ISBN-10:
0309083214
ISBN-13:
9780309083218
Pub. Date:
09/30/2002
Publisher:
National Academies Press

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Overview

Reducing Suicide: A National Imperative

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.

Product Details

ISBN-13: 9780309083218
Publisher: National Academies Press
Publication date: 09/30/2002
Edition description: New Edition
Pages: 512
Product dimensions: 6.00(w) x 9.00(h) x (d)

Table of Contents

Contents

EXECUTIVE SUMMARY....................1
Risk and Protective Factors....................2
Treatment....................4
Prevention....................6
Additional Challenges in Suicide Research....................7
Next Steps....................8
1 INTRODUCTION....................17
Personal Suffering....................17
The Federal Response....................19
Statement of Task....................20
Suicide Through History....................21
Suicide as an Interdisciplinary Effort....................25
Definitions....................27
Organization of the Report....................28
References....................29
2 MAGNITUDE OF THE PROBLEM....................33
Geographic Trends....................34
Populations at Risk....................39
Limitations of Data....................55
Cost to Society....................55
Findings....................57
References....................58
3 PSYCHIATRIC AND PSYCHOLOGICAL FACTORS....................69
Psychiatric/Substance Use Disorders and Suicide Risk....................70
Psychological Dimensions of Suicide Risk....................89
Findings....................99
References....................100
4 BIOLOGICAL FACTORS....................119
The Physiological Stress System....................120
Neurochemistry....................122
Genetic Factors....................130
Findings....................140
References....................142
5 CHILDHOOD TRAUMA....................157
Scope and Definitions....................158
Childhood Trauma as a Risk Factor for Suicidality....................164
ChildhoodSexual Abuse and Population Attributable Risk for Suicide....................167
Modifying Factors....................168
Biopsychosocial Effects of Childhood Trauma....................170
Childhood Trauma as a Risk Factor for Psychopathology....................177
Pathways to Suicidality....................179
Prevention/Intervention....................182
Findings....................183
References....................184
6 SOCIETY AND CULTURE....................193
Framework: A Social Safety Net....................194
Society and Culture in Suicide....................196
Challenges....................212
Findings....................215
References....................216
7 MEDICAL AND PSYCHOTHERAPEUTIC INTERVENTIONS....................229
Assessment....................229
Psychoactive Medications....................233
Electroconvulsive Therapy....................242
Psychotherapies....................244
Inpatient and Follow-Up Care for Suicidality....................250
Cultural Considerations and Faith-Based Interventions....................256
Findings....................257
References....................259
8 PROGRAMS FOR SUICIDE PREVENTION....................273
Framework for Prevention....................274
Universal Preventions....................275
Selective Prevention....................297
Indicated Prevention....................300
Integrated Approaches to Prevention....................302
Assessing the Effectiveness of Prevention Approaches....................313
Findings....................316
References....................318
9 BARRIERS TO EFFECTIVE TREATMENT AND INTERVENTION....................331
General Barriers to Treatment....................332
Clinician Barriers to Treatment....................339
Patient Barriers to Treatment....................349
Barriers to Treatment for High-Risk Groups....................351
Global Barriers....................360
Findings....................361
References....................362
10 BARRIERS TO RESEARCH AND PROMISING APPROACHES....................375
Methodology....................376
Surveillance of Suicide and Suicide Attempts....................379
Ethics and Safety....................389
Research Design and Analysis Issues....................393
Centers....................406
Findings....................411
References....................412
11 FINDINGS AND RECOMMENDATIONS....................423
Enhancing the Infrastructure....................423
Enhancing the Database on Suicide....................431
Enhancing Identification of Those at Risk for Suicide....................434
Enhancing Prevention and Interventions....................436
APPENDIXES A Statistical Details....................441
B Consultants....................469
C Workshop Agendas....................472
INDEX....................475

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