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Suicide kills and maims victims; traumatizes loved ones; preoccupies clinicians; and costs health care and emergency agencies fortunes. It should therefore demand a wealth of theoretical, scientific, and fiduciary attention. But in many ways it has Why? Although the answer to this question is multi-faceted, this volume not. supposes that one answer to the question is a lack of elaborated and penetrating theoretical approaches. The authors of this volume were challenged to apply their considerable theoretical wherewithal to this state of affairs. They have risen to this challenge admirably, in that several ambitious ideas are presented and developed. Ifever a phenomenon should inspire humility, it is suicide, and the volume’s authors realize this. Although several far-reaching views are proposed, they are pitched as first approximations, with the primary goal of stimulating still more conceptual and empirical work. A pressing issue in suicide science is the topic of clinical interventions, and clinical approaches more generally. Here too, this volume contributes, covering such topics as therapeutics and prevention, comorbidity, special populations, and clinicalrisk factors.
With recent studies using genetic, epigenetic, and other molecular and neurochemical approaches, a new era has begun in understanding pathophysiology of suicide. Emerging evidence suggests that neurobiological factors are not only critical in providing potential risk factors but also provide a promising approach to develop more effective treatment and prevention strategies. The Neurobiological Basis of Suicide discusses the most recent findings in suicide neurobiology. Psychological, psychosocial, and cultural factors are important in determining the risk factors for suicide; however, they offer weak prediction and can be of little clinical use. Interestingly, cognitive characteristics are different among depressed suicidal and depressed nonsuicidal subjects, and could be involved in the development of suicidal behavior. The characterization of the neurobiological basis of suicide is in delineating the risk factors associated with suicide. The Neurobiological Basis of Suicide focuses on how and why these neurobiological factors are crucial in the pathogenic mechanisms of suicidal behavior and how these findings can be transformed into potential therapeutic applications.
In the wake of a suicide, the most troubling questions are invariably the most difficult to answer: How could we have known? What could we have done? And always, unremittingly: Why? Written by a clinical psychologist whose own life has been touched by suicide, this book offers the clearest account ever given of why some people choose to die. Drawing on extensive clinical and epidemiological evidence, as well as personal experience, Thomas Joiner brings a comprehensive understanding to seemingly incomprehensible behavior. Among the many people who have considered, attempted, or died by suicide, he finds three factors that mark those most at risk of death: the feeling of being a burden on loved ones; the sense of isolation; and, chillingly, the learned ability to hurt oneself. Joiner tests his theory against diverse facts taken from clinical anecdotes, history, literature, popular culture, anthropology, epidemiology, genetics, and neurobiology--facts about suicide rates among men and women; white and African-American men; anorexics, athletes, prostitutes, and physicians; members of cults, sports fans, and citizens of nations in crisis. The result is the most coherent and persuasive explanation ever given of why and how people overcome life's strongest instinct, self-preservation. Joiner's is a work that makes sense of the bewildering array of statistics and stories surrounding suicidal behavior; at the same time, it offers insight, guidance, and essential information to clinicians, scientists, and health practitioners, and to anyone whose life has been affected by suicide.
Every year, about 30,000 people die by suicide in the U.S., and some 650,000 receive emergency treatment after a suicide attempt. Often, those most at risk are the least able to access professional help. Reducing Suicide provides a blueprint for addressing this tragic and costly problem: how we can build an appropriate infrastructure, conduct needed research, and improve our ability to recognize suicide risk and effectively intervene. Rich in data, the book also strikes an intensely personal chord, featuring compelling quotes about people's experience with suicide. The book explores the factors that raise a person's risk of suicide: psychological and biological factors including substance abuse, the link between childhood trauma and later suicide, and the impact of family life, economic status, religion, and other social and cultural conditions. The authors review the effectiveness of existing interventions, including mental health practitioners' ability to assess suicide risk among patients. They present lessons learned from the Air Force suicide prevention program and other prevention initiatives. And they identify barriers to effective research and treatment. This new volume will be of special interest to policy makers, administrators, researchers, practitioners, and journalists working in the field of mental health.
"Primary care is the new frontier for preventing suicide and Bryan and Rudd are its pioneers, offering wisdom and guidance based on their experience in bridging behavioral health care to the primary health care setting. This is a truly significant reference." Lanny Berman, PhD, ABPP Executive Director, American Association of Suicidology President, International Association for Suicide Prevention "In their pragmatic and useful book titled Managing Suicide Risk in Primary Care, Bryan and Rudd provide an essential reference guide for health care professionals working in primary care settings."--PsycCRITIQUES "This book offers a comprehensive approach that can help the physician become competent to assess and intervene with suicidal risk as well as lessen his or her anxiety when dealing with patients at suicide risk. Needless to say, this can be a life and death matter for some patients... One of the great strengths of this book is how they have adapted insights and interventions from traditional mental health care for the uniqueness of primary care... I highly recommend this book for any professional working in primary care. It will be taken off the shelf for reference and reviewed many times in the course of a career."--Family Medicine Journal Roughly forty-five percent of individuals who commit suicide make contact with a primary medical provider in the month prior to their death; nearly twenty percent make contact within one day of their death. This practical guide demonstrates how the primary care setting-an increasingly important provider of mental health treatment-can be an effective place for preventing suicide and providing ameliorative care. Firmly grounded in the clinical realities of primary care, Bryan and Rudd address the key issues that often plague behavioral health consultants (BHCs) in such settings where appointments are brief, patient contact is limited, and decision making and treatment are collaborative. They offer effective strategies for BHCs to manage patients across a suicidal crisis beginning with the development of procedures prior to crisis, steps to take during a crisis, planning for post-crisis care, transition to specialty mental health facilities, and legal issues. Key Features: Targets techniques for suicide assessment and prevention in primary care settings Addresses the clinical realities of working in a primary care setting and how to adapt them to the needs of suicidal patients Covers clinical protocols, legal issues, and risk management Discusses the formation of collaborative relationships with patients and staff Provides brief interventions with suicidal patients and post-crisis strategies Written by leading specialists in behavioral health, primary care, and suicidology
Alternatives to Suicide: Beyond Risk and Toward a Life Worth Living demonstrates how fostering resilience and a desire for life can broaden and advance an understanding of suicide. The book summarizes the existing literature and outlines a new focus on the dynamic interplay of risk and resilience that leads to a life-focus approach to suicide prevention. It calls for a treatment approach that enhances the opportunity to collaboratively engage clients in discussion about their lives. Providing a new perspective on how to approach suicide prevention, the book also lays out key theories on resilience and the interplay of risk and protective factors. Finally, the book outlines how emerging technologies and advances in data-analytic sophistication using real-time monitoring of suicide dynamics are ushering the field of suicide research and prevention into a new and exciting era.
Suicide is undoubtedly a worldwide major challenge for the public health. It is estimated that more than 150,000 persons in Europe die as a result of suicide every year and in several European countries suicide represents the principal cause of death among young people aged 14–25 years. It is true that suicide is a complex (and yet not fully understood) phenomenon and may be determined by the interaction between various factors, such as neurobiology, personal and familiar history, stressful events, sociocultural environment, etc. The suicide is always a plague for the population at risk and one of the most disgraceful events for a human being. Moreover, it implies a lot of pain often shared by the relatives and persons who are close to suicide subjects. Furthermore, it has been widely demonstrated that the loss of a subject due to suicide may be one of the most distressing events that may occur in mental health professionals resulting in several negative consequences, such as burnout, development of psychiatric symptoms and lower quality of life and work productivity. All considered, it is clear that the suicide prevention is a worldwide priority and every effort should be made in order to improve the early recognition of imminent suicide, manage suicidal subjects, and strengthen suicide prevention strategies. In our opinion, the first step of prevention is the improvement of knowledge in the field: this was the aim of this present special issue on Frontiers in Psychiatry. In this special issue, several papers have contributed to the suicide knowledge from several viewpoints and we hope that this will contribute to improve and disseminate knowledge on this topic.
Approximately one million people worldwide commit suicide each year, and at least ten times as many attempt suicide. A considerable number of these people are in contact with members of the healthcare sector, and encounters with suicidal individuals form a common part of the everyday work of many healthcare professionals. Suicide: An unnecessary death examines the pharmacological, psychotherapeutic, and psychosocial measures adopted by psychiatrists, GPs, and other health-care staff, and emphasizes the need for a clearer psychodynamic understanding of the self if patients are to be successfully recognized, diagnosed, and treated. Drawing on the latest research by leading international experts in the field of suicidology, this new edition provides clinicians with an accessible summary of the latest research into suicide and its prevention. The abundance of new literature can make it difficult for those whose clinical practice involves daily contact with suicidal patients to devote sufficient time to penetrating the research and, accordingly, apply new findings in their clinical practice. In light of the WHO Mental Health Action Plan 2013-2020, this new edition is a timely contribution to the field, and a vital and rapid overview, that will increase awareness of suicide prevention methods.
The book includes a chapter, written by the treatment developer(s), on each of the six treatments that have been shown in randomized controlled trials to reduce suicidal and/or self-harm behavior in adolescents with prior histories of these behaviors.
Today's psychiatrists practice in an environment that poses difficult challenges. Both treatment time and duration are limited by insurance requirements; many facilities are understaffed; split treatment arrangements are typical; and high-risk, acutely suicidal patients are admitted to inpatient units for short lengths of stay. In addition, law now plays a pervasive role in the practice of psychiatry. The doctor-patient relationship is no longer defined solely by the involved parties. Clinicians must juggle these requirements and limitations while providing the very best care to their patients, especially those at high risk. Preventing Patient Suicide: Clinical Assessment and Management provides the wisdom of Dr. Robert I. Simon's vast clinical experience, combined with the latest insights from the evidence-based psychiatric literature, to offer a cutting-edge survey of suicide prevention and management techniques. The author: Addresses sudden improvement in high-risk suicidal patients, a phenomenon both common and perilous, with techniques for determining whether the improvement is real or feigned. Explores in depth the misuse of suicide risk assessment forms, with emphasis on their inherent limitations. Examines the many entrenched myths and traditions about suicide, exposing them to the critical light of evidence-based medicine, including the concept of "imminent suicide risk" and the myth of "passive suicide ideation". Discusses the continuum of chronic and acute high-risk suicidal patients, the fluidity with which one can become the other, and the difficulty in assessing these patients. Explores how the law and psychiatry interact in frequently occurring clinical situations, and the importance of therapeutic risk management. In addition, the book contains a variety of features that illuminate the subject and enhance the reader's understanding, including: Inclusion of illustrative case studies, combined with commentary on commonly occurring but complex clinical situations. Key points at the end of each chapter that identify critical information. A Suicide Risk Assessment Self-Test, a teaching instrument that consists of fifty questions designed to enhance clinician suicide risk assessment by incorporating evidence-based risk and protective factors. Dr. Simon provides a nuanced, empathic, yet pragmatic perspective on identifying, assessing, and managing the suicidal patient while successfully navigating a complex legal and clinical environment that poses its own risks to the practitioner.