; D012307:Risk Factors; D013405:Suicide; D000078202:Systematic Reviews as Topic; D015201:Meta-Analysis as Topic