The Harvard Medical School Guide to Suicide Assessment and Intervention / Edition 1

by Douglas G. Jacobs

Overview

This vital resource—edited by Harvard Medical School's DouglasJacobs, a nationally recognized expert on suicide anddepression—is the definitive guide for helping mental healthprofessionals determine the risk for suicide and appropriateinterventions for suicidal or at-risk patients. Created primarilyfor mental health clinicians (with several chapters directed towardprimary care physicians), the book is a hands-on guide for thosewho are often the first line of defense for assessing if a patientor client is suicidal.

Comprehensive in scope, the book offers a wealth of informationabout such useful topics as inpatient and outpatient issues,psychopharmacology, and advice about working with specialpopulations. Most importantly, the book's contributors detaileffective techniques for intervention and offer a model of suicideassessment that focuses on predisposing conditions, potentiatingconditions, and specific suicide inquiries. As a special feature,the book also includes a helpful section on contracts—agreementsmade with the patient not to harm themselves—and useful factsabout the subsequent liability issues. In addition, there is acompelling analysis of the controversial issues surroundingassisted suicide as well as an honest personal account ofsuicidality from a professional who has experienced it for herself.

Product Details

ISBN-13:	9780787943035
Publisher:	Wiley
Publication date:	12/15/1998
Series:	Health and Psychology Series
Pages:	736
Product dimensions:	7.19(w) x 9.37(h) x 2.13(d)

About the Author

DOUGLAS G. JACOBS M.D., is associate clinical professor of psychiatry at the Harvard Medical School and executive director of the nonprofit National Mental Illness Screening Project. He has edited two textbooks on suicide, Suicide: Understanding and Responding and Suicide and Clinical Practice.

Table of Contents

Foreword, Joseph T. Coyle, M.D.

Preface, Douglas G. Jacobs, M.D.

ASSESSMENT.

Suicide Assessment: An Overview and Recommended Protocol (D.Jacobs, et al.).

Epidemiology of Suicide (E. Moscicki).

A Community Psychiatry Approach to Preventing Suicide (R. Dorwart& M. Ostacher).

The Psychodynamic Understanding of Suicide (J. Maltsberger).

Perturbation and Lethality: A Psychological Approach to Assessmentand Intervention (E. Shneidman).

The Neurobiology of Suicidal Behavior (J. Mann & V.Arango).

Profiles of Completed Suicides (J. Fawcett).

Self-Mutilation (A. Favazza).

Standard Protocol for Assessing and Treating Suicidal Behaviors forPatients in Treatment (M. Linehan).

Murder Suicide: Phenomenology and Clinical Implications (M. Nock& P. Marzuk).

Excerpts from Academic Conference and Recognition of Suicidal RisksThrough the Psychologic Examination (L. Havens).

Critical Points in the Assessment and Management of Suicide Risk(J. Motto).

Can Suicide Ever Be Eradicated?: A Personal Journey (P.Cantor).

INTERVENTION.

Suicide and Manic-Depressive Illness: An Overview and PersonalAccount (K. Jamison).

Lifetime Risk of Suicide in Major Affective Disorders (D. Clark& A. Goebel-Gabbri).

Suicide and Schizophrenia (M. Tsuang, et al.).

Substance Abuse and Suicide (R. Weiss & M. Hufford).

Borderline Personality Disorder (T. Davis, et al.).

Trauma and Suicide (J. Chu).

Antisuicidal Effect of Lithium Treatment in Major Mood Disorders(R. Baldessarini & L. Tondo).

Treatment of the Suicidal Patient with Psychotropic Drugs and ECT(C. Salzman).

The Inpatient Management of Suicidality (G. Jacobson).

ECT and Suicide (E. Metzger).

SPECIAL ISSUES.

Suicide in Children and Adolescents (S. Goldman & W.Beardslee).

Suicide in the Elderly (D. Steffens & D. Blazer).

Suicide-Prevention Contracts: Advantages, Disadvantages, and andAlternative Approach (M. Miller).

Guidlines for Conducting a Suicide Review (S. Stelovich).

Medical Settings and Suicide (M. Kelly, et al.).

Suicide Assessment in the Primary Care Setting (M. Miller & R.Paulsen).

Suicide, Assisted Suicide, and Euthanasia (H. Hendin).

Liability Issues and Liability Prevention in Suicide (T.Gutheil).

Appendix A: Guidelines for Identification, Assessment, andTreatment for Suicidality.

Appendix B: Risk Management Foundation of the Harvard MedicalInstitutions.

References.

About the Authors.

Name Index.

Subject Index.

What People are Saying About This

From the Publisher

"The Harvard Guide puts the best and the brightest of consulting suicidologists on the practicing clinician's bookshelf, . . . . must-read." (Lanny Berman, executive director, American Association of Suicidology)

"[This book] presents the most up-to-date material and combines this framework with practical suggestions for the clinician. This is sure to become a classic." (Alan F. Schatzberg, Kenneth T. Norris, Jr. Professor and chairman, Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine)

"The threat of suicide is riveting; its reality is devastating; it is our life-or-death clinical challenge. This volume is the singularly comprehensive, authoritative, definitive, and useful text on suicide. We are now strengthened for our work." (Jerrold F. Rosenbaum, Massachusetts General Hospital, Harvard Medical School)

"For the clinician needing help with a suicidal patient-this is your book. For the student or researcher seeking the state of the art on suicide-this is your book." (Robert M. A. Hirschfeld, Titus Harris Distinguished Professor and chair, Department of Psychiatry and Behavioral Sciences, University of Texas Medical Branch at Galveston)

Editorial Reviews

Reviewer: Howard M. Kravitz, DO, MPH (Rush University Medical Center)
Description: This book is a rather large handbook of current work on suicide. It was written to serve as both a basic reference resource and a hands-on practice guide.
Purpose: The text evolved from a two-day suicide conference in 1997 that brought together Harvard faculty and outside experts. Its purpose is to help clinicians assess and treat suicidal patients, an unequivocally laudable goal. An important feature of the book that demonstrates the editor's sincerity in achieving this purpose is the inclusion of an "implications for the clinician" section at the end of almost every chapter, which serves to summarize and highlight key points and ties together the clinical and evidence-based aspects of each presentation.
Audience: The broad audience includes practitioners who need to assess suicidal persons: psychiatrists, primary care physicians, school counselors, psychologists, psychotherapists, and other mental health professionals. The editor has assembled an all-star line-up of contributors who comprise a virtual who's who in suicidology, ranging from A to Z (actually only A to W: Arango to Weiss).
Features: This guide is divided into three parts: assessment, intervention, and special issues. The result is an interesting blend of experiential and empirical views on suicide, its assessment, and practical management guidelines. The writing style emphasizes simple language and lucidity, which make an easy read of this weighty subject. The editor indicates points of overlap and/or alternative views and cross-references the reader to the appropriate chapter(s). Controversies and speculations are underplayed; the main thrust is to provide usable information for practitioners. Tables and exhibits (another term for tables in some chapters) highlight important facts; figures are presented sparingly. Vignettes are used to highlight clinical points. Quite impressively, most chapters are quite up-to-date, with a large number of references from the 1990s, up to and including 1998. Non-glossy, acid-free, and chlorine-free paper adds to user-friendliness.
Assessment: This book represents an attempt to cover assessment and intervention comprehensively from both evidence-based and state-of-the-art clinical practice perspectives. Although largely successful, it more convincingly achieves the latter than the former; the presentations tend more toward anecdotal and experiential than data-driven and evidence-based. Removing the anecdotal and overly personalized chapters would have shortened the text, but perhaps made it less interesting. Furthermore, the contributors' expertise adds an aura of authoritativeness and credibility to the chapters. One caveat is that this is a book for practitioners, not for suicide researchers, unless they also see patients. It is competitively priced and will be a well-used addition to the library of any practitioner who evaluates or treats potentially suicidal individuals, or provides clinical supervision for someone who does.

Doody's Review Service

"The Harvard Guide puts the best and the brightest of consultingsuicidologists on the practicing clinician's bookshelf, . . . .must-read." (Lanny Berman, executive director, American Associationof Suicidology)

"[This book] presents the most up-to-date material and combinesthis framework with practical suggestions for the clinician. Thisis sure to become a classic." (Alan F. Schatzberg, Kenneth T.Norris, Jr. Professor and chairman, Department of Psychiatry andBehavioral Sciences, Stanford University School of Medicine)

"The threat of suicide is riveting; its reality is devastating; itis our life-or-death clinical challenge. This volume is thesingularly comprehensive, authoritative, definitive, and usefultext on suicide. We are now strengthened for our work." (Jerrold F.Rosenbaum, Massachusetts General Hospital, Harvard MedicalSchool)

"For the clinician needing help with a suicidal patient-this isyour book. For the student or researcher seeking the state of theart on suicide-this is your book." (Robert M. A. Hirschfeld, TitusHarris Distinguished Professor and chair, Department of Psychiatryand Behavioral Sciences, University of Texas Medical Branch atGalveston)

From the Publisher

4 Stars! from Doody

This book is a rather large handbook of current work on suicide. It was written to serve as both a basic reference resource and a hands-on practice guide. The text evolved from a two-day suicide conference in 1997 that brought together Harvard faculty and outside experts. Its purpose is to help clinicians assess and treat suicidal patients, an unequivocally laudable goal. An important feature of the book that demonstrates the editor's sincerity in achieving this purpose is the inclusion of an ""implications for the clinician"" section at the end of almost every chapter, which serves to summarize and highlight key points and ties together the clinical and evidence-based aspects of each presentation. The broad audience includes practitioners who need to assess suicidal persons: psychiatrists, primary care physicians, school counselors, psychologists, psychotherapists, and other mental health professionals. The editor has assembled an all-star line-up of contributors who comprise a virtual who's who in suicidology, ranging from A to Z (actually only A to W: Arango to Weiss). This guide is divided into three parts: assessment, intervention, and special issues. The result is an interesting blend of experiential and empirical views on suicide, its assessment, and practical management guidelines. The writing style emphasizes simple language and lucidity, which make an easy read of this weighty subject. The editor indicates points of overlap and/or alternative views and cross-references the reader to the appropriate chapter(s). Controversies and speculations are underplayed; the main thrust is to provide usable information for practitioners. Tables and exhibits (another term for tablesin some chapters) highlight important facts; figures are presented sparingly. Vignettes are used to highlight clinical points. Quite impressively, most chapters are quite up-to-date, with a large number of references from the 1990s, up to and including 1998. Non-glossy, acid-free, and chlorine-free paper adds to user-friendliness. This book represents an attempt to cover assessment and intervention comprehensively from both evidence-based and state-of-the-art clinical practice perspectives. Although largely successful, it more convincingly achieves the latter than the former; the presentations tend more toward anecdotal and experiential than data-driven and evidence-based. Removing the anecdotal and overly personalized chapters would have shortened the text, but perhaps made it less interesting. Furthermore, the contributors' expertise adds an aura of authoritativeness and credibility to the chapters. One caveat is that this is a book for practitioners, not for suicide researchers, unless they also see patients. It is competitively priced and will be a well-used addition to the library of any practitioner who evaluates or treats potentially suicidal individuals, or provides clinical supervision for someone who does.

Howard M. Kravitz

A massive compendium of current research and thought to help clinicians identify patients who may be at risk for suicide and take appropriate steps to reduce the risk. Explains methods for determining the risk level for suicidal or at-risk patients, recommends a suicide assessment protocol that can fold easily into clinical practice, and provides guidelines for intervening when people risk harming themselves. Ranges through such populations as adolescents; the physically ill; and those with major mental illness, alcoholism, and borderline personality disorder. Also considers somatic treatment, highlighting new findings about lithium. One chapter is an intimate account by a professional who once attempted suicide; another looks at assisted suicide and euthanasia. Annotation c. by Book News, Inc., Portland, Or.

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