Title Page

Copyright Page

Contents

Notes on Contributors

Introduction

Part I Suicidal Determinants and Frameworks

Chapter 1 Challenges to Defining and Classifying Suicide and Suicidal Behaviors

Introduction

Challenges to Developing and Implementing a Standardized Nomenclature and Classification System

Clarifying Terminology

Terminology in Suicide Classification Systems

Examples of Definitional Obfuscation

Relevance to the General Population’s Understanding and use of Terminology

The Need for Sensitivity and Consistency

Recent Efforts to Clarify Suicidal Behaviors

Key Questions

Future Directions

Conclusions

References

Chapter 2 International Perspectives on the Epidemiology and Etiology of Suicide and Self-Harm

Introduction

Suicide

Self-Harm

Conclusion

References

Chapter 3 Self-Harm: Extent of the Problem and Prediction of Repetition

Introduction

Extent of the Problem of Self-Harm and Repetition

Prediction of Repeated Self-Harm Across the Lifespan

Gender Differences

Ethnicity

Assessment of Risk of Repeated Self-Harm

Conclusions

References

Chapter 4 Major Mood Disorders and Suicidal Behavior

Introduction

Suicidal Behavior in People With Mood Disorders

Clinically Detectable Suicide Risk Factors in People With Mood Disorders

Suicide Protective Factors in People With Mood Disorders

Key Achievements in Suicide Prevention: Interventions to Decrease Suicide in Patients With Mood Disorders

Challenges for the Future

Conclusions

Key Resources

References

Chapter 5 Schizophrenia, Other Psychotic Disorders, and Suicidal Behavior

Introduction

Suicide in Psychotic Disorders

The Risk of Suicide in Schizophrenia and Other Psychotic Disorders

Relationship with Other Suicide and Sociodemographic Characteristics

Characteristics of Psychotic Illness in Suicide

Insight into Psychotic Illness

Psychopathology, Personality Traits, and Family History of Suicidal Behavior

Treatment of Chronic Psychotic Disorders: Implications for Suicide Risk

Conclusions

Key Resources

References

Chapter 6 Substance Use Disorders and Suicidal Behavior: A Conceptual Model

Introduction

Terms Used Throughout

Conceptual Model of Risk for Suicidal Behavior Among Individuals With SUDs

Evidence for the Conceptual Model: Research Showing that Individuals with SUDs are at Elevated Risk

Evidence for the Conceptual Model: Distal Risk Factors for Suicidal Behavior Among Individuals With SUDs

Evidence for the Conceptual Model: Proximal Risk Factors Among Individuals With SUDs

Future Directions

Key Resources

References

Chapter 7 Personality Disorders and Suicidality

Introduction

The Management of Suicidality in Borderline Personality Disorder

Conclusions and Implications for Practice

Key Resources

References

Chapter 8 The Association Between Physical Illness/Medical Conditions and Suicide Risk

Introduction

Multiple Sclerosis

Epilepsy

Huntington’s Disease

Cancer

HIV

End-Stage Kidney Disease

Diabetes Mellitus

Stroke

Conclusions

References

Chapter 9 Relationships of Genes and Early-Life Experience to the Neurobiology of Suicidal Behavior

Introduction

Biological Alterations in Suicidal Behavior

Stress-Response Systems

Neural Circuitry of Suicidal Behavior

Developmental Factors Related to the Neurobiology of Suicide

Genes and Suicidal Behavior

Genes and Early-Life Environment Interaction

Key Questions and Challenges for the Future

Conclusion

Acknowledgments

Key Resources

References

Chapter 10 Understanding the Suicidal Brain: A Review of Neuropsychological Studies of Suicidal Ideation and Behavior

Introduction

Neuropsychological Studies of Suicidal Ideation and Behavior

Discussion

Conclusions

References

Chapter 11 Visualizing the Suicidal Brain: Neuroimaging and Suicide Prevention

Introduction

Brain Imaging Findings in Suicide Attempters

Discussion

Neuroimaging and Suicide Prevention

Challenges and Future Considerations

Conclusion

Key Resources

References

Chapter 12 Present Status and Future Prospects of the Interpersonal–Psychological Theory of Suicidal Behavior

Introduction

Key Concepts

Main Predictions

Future Directions

Conclusion

Key Resources

References

Chapter 13 The Integrated Motivational-Volitional Model of Suicidal Behavior: An Update

Introduction

Brief Overview of Integrated Motivational-Volitional Model of Suicidal Behavior

Conceptual and Empirical Rationale for IMV Model

Implications of the IMV Model for Research, Policy, and Practice

Conclusions

Key Resources

References

Chapter 14 Sociological Perspectives on Suicide: A Review and Analysis of Marital and Religious Integration

Marital Integration and the Prevention of Suicide: A Review

An Empirical Study of Marriage, Religion, and Suicide: Analysis of an Integrated Model of Suicide Prevention

Results

Discussion

References

Chapter 15 Inequalities and Suicidal Behavior

Introduction

Socioeconomic Inequalities in Suicide: The Evidence

Empirical Investigation of Socioeconomic Inequalities in Suicide in Scotland

Discussion

Conclusion

Key Resources

References

Chapter 16 Economic Recession, Unemployment, and Suicide

Introduction

Epidemiological Evidence

Evidence of the Causal Nature of the Association Between Economic Recession and Suicide

Age- and Sex-Specific Effects

Mechanisms to Explain the Rise in Suicide During Recessions

Interventions to Offset the Impact of Recession on Suicide

What Research Issues Remain Unanswered?

What Are the Key Achievements in Suicide Prevention Within This Area?

Conclusions

Key Resources

References

Part II Intervention, Treatment, and Care

Chapter 17 Evidence-Based Prevention and Treatment of Suicidal Behavior in Children and Adolescents

Introduction

Understanding Effective Prevention Through Changes in the Epidemiology of Youth Suicide

Risk Factors for Suicidal Behavior as Targets of Prevention and Treatment

Assessment

Suicide Prevention in Children and Adolescents

Conclusions

References

Chapter 18 Prevention and Treatment of Suicidality in Older Adults

Introduction

Peculiarities of Suicidal Behavior in Older Age

Epidemiological Trends

Risk Factors for Suicide Among Older Adults

Treatment of Suicidality Among Older Adults

Conclusions

Key Resources

References

Chapter 19 Therapeutic Alliance and the Therapist

Introduction

Problems in the Communication of Suicidal Intent

Patient-Oriented Versus Physician-Oriented Approach

Therapeutic Assessment of Suicide Risk

Therapeutic Alliance: Some Basics

Therapeutic Alliance with the Suicidal Patient

Therapeutic Alliance in Treatments for Suicidality

Understanding Suicide as Goal-Directed Behavior

Where the Truth Lies: The Patients’ Stories

The Provision of a Secure Base: Long-Term Anchoring

Conclusion

Key Resources

References

Chapter 20 Clinical Care of Self-Harm Patients: An Evidence-Based Approach

Introduction

What Can Be Learned From Studies of Service Users’ Attitudes Toward Self-Harm Services?

What Can Be Learned From Studies of Staff Attitudes to Self-Harm Patients?

What Do We Know About Effectiveness of Psychosocial and Physical Interventions for Self-Harm Patients?

What Do We Know About Variations Between Services for Self-Harm Patients?

What Can One Conclude From the Current Evidence About the Most Effective Design and Activities of a Service for Self-Harm Patients?

Further Developments

Conclusions

Key Resources

References

Chapter 21 After the Suicide Attempt—The Need for Continuity and Quality of Care

Introduction

The Magnitude of the Problem

Follow-Up Treatments for People Who Make a Suicide Attempt

Recommended Standards of Care and Aftercare After a Suicide Attempt

Adherence to Recommended Treatment Standards

The Norwegian Chain-of-Care Model

Conclusions and Recommendations for Policy and Clinical Practice

Key Resources

References

Chapter 22 Management of Suicidal Risk in Emergency Departments: A Clinical Perspective

Introduction

Why Is the Emergency Department an Important Setting for Suicide Prevention?

Why the Traditional Approach to Risk Management in Suicidal Patients is Unhelpful and Alternative Approaches to Managing Suicidal People in the Emergency Department are Required

Key Achievements

Conclusion

Key Resources

References

Chapter 23 Treating the Suicidal Patient: Cognitive Therapy and Dialectical Behavior Therapy

Introduction

Cognitive Therapy

Dialectical Behavior Therapy

Comparison of CT and DBT for Suicide Prevention

Conclusions and Recommendations for Future Research

Key Resources

References

Chapter 24 Lessons Learned from Clinical Trials of the Collaborative Assessment and Management of Suicidality (CAMS)

CAMS Overview

CAMS Therapeutic Philosophy

The CAMS Therapeutic Framework: Collaborative SSF Assessment

The CAMS Therapeutic Framework: Collaborative SSF Treatment Planning

Clinical Studies and Trials of the SSF and CAMS

Current RCTs of CAMS

Key Next Steps for CAMS

Conclusion

Key Resources

References

Chapter 25 Modes of Mind and Suicidal Processes

Introduction

Background

Empirical Evidence

Can Mindfulness Help?

The Effect of Mindfulness Training on Self-Discrepancy

Conclusion

Key Resources

References

Chapter 26 Brief Contact Interventions: Current Evidence and Future Research Directions

Introduction

What is a Brief Contact Intervention?

Content of BCIS

Evidence of Effectiveness From Reviews

Continuing Questions and Areas for Future Research

Conclusion

Key Resources

References

Chapter 27 Delivering Online Cognitive Behavioral Therapy Interventions to Reduce Suicide Risk

Introduction

Studies Targeting Depression With Suicide Ideation as Treatment Outcome

Study Targeting Suicidal Ideation: Living Under Control

Rationale

Effectiveness

Conclusion

Key Resources

References

Chapter 28 Helplines, Tele-Web Support Services, and Suicide Prevention

Introduction

Conceptualization of Helplines and Tele-Web Support Services

Empirical Evidence

Discussion: Challenges and Future Directions

Conclusions

References

Part III Suicide Prevention: Bringing Together Evidence, Policy, and Practice

Chapter 29 Suicide Prevention in Low- and Middle-Income Countries

Introduction

Epidemiology of Suicide in LMICs

Risk and Protective Factors in LMICs

Prevention Efforts in LMICs

Preventing Suicides in LMICs

Evidence Gap and the Way Forward

Conclusion

Acknowledgments

References

Chapter 30 Suicide in Asia: Epidemiology, Risk Factors, and Prevention

Setting the Context

The Challenge of Suicide Prevention in Asia

Conclusions

Key Resources

References

Chapter 31 Cultural Factors in Suicide Prevention

Introduction

How Does Culture Influence Suicidal Behavior?

Conclusions

Key Resources

References

Chapter 32 Suicide Prevention Strategies: Case Studies from Across the Globe

Introduction

The Primary, Secondary, and Tertiary Prevention Model

The Institute of Medicine (IOM) Model

Suicide Prevention Programs and Actions Across the Globe

Dilemma of Evidence-Based Suicide Prevention

Conclusion

Key Resources

References

Chapter 33 Rurality and Suicide

Introduction

Suicide in Rural Areas

Themes in Rural Suicide Epidemiology

Achievements in Rural Suicide Prevention

Models of Rural Suicide

Key Questions for the Future

Conclusions

Key Resources

References

Chapter 34 Why Mental Illness is a Risk Factor for Suicide: Implications for Suicide Prevention

Model 1: Suicide and Mental Disorders have a Common Etiology

Model 2: Some Mental Disorders are Alternatives to Suicide

Model 3: Suicide is a Direct Consequence of Mental Disorders

Model 4: Suicide is the Result of the Consequences of Living With a Mental Disorder

Model 5: Suicide Results from Treatment: It is “Iatrogenic” or Related to Inadequate, Inappropriate, or Incomplete Treatment

Model 6: Combined Model with the Addition of the Crisis Situation

Why the Suicide Risk for Different Mental Disorders Varies During the Course of the Disorder

Prevention Activities for Persons With Mental Disorders

Conclusions

References

Chapter 35 Suicide Prevention Through Restricting Access to Suicide Means and Hotspots

Introduction

Rationale and Evidence

Cognitive Availability

Restricting Access to Suicidal Means and Hotspots in Suicide Prevention

Conclusion

Key Resources

References

Chapter 36 Reducing Suicide Without Affecting Underlying Mental Health: Theoretical Underpinnings and a Review of the Evidence Base Linking the Availability of Lethal Means and Suicide

Introduction

Why Means Matter

Principles Guiding This Review

Empirical Studies

Conclusion

Acknowledgments

Key Resources

References

Chapter 37 Surviving the Legacy of Suicide

Introduction

The Problem of Terminology

The Number of Suicide Survivors

The Trajectory of the Bereavement Process

Models of Bereavement After Suicide

Grief Complications of Those Bereaved by Suicide

Helping the Bereaved by Suicide

Symbols and Other Substitutes for Remembering the Deceased

End of the Bereavement

Caregivers and Professionals Who Lose a Client to Suicide

Conclusions

References

Chapter 38 Suicide Prevention Through Personal Experience

Introduction and Terminology

How Do You Measure the Impact of Personal Experience on Suicide Prevention?

Stigma: A Multifaceted Challenge

Impact of Experience-Based Programs

Peer Support Programs

Research Directions

Challenges and Personal Experience

Conclusion

Key Resources

References

Chapter 39 Time to Change Direction in Suicide Research

Introduction

A Critical Look at Current Mainstream Suicide Research

The Kind of Research the Field Now Needs (More of)

Conclusion

Key Resources

References

Chapter 40 Suicide Research Methods and Designs

Introduction

Methodological Considerations

Research Study Designs

Instruments and Informants

Conclusions and Suggestions for Future Research

Key Resources

References

Chapter 41 School-Based Suicide Prevention Programs

Introduction

Awareness and Education Curricula

Screening

Gatekeeper Training

Skills Training

Culturally Adapted Programs

Key Achievements in School-Based Suicide Prevention and Influence on the Evidence Base

Limitations of the Literature

Future Directions

Conclusion

Related Readings

Key Resources

References

Chapter 42 Media Influences on Suicidal Thoughts and Behaviors

Suicide and Traditional Media

Suicide and Newer Media

Suggested Theoretical Underpinnings

Key Achievements

Key Challenges for the Future

Conclusions

Key Resources

References

Chapter 43 Suicide Clusters

Introduction

Definition of Suicide Clusters

Ways in Which Suicide Clusters Are Investigated

Clusters of Self-Harm and Suicide Attempts

Prevalence of, and Risk Factors for, Suicide Clusters

Mechanisms by Which Suicide Clusters Are Thought to Occur

The Role of the Internet and Social Media

Preventing and Managing Suicide Clusters

Key Questions and Future Challenges

Conclusions

Key Resources

References

Chapter 44 Making an Economic Case for Investing in Suicide Prevention: Quo Vadis?

Introduction

The Use of Economic Evidence in Health Policy Making

Question 1: Assessing the Cost of Not Taking Action

Question 2: Assessing the Costs of Taking Action

Question 3: Assessing Value for Money

Question 4: Incentivizing Investment in Suicide Prevention Actions

Conclusions: How Can the Economic Evidence Base Be Strengthened?

References

Index

EULA