Outlines model for crisis intervention with highly lethal suicidal people. Explores idea that crisis is a perception, including issues of lethality and perturbation, object relations, responsibility, weapon availability, and active versus passive response. Highlights specific problems with transference and countertransference. Suggests that there…

Presents case of Tillie, 36-year-old female office manager of law firm who committed suicide by jumping off balcony in her home in presence of co-workers. Douglas Jacobs from Harvard Medical School and David Jobes from the Catholic University of America discuss case and role of consultant called in to help co-workers deal with impact of this…

Refutes certain myths about adolescent suicide and discusses the characteristics and symptoms of suicidal behavior. Offers considerations for counseling the suicidal teenager. Lists counselors' responsibilities which include being informed on the subject, arranging workshops to educate others, and offering immediate support and evaluation of the…

The suicide of a competent and popular teacher required rapid but careful response by administrators at a midwestern high school. This article explains how faculty members and students were informed and how crisis specialists were brought in to help respond to strong student reactions. (PGD)

Compares and contrasts the contributions of various prevention models toward the theoretical reduction of suicide in the general population, and explores conceptual frameworks used to understand population-level risk factors. First-order and second-order targets of change in prevention efforts are defined and examples provided. (JPS)

Suicide prevention initiatives at the national level are most likely to impact the largest numbers of citizens. Canada lays some claim for recognition in the general field of suicide prevention as a result of a 1974 federal document focusing on health promotion. The authors discuss innovations and problems occurring in the various Canadian…

Presents two case vignettes that pose issues of concern for suicide postvention, with particular relevance to the development of school-based crisis intervention response programs. Two commentaries follow the vignettes. (Author/NB)

Focusing on emerging models of population-level risk reduction, the authors discuss the essential ingredients for successful suicide prevention programs: comprehensiveness, fidelity, and intensity. Issues of feasibility, access, and effectiveness are discussed. The authors argue for nesting suicide prevention programs within existing public health…

The epidemiology of adolescent suicide is summarized with particular emphasis on temporal trends by age and gender. "First-generation" prevention programs are examined, followed by a description of selective, targeted, "second generation" prevention efforts, which are focused toward targets of individual predisposition, the…

Argues for paradigm shift in how mental health professionals approach their work with psychiatric patients in midst of suicidal crisis and suggests that time has come to discuss standard of care based on integration of detected risk factors, effective education and training in suicidology, and routine use of consultation and teamwork. (Author/NB)

Explores some of the possible distinctive traits of midlife suicides, which include: loss of spouse, years of heavy drinking, reaching the age of high depression risk, and occupational problems. Midlife suicides tend to be highest among white males, although female suicide rates peak in midlife. The paper concludes with a review of assessment and…

Presents rationale for therapy, from assessment through psychotherapy, with suicidal elderly patients. Describes process including attention to situational and family components, crisis intervention, general treatment principles, and application of these principles to individual, group, and family therapy. Emphasizes intensity and complexity of…

The public health approach to suicide prevention consists of health-event surveillance to describe the problem, epidemiologic analysis to identify risk factors, the design and evaluation of interventions, and the implementation of prevention programs. Community suicide prevention programs should include more than one strategy and, where…

The relationship between medical illness and suicide seems to be multi-faceted. While medical illness is not the sole determinant of suicide, certain illnesses, such as HIV/AIDS and brain cancers, do appear to elevate the risk of suicide. Possible effective prevention efforts include education of primary care providers, and improved medication…

Emphasizes the value of a systemic approach, when encountering life-threatening behavior in a clinical practice. Presents two case studies that employed therapeutic methods derived from systemic therapy. Illustrates the importance of the therapist's ability to speak the client's language in formulating an intervention for reducing the likelihood…