Understanding and Preventing Suicide

Abstract

Identifying patients at risk for suicidal behavior and implementing treatment and intervention strategies is an urgent yet difficult task. It involves cognizance of both the long-term traits that predispose individuals to suicidal behavior and the more transient states that might precipitate that behavior. In terms of stressors, the onset of or failure to recover from a mood disorder is a powerful stressor, and psychosocial events also require consideration. Interventions available at this level include treatment of depression, substance use disorder, or psychosis; psychotherapy to strengthen coping skills; and improvement of the psychosocial support systems for the patient, including psychoeducation for the family. Indicators of heightened risk of suicide in the face of such stressors include a history of suicidal activity, a family history of suicidal behavior, and comorbid alcohol or substance abuse. Current suicidal ideation and active planning indicate potentially imminent risk. Long-term interventions might include effective antidepressant treatment, possibly with medication that has shown indications of antisuicidal effects; psychotherapies such as dialectical behavior therapy for borderline personality disorder; and the treatment of alcohol and substance abuse. Hospitalization and removal of the means of suicide may reduce imminent risk. Public health efforts to educate medical professionals, community workers, and the general population about both mental illness and suicide also may contribute to more effective identification of those at risk and more timely and effective intervention. (PsycINFO Database Record (c) 2015 APA, all rights reserved)(chapter)