579,99 zł
The International Handbook of Suicide Prevention, 2nd Edition, presents a series of readings that consider the individual and societal factors that lead to suicide, it addresses ways these factors may be mitigated, and presents the most up-to-date evidence for effective suicide prevention approaches. * An updated reference that shows why effective suicide prevention can only be achieved by understanding the many reasons why people choose to end their lives * Gathers together contributions from more than 100 of the world's leading authorities on suicidal behavior--many of them new to this edition * Considers suicide from epidemiological, psychological, clinical, sociological, and neurobiological perspectives, providing a holistic understanding of the subject * Describes the most up-to-date, evidence-based research and practice from across the globe, and explores its implications across countries, cultures, and the lifespan
Ebooka przeczytasz w aplikacjach Legimi na:
Liczba stron: 2045
Cover
Title Page
Notes on Contributors
Introduction
References
Part I: Suicidal Determinants and Frameworks
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
2 International Perspectives on the Epidemiology and Etiology of Suicide and Self‐Harm
Introduction
Suicide
Self‐Harm
Conclusion
References
3 Self‐Harm
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
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
5 Schizophrenia, Other Psychotic Disorders, and Suicidal Behavior
Introduction
Suicide in Psychotic Disorders
The Risk of Suicide in Schizophreniaand 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
6 Substance Use Disorders and Suicidal Behavior
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
7 Personality Disorders and Suicidality
Introduction
The Management of Suicidality in Borderline Personality Disorder
Conclusions and Implications for Practice
Key Resources
References
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
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
10 Understanding the Suicidal Brain
Introduction
Neuropsychological Studies of Suicidal Ideation and Behavior
Discussion
Conclusions
References
11 Visualizing the Suicidal Brain
Introduction
Brain Imaging Findings in Suicide Attempters
Discussion
Neuroimaging and Suicide Prevention
Conclusion
Key Resources
References
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
13 The Integrated Motivational‐Volitional Model of Suicidal Behavior
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
14 Sociological Perspectives on Suicide
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
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
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
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
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
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
20 Clinical Care of Self‐Harm Patients
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
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
22 Management of Suicidal Risk in Emergency Departments
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
23 Treating the Suicidal Patient
Introduction
Cognitive Therapy
Dialectical Behavior Therapy
Comparison of CT and DBT for Suicide Prevention
Conclusions and Recommendations for Future Research
Key Resources
References
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
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
26 Brief Contact Interventions
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
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
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
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
30 Suicide in Asia
Setting the Context
The Challenge of Suicide Prevention in Asia
Conclusions
Key Resources
References
31 Cultural Factors in Suicide Prevention
Introduction
How Does Culture Influence Suicidal Behavior?
Conclusions
Key Resources
References
32 Suicide Prevention Strategies
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
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
34 Why Mental Illness is a Risk Factor for Suicide
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
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
36 Reducing Suicide Without Affecting Underlying Mental Health
Introduction
Why Means Matter
Principles Guiding This Review
Empirical Studies
Conclusion
Acknowledgments
Key Resources
References
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
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
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
40 Suicide Research Methods and Designs
Introduction
Methodological Considerations
Research Study Designs
Instruments and Informants
Conclusions and Suggestions for Future Research
Key Resources
References
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
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
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
44 Making an Economic Case for Investing in Suicide Prevention
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
End User License Agreement
Chapter 08
Table 8.1 Main Suicide Risk and Prognostic Factors
Table 8.2 Risk Factors Associated with Suicidal Behavior in those with HIV
Chapter 10
Table 10.1 Brief Summary of Findings in Association with Suicidal Ideation or Behavior per Neuropsychological Domain
Chapter 11
Table 11.1 Summary of Findings in Suicide Attempters, by Brain Region
Chapter 13
Table 13.1 Selected Predominant Models of Suicidal Behavior from the Past 30 Years
Chapter 14
Table 14.1 Hierarchical Linear Regression Results of the Effect of Marital and Religious Integration on Suicide Acceptability, World Values Surveys, 1999–2000
Chapter 16
Table 16.1 Approaches to Mitigating the Impact of the Economic Crisis on Suicide
Chapter 18
Table 18.1 Ubiquitous Causes of Underreporting of Suicide Mortality Data in Older Adults
Chapter 22
Table 22.1 Five Reasons why the Emergency Department is Important in Suicide Prevention
Table 22.2 Examples of Assessment Tools for Assessing Future Risk of Suicide
Chapter 25
Table 25.1 Decentered Meta‐Awareness of Thoughts and Feelings as Reasons for Not Self‐Harming
Chapter 29
Table 29.1 Epidemiological Differences Between LMICs and HICs
Table 29.2 Multisector Approach to Suicide Prevention in LMICs
Chapter 30
Table 30.1 Selected Asian countries: Estimated Numbers and Age‐Standardized Suicide Rates (per 100,000) 2012
Table 30.2 Suicide Rates of Women in Cities/Districts of Selected Asian Countries
Chapter 31
Table 31.1 The Influence of Culture on Suicidal Behavior
Chapter 35
Table 35.1 Studies Published between (Jan 2001–Feb 2015) Examining Changes in Suicide Trends Following Restriction of Methods and Proposed Method‐Specific Measures for Future Research
Chapter 36
Table 36.1 Case Fatality Ratios for Selected Methods Commonly Used in Intentional Self‐Harm
Chapter 38
Table 38.1 Suicide Attempt Survivor Core Values Compared to Recovery Principles
Chapter 44
Table 44.1 Estimates of the Average Cost per Completed Suicide U.S. Purchasing Power Parity (PPP) $ (2014 prices)
Chapter 02
Figure 2.1 Age‐standardized suicide rates in 2012 for selected countries based on most recent data from the WHO.
Figure 2.2 Age‐standardized suicide rates in 2012 in low‐ and middle‐income regions.
Figure 2.3 (a) Increase (percentage change) in suicide rates between 2000 and 2012 in selected countries .
Figure 2.4 (a) Average percentage method of suicide for males across 56 countries.
Figure 2.5 Male:female ratio of suicide rates by age group and income level of country, 2012.
Chapter 06
Figure 6.1 Model of suicidal behavior among individuals with SUDs.
Note.
Moderating effects are depicted by a broken arrow and mediating effects by unbroken arrows.
Chapter 12
Figure 12.1 A visual representation of the primary predictions of the IPT.
Chapter 13
Figure 13.1 Integrated motivational‐volitional (IMV) model of suicidal behavior.
Figure 13.2 Predictors of repeat suicidal behavior.
Note.
The boxes surrounding past suicide attempt and entrapment indicate that these are significant predictors in the multivariate analyses.
Figure 13.3 The probability of self‐harm between Time 1 and Time 2 as a function of acute life stress and socially prescribed perfectionism .
Chapter 15
Figure 15.1 Suicide rates by social class, males, Scotland, 1989–1995 and 1996–2002.
Figure 15.2 Standardized mortality ratios (SMRs) by population‐weighted deprivation quintile, all persons, Scotland, 1989–1995 and 1996–2002.
Figure 15.3 Male suicide rates by deprivation quintile and social class, 1989–1995, Scotland.
Figure 15.4 Male suicide rates by deprivation quintile and social class, 1996–2002, Scotland.
Figure 15.5 Male suicide rates by deprivation quintile and social class, 1989–2002, Scotland: relative risks (multilevel analysis).
Chapter 16
Figure 16.1 The Great Depression: Trends in the number of male suicides (solid line) and number of unemployed males (dotted line) in 1923–1947.
Figure 16.2 The Russian economic crisis: Trends in age‐standardized male suicide rates in former Soviet Union countries.
Figure 16.3 The Asian economic crisis (1997–1998): Trends in age‐standardized suicide rates in Japan, Republic of Korea, and Taiwan; the gray bar highlights the years of the economic crisis.
Figure 16.4 The Great Recession from 2008: Trends in age‐standardized suicide rate in new EU, old EU, and non‐EU countries, weighted by population size. the gray bar highlights the years of the economic crisis.
Figure 16.5 Trends in the number of research articles indexed on Medline with key words relating to suicide and mental health in relation to the economy or employment 2004–2013. [Key words: (Econom?? Or unemployment) and (suicide? Or mental?)]
Chapter 18
Figure 18.1 Suicide mortality rates (per 100,000) by sex and age, 1992–1995/2004–2009; 62 selected countries .
Figure 18.2 Suicide mortality variation (%) by sex and age, 1992–2009; 62 selected countries
Chapter 24
Figure 24.1 CAMS course of care.
Chapter 25
Figure 25.1 Escalation of negative cognitions into suicidal crisis fueled by rumination and avoidance.
Figure 25.2 Proportion of participants surviving without a further readmission to hospital for self‐harm over follow‐up (Y axis) as a function of performance on the Means‐End Problem Solving Task. Each drop in the survival curve indicates one or more readmissions to hospital.
Chapter 29
Figure 29.1 Rates of suicide by age and region.
Note
. Based on data from
Preventing suicide: A global imperative
, WHO (2014) as per WHO regional classification.
Chapter 31
Figure 31.1 The Inglehart‐Welzel cultural map of the world. http://www.worldvaluessurvey.org/images/Cultural_map_WVS6_2015.jpg
Chapter 33
Figure 33.1 A conceptual model of suicide in rural areas.
Figure 33.2 An example of the use of the conceptual model.
Chapter 34
Figure 34.1 Model 1: Suicide and mental disorders have a common etiology.
Figure 34.2 Model 2: Some mental disorders are alternatives to suicide.
Figure 34.3 Model 3: Suicide is a direct consequence of mental disorders.
Figure 34.4 Model 4: Suicide is the result of the consequences of living with a mental disorder.
Figure 34.5 Model 5: Suicide results from treatment; it is “iatrogenic” or related to inadequate, inappropriate, or incomplete treatment.
Figure 34.6 Model 6: Combined model with the addition of the crisis situation.
Figure 34.7 Implications of (a) Model 1 (Suicide and mental disorders have a common etiology) and (b) Model 3 (Suicide is a direct consequence of mental disorders) for prevention.
Figure 34.8 Implications of Model 4 (Suicide is the result of the consequences of living with a mental disorder) for prevention.
Figure 34.9 Implications of Model 6 (Combined model with the addition of the crisis situation) for prevention.
Chapter 36
Figure 36.1 Pathways through which reductions in access to lethal means may result in lower suicide rates.
Chapter 43
Figure 43.1 The Circles of Vulnerability model.
Cover
Table of Contents
Begin Reading
ii
iii
iv
v
vi
v
vi
xi
xii
xiv
xv
xvi
xvii
xviii
xix
xx
2
3
4
5
6
7
9
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
115
116
117
118
119
120
121
122
123
124
125
126
127
128
129
130
131
132
133
134
135
136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
154
155
156
157
158
159
160
161
162
163
164
165
166
167
168
169
170
171
172
173
174
175
176
177
178
179
180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200
201
202
203
204
205
206
207
208
209
210
211
212
213
214
215
216
217
218
219
221
222
223
224
225
226
227
228
229
230
231
232
233
234
235
236
237
238
239
240
241
242
243
244
245
246
247
248
249
251
252
253
254
255
256
257
258
259
260
261
262
263
264
265
266
267
268
269
270
271
272
273
274
275
276
277
278
279
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
295
296
297
298
299
300
309
303
304
305
306
307
308
309
310
311
312
313
314
315
316
317
318
319
320
321
322
323
324
325
326
327
328
329
330
331
332
333
334
335
336
337
338
339
340
341
342
343
344
345
346
347
348
349
350
351
352
353
354
355
356
357
358
359
360
361
362
363
364
365
366
367
368
369
370
371
372
373
374
375
376
377
378
379
380
381
382
383
384
385
386
387
388
389
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
405
406
407
408
409
410
411
412
413
414
415
416
417
418
419
420
421
422
423
424
425
426
427
428
429
430
431
432
433
434
435
436
437
438
439
440
441
442
443
444
445
446
447
448
449
450
451
452
453
454
455
456
457
458
459
460
461
462
463
464
465
466
467
468
469
470
471
472
473
474
475
476
477
478
479
480
481
482
483
484
485
486
487
488
489
490
491
492
493
494
495
496
497
498
499
500
501
502
503
504
505
507
508
509
510
511
512
513
514
515
516
517
518
519
520
521
522
523
524
525
526
527
528
529
530
531
532
533
534
535
536
537
538
539
540
541
542
543
544
545
546
547
548
549
550
551
552
553
554
555
556
557
558
559
560
561
562
563
564
565
566
567
568
569
570
571
572
573
574
575
576
577
578
579
580
581
582
583
584
585
586
587
588
589
590
591
592
593
594
595
596
597
598
599
600
601
602
603
604
605
606
607
608
609
610
611
612
613
614
615
616
617
626
627
628
629
630
631
632
633
634
635
636
637
638
639
640
641
642
643
644
645
646
647
648
649
650
651
652
653
654
655
656
657
658
659
660
661
662
663
664
665
666
667
668
669
670
671
672
673
674
675
676
677
678
679
680
681
682
683
684
685
686
687
688
689
690
691
692
693
695
696
697
698
699
700
701
702
703
704
705
706
707
708
709
710
711
712
713
714
715
716
717
718
719
720
721
722
723
724
725
726
727
728
729
730
731
732
733
734
735
736
737
738
739
740
741
742
743
744
745
746
747
748
749
750
751
752
753
754
755
756
757
758
759
760
761
762
763
764
765
766
767
768
769
770
771
772
773
774
775
776
777
778
779
780
781
782
783
784
785
786
787
788
789
790
791
792
793
794
795
798
796
797
799
801
800
802
803
804
805
806
807
808
809
810
811
812
813
814
815
816
817
818
819
820
821
822
823
For two people who made me a better person.
Dr Clare Cassidy (1968–2008)
I continue to be inspired by Clare’s memory daily.An amazing friend and colleague.
“But then with autumn upon us, so breezy and cruel,Clare left us in Paris, heartbroken and cool.But we remember Clare’s grace, her beauty, her light;Her kindness, her smile and sadness, its might.”(RO’C, 2008)
Professor Noel Sheehy (1955–2011)
One day in the summer of 1994 Noel asked me whether I might be interested in undertaking a PhD on suicide—without hesitation I jumped at the chance. Without him, I would never have embarked on a career in suicide research. He took a chance on me. For this (and many other things besides) I will always be grateful. So kind and generous.
In my thoughts
Rory C. O’Connor
Second Edition
Edited by
Rory C. O'Connor and Jane Pirkis
This second edition first published 2016© 2016 John Wiley & Sons, Ltd
Edition history: John Wiley & Sons, Ltd (1e, 2011)
Registered OfficeJohn Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Offices350 Main Street, Malden, MA 02148‐5020, USA9600 Garsington Road, Oxford, OX4 2DQ, UKThe Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
For details of our global editorial offices, for customer services, and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley‐blackwell.
The right of Rory C. O'Connor and Jane Pirkis to be identified as the authors of the editorial material in this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.
Limit of Liability/Disclaimer of Warranty: While the publisher and authors have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. It is sold on the understanding that the publisher is not engaged in rendering professional services and neither the publisher nor the author shall be liable for damages arising herefrom. If professional advice or other expert assistance is required, the services of a competent professional should be sought.
Library of Congress Cataloging‐in‐Publication Data
Names: O’Connor, Rory C., editor. | Pirkis, Jane, editor.Title: The international handbook of suicide prevention / edited by Rory C. O’Connor and Jane Pirkis.Description: 2nd Edition. | Hoboken : Wiley, 2016. | Revised edition of International handbook of suicide prevention research, policy and practice, 2011. | Includes bibliographical references and index.Identifiers: LCCN 2016021173 (print) | LCCN 2016022004 (ebook) | ISBN 9781118903278 (cloth) | ISBN 9781118903230 (pdf) | ISBN 9781118903247 (epub)Subjects: LCSH: Suicide–Prevention–Research. | Suicidal behavior–Research.Classification: LCC HV6545 .I594 2016 (print) | LCC HV6545 (ebook) | DDC 616.85/8445–dc23LC record available at https://lccn.loc.gov/2016021173
A catalogue record for this book is available from the British Library.
Cover image: Gettyimages/Kenichi Sotozaki / EyeEm
To all those who have been affected by suicide and to those who struggle daily to stay alive.
To Suzy, Poppy, and Oisin for all their continued support
Karl AndriessenSchool of PsychiatryUniversity of New South WalesRandwick NSWAustraliaAlan ApterFeinberg Child Study CenterSchneider's Children's Medical Center of IsraelPetach Tikvah and Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsraelElla ArensmanNational Suicide Research FoundationDepartment of Epidemiologyand Public HealthWHO Collaborating Centre for Surveillance and Research in Suicide PreventionUniversity College CorkCorkIrelandUrška ArnautovskaAustralian Institute for Suicide Research and PreventionWHO Collaborating Centre on Research and Training in Suicide PreventionGriffith UniversityAustraliaNargis AsadDepartment of PsychiatryAga Khan UniversityKarachiPakistanDeborah AzraelHarvard Injury Control Research CenterHarvard T.H. Chan School of Public HealthBoston, MassachusettsUSAAlan L. BermanDepartment of PsychiatryJohns Hopkins School of MedicineBaltimore, MarylandUSAStijn BijttebierUnit for Suicide ResearchGhent UniversityGhentBelgiumLisa A. BrennerVA Veteran Integrated Service Network 19 – Mental Illness Research Education, & Clinical CenterDenverColoradoUSAGregory K. BrownDepartment of PsychiatryUniversity of PennsylvaniaPennsylvaniaUSAGregory L. CarterCentre for Translational Neuroscience and Mental HealthFaculty of Health and MedicineUniversity of Newcastle, CallaghanAustraliaFrançois ChagnonCentre for Research and Intervention on Suicide and Euthanasia andPsychology DepartmentUniversité du Québec à MontréalMontréal, QuébecCanadaLai Fong ChanDepartment of PsychiatryUniversiti Kebangsaan Malaysia [National University of Malaysia]Kuala LumpurMalaysiaNadine A. ChangDepartment of Psychiatry Mount Sinai St. Luke’s HospitalNew YorkUSAShu‐Sen ChangInstitute of Health Behaviors and Community Sciences andDepartment of Public HealthCollege of Public HealthNational Taiwan UniversityTaiwanYing‐Yeh ChenTaipei City Psychiatric Center Taipei City Hospital &National Yang‐Ming UniversityTaipeiTaiwanSeonaid CleareSuicidal Behaviour ResearchLaboratoryInstitute of Health & WellbeingUniversity of GlasgowGlasgowScotlandUKKatherine Anne ComtoisDepartment of Psychiatry and Behavioral Sciences andDepartment of Psychology Harborview Medical CenterUniversity of WashingtonSeattleWashingtonUSAKenneth R. ConnerUniversity of Rochester Medical CenterRochesterNew YorkUSAVA VISN 2 Center of ExcellenceCanandaiguaNew YorkUSAPaul CorcoranNational Suicide Research FoundationDepartment of Epidemiology andPublic HealthNational Perinatal Epidemiology CentreWHO Collaborating Centre for Surveillance and Research in Suicide PreventionUniversity College CorkCorkIrelandCatherine CraneOxford Mindfulness CentreDepartment of PsychiatryUniversity of OxfordEnglandUKAmy CunninghamCentre for Acceptance and ChangePennsylvaniaUSADianne CurrierCentre for Epidemiology and BiostatisticsMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustraliaDiego De LeoAustralian Institute for Suicide Research and PreventionWHO Collaborating Centre on Research and Training in Suicide Prevention and Life PromotionClinicGriffith UniversityAustraliaAntoine DesîletsMcGill Group for Suicide StudiesDouglas Mental Health University InstituteMcGill UniversityMontrealCanadaPeter DömeLaboratory for Suicide Research and PreventionNational Institute of Psychiatry and AddictionsBudapestHungaryNadine DougallNMAHP Research UnitSchool of Health SciencesUniversity of StirlingStirlingScotlandUKDanielle S. DugganOxford Mindfulness CentreDepartment of PsychiatryUniversity of OxfordEnglandUKSarah EschleSuicidal Behaviour ResearchLaboratoryInstitute of Health & WellbeingUniversity of GlasgowGlasgowScotlandUKAlberto ForteDepartment of Neurosciences, Mental Health and Sensory Organs Suicide Prevention CenterSant'Andrea HospitalSapienza University of RomeItalyJoseph C. FranklinDepartment of PsychologyVanderbilt UniversityNashvilleTennesseeUSABergljot GjelsvikOxford Mindfulness CentreDepartment of PsychiatryUniversity of OxfordOxfordEnglandUKCatherine R. GlennDepartment of Clinical and Social Sciences in PsychologyUniversity of RochesterRochesterNew YorkUSAOnja T. GradCentre for Mental HealthUniversity Psychiatric HospitalLjubljanaSloveniaEve GriffinNational Suicide Research FoundationWHO Collaborating Centre for Surveillance and Research in Suicide PreventionUniversity College CorkCorkIrelandDavid GunnellSchool of Social and Community MedicineUniversity of BristolEnglandUKPeter M. GutierrezVA Veteran Integrated Service Network 19 – Mental Illness Research, Education and Clinical CenterDenverColoradoUSAYari GvionDepartment of PsychologyBar Ilan UniversityRamat GanIsraelGergö HadlaczkyNational Centre for Suicide Research and Prevention of Mental lll‐Health (NASP)Karolinska InstitutetStockholmSwedenChristopher R. HaganLaboratory for the Study and Prevention of Suicide‐Related Conditions and BehaviorsDepartment of PsychologyFlorida State UniversityUSAEmily HargusOxford Mindfulness CentreDepartment of PsychiatryUniversity of OxfordOxfordEnglandUKSimon HatcherDepartment of PsychiatryUniversity of OttawaOttawaCanadaKeith HawtonCentre for Suicide ResearchDepartment of PsychiatryUniversity of OxfordEnglandUKSilvia R. HepburnDepartment of Clinical Health PsychologySt Mary's HospitalEnglandUKHeidi HjelmelandDepartment of Social Workand Health ScienceNorwegian University of Science and TechnologyTrondheimNorwayChristina W. HovenDepartment of Epidemiology and Division of Child PsychiatryChild Psychiatric Epidemiology Group, College of Physicians andSurgeons andMailman School of Public Health, Columbia UniversityNew York State PsychiatricInstituteNew YorkUSAIsabelle M. HuntCentre for Suicide PreventionCentre for Mental Health and SafetyUniversity of ManchesterManchesterEnglandUKShari Jager‐HymanAaron T. Beck Psychopathology Research CenterUniversity of PennsylvaniaPennsylvaniaUSAMark A. IlgenVA Serious Mental Illness Treatment Research and Evaluation Center & University of MichiganDepartment of PsychiatryAnn ArborMichiganUSADavid A. JobesSuicide Prevention LabDepartment of PsychologyThe Catholic University of AmericaDepartment of PsychologyWashington, DCUSAThomas E. JoinerLaboratory for the Study and Prevention of Suicide‐Related Conditions and BehaviorsDepartment of PsychologyFlorida State UniversityUSANavneet KapurCentre for Suicide PreventionCentre for Mental Health and SafetyUniversity of ManchesterManchesterEnglandUKLaurence Y. KatzDepartment of PsychiatryUniversity of ManitobaWinnipegCanadaJaclyn C. KearnsNational Center for PTSDVA Boston Healthcare SystemBostonMassachusettsUSAAd KerkhofDepartment of Clinical, Neuro, and Developmental Psychology and the EMGO Institute for Health and Care ResearchFaculty of Behavioural and Movement SciencesVU UniversityAmsterdamThe Netherlands Murad M. KhanDepartment of PsychiatryAga Khan UniversityKarachiPakistanOlivia J. KirtleySuicidal Behaviour Research LaboratoryInstitute of Health & WellbeingUniversity of GlasgowGlasgowScotlandUKBirthe Loa KnizekDepartment of Applied Social SciencesDepartment of Social Work and Health ScienceNorwegian University of Science and TechnologyTrondheimNorwayLynda KongDepartment of PsychiatryUniversity of ManitobaWinnipegCanadaAugustine J. KposowaDepartment of SociologyUniversity of CaliforniaRiversideUSAMyriam LabossièreMcGill Group for Suicide StudiesDouglas Mental Health University InstituteMcGill UniversityMontrealCanadaDorian A. LamisDepartment of Psychiatry and Behavioral Sciences Emory University School of MedicineAtlantaGeorgiaUSAElizabeth C. LanzilloDepartment of PsychologyBrown UniversityRhode IslandUSADeQuincy A. LezinePrevention CommunitiesFresnoCaliforniaUSADonald J. MandellInternational Center for Child Mental HealthNational Center for Disaster PreparednessMailman School of Public HealthColumbia UniversityNew York State Psychiatric InstituteNew YorkUSAManiam ThambuDepartment of PsychiatryUniversiti Kebangsaan Malaysia [National University of Malaysia]Kuala LumpurMalaysiaJ. John MannDivision of Molecular Imaging & NeuropathologyDepartment of PsychiatryCollege of Physicians and SurgeonsColumbia UniversityNew York State Psychiatric InstituteUSADavid McDaidPersonal Social Services Research UnitLSE Health and Social CareLondon School of Economics and Political ScienceLondonUKAlexander McGirrDepartment of PsychiatryUniversity of British ColumbiaVancouverCanadaLars MehlumNational Centre for Suicide Research and PreventionInstitute of Clinical MedicineUniversity of OsloOsloNorwayKonrad MichelUniversity Hospital of PsychiatryUniversity of BernBernSwitzerlandMatthew J. MillerDepartment of Health SciencesNortheastern UniversityBostonMassachusettsUSAAllison J. MilnerMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustraliaCentre for Mental Health ResearchSchool of Population and Global HealthThe University of MelbourneMelbourneAustraliaBrian L. MisharaCentre for Research and Intervention on Suicide and Euthanasia and Psychology DepartmentUniversité du Québec à MontréalMontréalQuébecCanadaErlend MorkNational Centre for Suicide Research and PreventionInstitute of Clinical MedicineUniversity of OsloOsloNorwayKatherine MokCentre for Mental HealthMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustraliaMatthew K. NockDepartment of PsychologyHarvard UniversityCambridgeMassachusettsUSAMerete NordentoftPsychiatric Center CopenhagenUniversity of CopenhagenCopenhagenDenmarkRory C. O’ConnorSuicidal Behaviour Research LaboratoryInstitute of Health & WellbeingUniversity of GlasgowGlasgowScotlandUKStephen S. O’ConnorDepartment of Psychiatry and Behavioral SciencesUniversity of LouisvilleLouisvilleKentuckyUSAMaria A. OquendoMolecular Imaging & Neuropathology Division (MIND)Department of PsychiatryCollege of Physicians and SurgeonsColumbia UniversityNew York State Psychiatric InstituteUSAJoel ParisInstitute of Community and Family PsychiatryMcGill UniversityMontrealQuebecCanadaMichael PhillipsSuicide Research and Prevention CentreShanghai Jiaotong University School of Medicine and Emory University School of MedicineShanghaiChinaJane PirkisCentre for Mental HealthMelbourne School of Population and Global HealthUniversity of MelbourneMelbourneAustraliaStephen PlattUsher Institute of Population Health Sciences & InformaticsUniversity of EdinburghScotlandUKMaurizio PompiliDepartment of Neurosciences, Mental Health and Sensory OrgansSuicide Prevention CenterSant'Andrea HospitalSapienza University of RomeItalyZoltán RihmerLaboratory for Suicide Research and PreventionNational Institute of Psychiatry and AddictionsBudapestHungaryJessica D. RibeiroVanderbilt UniversityNashvilleTennesseeUSAVincent RiordanWest Cork Mental Health Services, Cork, Ireland andCentre for Rural Health Research and PolicyInvernessScotlandUKJo RobinsonOrygen, The National Centre of Excellence in Youth Mental HealthMelbourneVictoriaAustraliaJitender SareenDepartment of PsychiatryUniversity of ManitobaWinnipegCanadaKate E. A. SaundersDepartment of PsychiatryUniversity of OxfordWarneford HospitalEnglandUKMorton M. SilvermanDepartment of PsychiatrySchool of MedicineUniversity of ColoradoDenverUSASteven StackDepartments of Criminology, and Psychiatry & BehavioralNeuroscienceWayne State UniversityDetroitUSABarbara StanleyDivision of Molecular Imaging & NeuropathologyDepartment of PsychiatryCollege of Physicians and SurgeonsColumbia UniversityNew York State Psychiatric InstituteUSACameron R. StarkDepartment of Public HealthNHS Highland, InvernessCentre for Rural HealthUniversity of AberdeenAberdeenScotlandUKSarah SteegCentre for Suicide PreventionCentre for Mental Health andSafetyUniversity of ManchesterManchesterEnglandUKKatherin SudolFrank H. Netter, M.D.School of MedicineQuinnipiac UniversityNorth Haven, ConnecticutUSAEhsanullah SyedDepartment of PsychiatryPenn State Milton S Hershey Medical CenterPenn State College Of MedicineHersheyPennsylvaniaUSAGustavo TureckiMcGill Group for Suicide StudiesDouglas Mental Health University InstituteMcGill UniversityMontrealCanadaKees van HeeringenUnit of Suicide Research and Flemish Suicide Prevention CentreGhent UniversityGhentBelgiumBregje van SpijkerNational Institute for Mental Health ResearchResearch School of Population HealthThe Australian National UniversityAustralia Capital TerritoryAustraliaLakshmi VijayakumarVoluntary Health ServicesSNEHA Suicide Prevention CentreIndia & University of MelbourneChennaiIndiaYun WangHong Kong Jockey Club Centre for Suicide Research and PreventionUniversity of Hong KongHong KongCamilla WassermanChild Psychiatric EpidemiologyDepartment of Child and Adolescent PsychiatryColumbia UniversityNew York State Psychiatric InstituteNew YorkUSADanuta WassermanNational Centre for Suicide Research and Prevention of Mental lll‐Health (NASP)Karolinska InstitutetStockholmSwedenKaren WetherallSuicidal Behaviour ResearchLaboratoryInstitute of Health & WellbeingUniversity of GlasgowGlasgowScotlandUKJ. Mark G. WilliamsOxford Mindfulness CentreDepartment of PsychiatryUniversity of OxfordOxfordEnglandUKKirsten WindfuhrCentre for Suicide PreventionCentre for Mental Health and SafetyUniversity of ManchesterManchesterEnglandUKAlan WoodwardLifeline Research FoundationLifeline AustraliaCanberraAustralian Capital TerritoryAustraliaKevin Chien‐Chang WuDepartment and Graduate Institute of Medical Education and BioethicsNational TaiwanUniversity College of MedicineDepartment of PsychiatryNational TaiwanUniversity HospitalTaiwanClare WyllieResearch & EvaluationSamaritansUKPaul S. F. YipCentre for Suicide Research and Prevention & Department of Social Work and Social AdministrationUniversity of Hong KongHong Kong
Rory C. O’Connor and Jane Pirkis
Since the publication of the first edition of the International Handbook of Suicide Prevention in 2011 (O’Connor, Platt, & Gordon, 2011), Preventing Suicide: A Global Imperative has been published by the World Health Organization (World Health Organization [WHO], 2014). This landmark publication, the first ever world suicide prevention report, highlighted the scale of the task of suicide prevention. At least 804,000 people take their own lives each year across the globe, which translates into a death every 40 seconds. The report also touches on many of the issues that we examine in detail herein, including the epidemiology of suicide and how best to intervene to prevent it. We are delighted that many of those who contributed to the WHO report have authored chapters for the second edition of this Handbook.
There are a number of changes in this edition of the Handbook. First, there is a change in editorship. Rory C. O’Connor has been joined by Jane Pirkis from University of Melbourne as coeditor, and Jane takes the place of Stephen Platt and Jacki Gordon, who were coeditors of the first edition. Second, we have expanded the Handbook; in terms of chapters, it is now 20% longer, which has allowed us to include more hot topics in suicide research and prevention. Third, given that the majority of the world’s suicides occur in Asia and low‐ and middle‐income countries, additional chapters have been dedicated to better understand suicide across different countries and cultures. Fourth, the majority of chapters end with a section describing up to 10 key resources. These resources include a selection of journal articles, books, reports, or online resources that the authors believe the reader would benefit from reading.
As in the first edition of the Handbook, we have tried to understand why people attempt suicide and what can be done to reduce suicide by harnessing the expertise of more than 110 suicidologists from across the world. The Handbook offers kaleidoscopic views on the complex multitude of factors that may explain suicidal behavior and the array of approaches to suicide prevention. It should appeal to anyone with an interest in trying to comprehend suicide and, ultimately, prevent it. To this end, one of the guiding principles of this volume is to improve our understanding of the relationship between attempted suicide and deaths by suicide. A more comprehensive understanding of this relationship is important not only for theoretical and conceptual reasons but also because secondary prevention interventions are frequently directed at those who attempt suicide. Any national or international suicide prevention strategy, to be effective, must be able to engage those who have attempted suicide. Although this may seem self‐evident, it is crucial, given the universal recognition that maintaining patients who have attempted suicide in treatment is fraught with difficulties. Further, it is sobering to note that the best predictor of future suicidal behavior (and suicide) is past suicidal behavior. Therefore, if we can intervene with those who have previously tried to take their own lives, we should be able to prevent at least some of the future deaths by suicide. Consequently, nonfatal suicidal behavior and suicide receive equal attention in this Handbook. As suicide attempt and self‐harm are often used interchangeably in the research literature (also see the following text), where we use the term suicide attempt/suicidal behavior in this Introduction, we are referring to self‐injurious behavior with evidence of suicidal intent. Self‐harm is used to describe all self‐harming behaviors where suicidal intent is not explicitly ascertained.
The overarching aim of this Handbook is to bring together the different exponents of suicide research and prevention irrespective of country of origin or professional background, because only through learning and working together internationally and across disciplines will we rise to the challenge of reducing suicidal behavior in every country. Suicidology, defined as the science of suicide and suicide prevention (Maris, 1993), is little over 55 years old, and embraces researchers, practitioners, and policy planners whose disciplinary backgrounds include psychology, psychiatry, epidemiology, sociology, social work, health economics, nursing, emergency medicine, ethics, law, and public health. This heterogeneity is a major strength, as the whole (i.e., the discipline of suicidology) is much greater than the sum of its constituent disciplines. We continue to learn from each other’s difficulties and successes, and to exchange a broad range of theoretical and methodological perspectives. However, one of the challenges of working in an interdisciplinary manner is that there are inevitable differences in emphasis, which can lead to difficulties in how we communicate about self‐injurious behavior across countries and professions. Although there have been several efforts to reach consensus on definitions and nomenclature (see Chapter 1 by Silverman), as a discipline we have yet to agree on a common definition of suicidal behavior. This renders the comparison of studies difficult. One study may include a heterogeneous sample of patients, some of whom are reporting suicidal intent and some of whom are not, whereas another may include only individuals who have engaged in potentially lethal suicide attempts, with explicit and high suicidal intent. Despite our best efforts, we are unlikely to achieve an agreed definition of suicidal behavior for some considerable time. Indeed, an inspection of the international literature still yields a myriad of different terms to describe the broad spectrum of self‐injurious thoughts and behaviors (e.g., self‐harm, attempted suicide, suicidal behavior, nonsuicidal self‐injury; see Chapter 1 by Silverman). Consequently, we asked each contributing author to make explicit early in their chapter how they operationalized and defined suicidal behavior therein.
Additional aims of the book are to showcase the state of the science in terms of research, policy, and practice, to share insights and expertise, and to enhance mutual learning. In this Handbook, we present the latest research on determinants of suicidal behaviors and the most promising interventions, treatments, and ways of caring for those at risk. We also describe the challenges of translating research, policy, and practice into saving lives. The extent to which suicidologists meet this latter challenge will determine, in large part, whether or not the universal goal of reducing suicide rates across the globe is attained. In short, this Handbook addresses the key questions of why people attempt suicide, what the best interventions are for those at risk, and what the key international challenges are in our pursuit of suicide prevention. In addressing these questions, it is important to recognize that the evidence base is, by and large, limited and that it must be understood in terms of the specific characteristics of a study population or the particular context of an intervention. Encouragingly, though, there have been major advances in our understanding of how best to treat and prevent suicidal behavior since the publication of the first edition.
As before, this edition of the Handbook is organized into three parts. Part I is concerned with the determinants and frameworks that inform our understanding of suicide and attempted suicide. Part II focuses on treatment, intervention, and care, and Part III reviews a range of suicide prevention issues that span research, policy, and practice. Chapters 1 to 3 provide the foundations for many of the subsequent chapters. In Chapter 1, for example, Silverman provides an overview of how the international community defines, classifies, and communicates about self‐injury with and without suicidal intent. As noted earlier, these remain contested issues within the field with much of the recent debate stimulated by the inclusion of nonsuicidal self‐injury and suicidal behavior disorder in DSM 5 as areas requiring further research (e.g., Kapur, Cooper, O’Connor, & Hawton, 2013; Oquendo & Baca‐Garcia, 2014). In Chapter 2, Windfuhr, Steeg, Hunt, and Kapur endeavor to bring together the research literature on the factors associated with suicidal behavior from different disciplines, and in Chapter 3, Arensman, Griffin, and Corcoran consider the specific challenge of predicting repetition of self‐harm. These are followed by four chapters (Chapters 4–7) that summarize the research and clinical literature on the relationship between suicidal behavior and psychiatric illness (depression [Chapter 4 by Rihmer and Dome], schizophrenia and other psychotic disorders [Chapter 5 by Desîlets, Labossière, McGirr, & Turecki), substance user disorders [Chapter 6 by Conner and Ilgen], and personality disorders [Chapter 7 by Paris]). The Handbook also considers the extent to which the treatment of these disorders can reduce suicide and attempted suicide. The risk of suicide in medical conditions is described in Chapter 8 (by Pompili, Forte, Berman, and Lamis).
The neurobiological and neuropsychological substrates that underpin suicidal behavior are considered in Chapters 9 and 10. In Chapter 9, Mann and Currier review the role of the serotonergic and noradrenergic neurotransmitter systems and the hypothalamic–pituitary–adrenal axis. They highlight the importance of studying the interaction between genetic vulnerability and environmental adversity in early life as a means of understanding how the effects of developmental changes in neurobiological systems can persist into adulthood and affect suicide risk. Chapter 10 by van Heeringen and Bijttebier investigates how changes in brain function are mediated by neuropsychological factors to increase the risk of suicide in response to stressors. In a new addition to this edition, the research findings and clinical implications of magnetic resonance imaging (MRI), diffusion tensor imaging, functional MRI (fMRI), positron emission tomography, and single photon emission computed tomography studies in suicide attempters are reviewed in Chapter 11 by Sudol and Oquendo.
The central role of psychology in understanding suicide risk is highlighted in Chapters 12 and 13. For example, the interpersonal‐psychological theory of suicidal behavior is described by Hagan, Ribeiro, and Joiner in Chapter 12, together with its history, its current status, as well as suggestions for further directions. The integrated motivational‐volitional model of suicidal behavior, a tripartite model that maps the relationship between background factors and trigger events and the development of suicidal ideation/intent into suicidal behavior is outlined by O’Connor, Cleare, Eschle, Wetherall, and Kirtley in Chapter 13. In the final three chapters (Chapters 14–16) of Part I, the focus shifts to the social context of suicide. In Chapter 14, Stack and Kposowa consider sociological perspectives, including the role of marital and religious integration. The powerful effects of inequalities, economic recession, and unemployment on suicide rates across the globe receive detailed analyses in Chapters 15 and 16. Lower socioeconomic status (at an individual level) and socioeconomic deprivation (at an area level) are both risk factors, although the evidence presented by Platt in Chapter 15 suggests that the “area effect” is compositional (rather than contextual). The complicated relationship between an economic recession and suicide risk is emphasized by Gunnell and Chang in Chapter 16: levels of debt, house repossession, relationship difficulties, alcohol misuse, pressures on those remaining in work and job insecurity, and cuts in mental health services ought to be considered in addition to unemployment.
Part II begins with two chapters that review the evidence‐based treatment and care of suicidal children and adolescents (Chapter 17 by Gvion and Apter) and older adults (Chapter 18 by De Leo and Arnautovska). In the former, the interplay between biological, genetic, environmental, social, and psychological factors in the etiology and course of suicidal behavior is considered alongside the effectiveness of prevention and treatment among children and adolescents. Chapter 18 highlights the age‐specific and gender‐specific risk and protective factors in old age as well as reviewing the efficacy of existing treatment and preventative strategies. The fundamental role of the therapist and the importance of the therapeutic alliance are considered in Chapter 19 by Michel. The subsequent six chapters (Chapter 20–25) also address clinical issues concerning treatment of patients who have attempted suicide, are actively suicidal, or who have presented to hospital following self‐harm. Recent systematic reviews of studies of attitudes of self‐harm patients toward clinical services and staff attitudes toward self‐harm patients are included in Chapter 20 (by Hawton and Saunders), as is a study of service provision with recommendations for the clinical management of self‐harm patients. Results of a systematic review of aftercare interventions are also summarized in Chapter 20. The authors conclude that there is now robust evidence that short‐term psychological therapy should be routinely offered to patients following self‐harm. After reviewing the literature, with a particular focus on clinical practice, Mehlum and Mork’s Chapter 21 suggests a set of requirements to ensure the continuity of care of suicide attempters, and makes recommendations for policy and clinical practice. In another new chapter, Hatcher presents a systems approach (adopted elsewhere in medicine and in other industries) applied to the management of suicide risk in emergency departments (Chapter 22).
Chapters 23–25 focus on key psychological processes in suicidality and emphasize how a better understanding of such processes is integral to a range of psychotherapeutic treatments. Cognitive Therapy, Dialectical Behavior Therapy, and the Collaborative Assessment and Management of Suicidality are reviewed in Chapters 23 (by Chang, Jager‐Hyman, Brown, Cunningham, and Stanley) and 24 (by Jobes, Comtois, Brenner, Gutierrez, and O’Connor). Chapter 25 (by Williams, Duggan, Crane, Hepburn, Hargus, and Gjelsvik) explores the conditions under which suicidal ideas may persist and escalate. It also describes mindfulness training and presents preliminary evidence that such training may be beneficial to those at risk of suicidal ideation and behavior. In the final three chapters of Part II (Chapters 26–28), different types of interventions adopting alternative modes of delivery are examined. Because it is often difficult to engage suicidal patients in treatment, interest in brief contact interventions has grown in recent years, with studies yielding promising findings in some subgroups (Chapter 26 by Milner and Carter). The role of online interventions to reduce suicide risk is considered by Kerkhof and van Spijker in Chapter 27. The authors ask whether the high expectations around online interventions have been met and highlight a number of challenges for future research. The significance of helplines in suicide prevention is explored by Woodward and Wyllie in Chapter 28. Although crisis helplines have been a mainstay of many national suicide prevention activities for decades, the authors review the evidence for their efficacy, noting the difficulties of evaluating their benefits.
Part III of the Handbook