Preventing Patient Suicide

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.

Robert I. Simon, M.D., a preeminent psychiatrist and prolific author on the subject of law and psychiatry, offers a pragmatic and empathic guide for clinicians grappling with that most critical of questions: How can I protect my patients from themselves? Though even the most conscientious psychiatrist cannot prevent every suicide, suicide risk can be assessed, managed, and reduced. Dr. Simon acknowledges that the professional environment in which clinicians now practice is often inhospitable to the time-consuming task of understanding the patient; yet "Know thy patient" is his theme and imperative. Readers will benefit from the instructive case examples and commentary. Suicide risk assessment is a core competency that draws on both art and science. In Preventing Patient Suicide: Clinical Assessment and Management, Dr. Simon synthesizes his clinical experience, the shared clinical experiences of colleagues, and the evidence-based psychiatric literature to create an insightful guide which should be an essential component in any practicing psychiatrist's library.

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.

Suicide prevention initiatives are part of much broader systems connected to activities such as the diagnosis of mental illness, the recognition of clinical risk, improving access to care, and coordinating with a broad range of outside agencies and entities around both prevention and public health efforts. Yet suicide is also an intensely personal issue that continues to be surrounded by stigma. On September 11-12, 2018, the National Academies of Sciences, Engineering, and Medicine held a workshop in Washington, DC, to discuss preventing suicide among people with serious mental illness. The workshop was designed to illustrate and discuss what is known, what is currently being done, and what needs to be done to identify and reduce suicide risk. Improving Care to Prevent Suicide Among People with Serious Mental Illness summarizes presentations and discussions of the workshop.

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

This volume is a guide for the hospital workforce related to suicide prevention. Written by experts in the field, this text is the only one that also includes the revised DSM-5 guidelines. It is also the first to cover both prevention in one concise guide, offering a well-rounded approach to long- and short-term prevention. The book begins by establishing the neurobiology of suicide before discussing the populations at risk for suicide and the various environments where they may present. The book addresses the epidemiology, including groups at heightened risk; etiology, including several types of risk factors; prevention, including large-scale community-based activities; and postvention, including the few evidence-based approaches that are currently available. Unlike any other text on the market, this book does not simply focus on one particular demographic; rather, the book covers a wide range of populations and concerns, including suicide in youths, racial minorities, patients suffering from serious mental and physical illnesses, psychopharmacological treatment in special populations, and a wide array of challenging scenarios that are often not addressed in the very few up-to-date resources available. Suicide Prevention is an outstanding resource for psychiatrists, psychologists, hospitalists, primary care doctors, nurses, social workers, and all medical professionals who may interface with suicidal patients.

A practical and easy-to-use guide for healthcare professionals on the prevention, assessment and treatment of people at risk of suicide.