Alternatives to Suicide

Alternatives to Suicide: Beyond Risk and Toward a Life Worth Living demonstrates how fostering resilience and a desire for life can broaden and advance an understanding of suicide. The book summarizes the existing literature and outlines a new focus on the dynamic interplay of risk and resilience that leads to a life-focus approach to suicide prevention. It calls for a treatment approach that enhances the opportunity to collaboratively engage clients in discussion about their lives. Providing a new perspective on how to approach suicide prevention, the book also lays out key theories on resilience and the interplay of risk and protective factors. Finally, the book outlines how emerging technologies and advances in data-analytic sophistication using real-time monitoring of suicide dynamics are ushering the field of suicide research and prevention into a new and exciting era. Focuses on what attenuates the transition from thinking about suicide to attempting it Calls for a life-focus treatment approach as opposed to risk-aversion intervention techniques Demonstrates how fostering resilience can advance our understanding of pathways to suicide Discusses emerging technologies being used in current suicide research and prevention Outlines the differences between risk factors and risk correlates Covers real-time assessment of dynamic suicide risk

Celebrated transsexual trailblazer Kate Bornstein has, with more humor and spunk than any other, ushered us into a world of limitless possibility through a daring re-envisionment of the gender system as we know it. Here, Bornstein bravely and wittily shares personal and unorthodox methods of survival in an often cruel world. A one-of-a-kind guide to staying alive outside the box, Hello, Cruel World is a much-needed unconventional approach to life for those who want to stay on the edge, but alive. Hello, Cruel World features a catalog of 101 alternatives to suicide that range from the playful (moisturize!), to the irreverent (shatter some family values), to the highly controversial. Designed to encourage readers to give themselves permission to unleash their hearts' harmless desires, the book has only one directive: "Don't be mean." It is this guiding principle that brings its reader on a self-validating journey, which forges wholly new paths toward a resounding decision to choose life. Tenderly intimate and unapologetically edgy, Kate Bornstein is the radical role model, the affectionate best friend, and the guiding mentor all in one.

Suicide Prevention Contracting: The Pitfalls, Perils, and Seven Safer Alternatives demonstrates that suicide prevention contracting, a widely adopted but little-understood form of suicide prevention, is almost wholly counterproductive and potentially dangerous for both patients and the clinician attempting to assist them. Edwards and Goj make a compelling case for this alarming pronouncement and offer seven alternative procedures.

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.

In Critical Suicidology, a team of international scholars, practitioners, and people directly affected by suicide argue that the field of suicidology has become too focused on the biomedical paradigm: a model that pathologizes distress and obscures the social, political, and historical contexts that contribute to human suffering. The authors take a critical look at existing research, introduce the perspectives of those who have direct personal knowledge of suicide and suicidal behaviour, and propose alternative approaches that are creative and culturally sensitive. In the right hands, this book could save lives.

With recent studies using genetic, epigenetic, and other molecular and neurochemical approaches, a new era has begun in understanding pathophysiology of suicide. Emerging evidence suggests that neurobiological factors are not only critical in providing potential risk factors but also provide a promising approach to develop more effective treatment and prevention strategies. The Neurobiological Basis of Suicide discusses the most recent findings in suicide neurobiology. Psychological, psychosocial, and cultural factors are important in determining the risk factors for suicide; however, they offer weak prediction and can be of little clinical use. Interestingly, cognitive characteristics are different among depressed suicidal and depressed nonsuicidal subjects, and could be involved in the development of suicidal behavior. The characterization of the neurobiological basis of suicide is in delineating the risk factors associated with suicide. The Neurobiological Basis of Suicide focuses on how and why these neurobiological factors are crucial in the pathogenic mechanisms of suicidal behavior and how these findings can be transformed into potential therapeutic applications.

Written before Roman's carefully deliberated suicide, this book examines the idea of rational suicide as a human right and proposes an exit house for those who prefer a self-determined death

Lieberman looks at the cultural meaning of suicide and how it has gone from being seen as subversive to self-destructive.

Biblical Psychotherapy, Kalman J. Kaplan and Paul Cantz offer a new approach to suicide prevention based on biblical narratives that is designed to overcome the suicidogenic patterns in Greek and Roman stories implicit in modern mental health. More than sixteen suicides and self-mutilations emerge in the twenty-six surviving tragedies of Sophocles and Euripides and countless others occurred in Greek and Roman lives. In contrast, only six suicides are found in the Hebrew Scriptures, in addition to a number of suicide-prevention narratives. Kaplan and Cantz reclaim life-enhancing biblical narratives as alternatives to matched suicidal stories in Greek and Roman society with regard to seven evidence-based risk factors. These biblical narratives are employed to treat fourteen patients fitting into the outlined Graeco-Roman suicidal syndromes and to provide an in-depth positive psychology aimed at promoting life rather than simply preventing suicide.

All Major Ernie Bearclaw wanted was a clean house, an attractive wife and a little respect. But when he returns to the States for powwow after his Mideast deployment he finds chaos on the rez, in his home, and in his bed. Ernie speaks up. And then a couple of people shoot him. Now Ernie's in a coma and his family, enemies and grateful nation are trying to figure out who shot him and why. There are a lot of suspects, because Ernie is a complicated guy. The tribal chairman hates him for blabbing to the media about misuse of casino funds. The Army thinks an Iraqi treasure smuggling cartel is after him. Ernie's spurned love Ellen, furious at his survival, stalks the hospital corridors hoping to unplug him. His wife Julia fantasizes about how kindly people will treat her at his funeral. Who shot Ernie Bearclaw? Do the crows really have the answer? Do the elders have time for another bingo game? And is this any way to treat a war hero?ADULTERY AND OTHER ALTERNATIVES TO SUICIDE is the first book in the SPIDER CLOUD CASINO MYSTERY series.

What drives a person to take his or her own life? Why would an individual be willing to strap a bomb to himself and walk into a crowded marketplace, blowing himself up at the same time as he kills and maims the people around him? Does suicide or ‘voluntary death’ have the same meaning today as it had in earlier centuries, and does it have the same significance in China, India and the Middle East as it has in the West? How should we understand this distressing, often puzzling phenomenon and how can we explain its patterns and variations over time? In this wide-ranging comparative study, Barbagli examines suicide as a socio-cultural, religious and political phenomenon, exploring the reasons that underlie it and the meanings it has acquired in different cultures throughout the world. Drawing on a vast body of research carried out by historians, anthropologists, sociologists, political scientists and psychologists, Barbagli shows that a satisfactory theory of suicide cannot limit itself to considering the two causes that were highlighted by the great French sociologist Émile Durkheim – namely, social integration and regulation. Barbagli proposes a new account of suicide that links the motives for and significance attributed to individual actions with the people for whom and against whom individuals take their lives. This new study of suicide sheds fresh light on the cultural differences between East and West and greatly increases our understanding of an often-misunderstood act. It will be the definitive history of suicide for many years to come.

This is a frank, compassionate book written to those who contemplate suicide as a way out of their situations. The author issues an invitation to life, helping people accept the imperfections of their lives, and opening eyes to the possibilities of love.

This book brings together an international array of stars of the mental health professions to create a cutting edge volume that sheds light on many important and heretofore poorly understood issues in psychopathology. Mental Disorders-Theoretical and Empirical perspectives will be an important addition to the libraries of scholars and clinicians.

In the year 2000, approximately one million people died from suicide: a "global" mortality rate of 16 per 100,000, or one death every 40 seconds. In the last 45 years suicide rates have increased by 60% worldwide. Suicide is now among the three leading causes of death among those aged 15-44 years (both sexes); these figures do not include suicide attempts up to 20 times more frequent than completed suicide. Suicide worldwide is estimated to represent 1.8% of the total global burden of disease in1998, and 2.4% in countries with market and former socialist economies in 2020. Although traditionally suicide rates have been highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of countries, in both developed and developing countries. Mental disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide; however, suicide results from many complex sociocultural factors and is more likely to occur particularly during periods of socioeconomic, family and individual crisis situations (e.g., loss of a loved one, employment, honour). The economic costs associated with completed and attempted suicide are estimated to be in the billions of dollars. One million lives lost each year are more than those lost from wars and murder annually in the world. It is three times the catastrophic loss of life in the tsunami disaster in Asia in 2005. Every day of the year, the number of suicides is equivalent to the number of lives lost in the attack on the World Trade Center Twin Towers on 9/11 in 2001. Everyone should be aware of the warning signs for suicide: Someone threatening to hurt or kill him/herself, or taking of wanting to hurt or kill him/herself; someone looking for ways to kill him/herself by seeking access to firearms, available pills, or other means; someone talking or writing about death, dying or suicide, when these actions are out of the ordinary for the person. Also, high risk of suicide is generally associated with hopelessness; rage, uncontrolled anger, seeking revenge; acting reckless or engaging in risky activities, seemingly without thinking; feeling trapped – like there’s no way out; increased alcohol or drug use; withdrawing from friends, family and society, anxiety, agitation, unable to sleep or sleeping all the time; dramatic mood changes; no reason for living; no sense of purpose in life. Table 1: Understanding and helping the suicidal individual should be a task for all. Suicide Myths How to Help the Suicidal Person Warning Sights of Suicide Myth: Suicidal people just want to die. Fact: Most of the time, suicidal people are torn between wanting to die and wanting to live. Most suicidal individuals don’t want death; they just want to stoop the great psychological or emotional pain they are experiencing -Listen; -Accept the person’s feelings as they are; -Do not be afraid to talk about suicide directly -Ask them if they developed a plan of suicide; -Expressing suicidal feelings or bringing up the topic of suicide; -Giving away prized possessions settling affairs, making out a will; -Signs of depression: loss of pleasure, sad mood, alterations in sleeping/eating patterns, feelings of hopelessness; Myth: People who commit suicide do not warn others. Fact: Eight out of every 10 people who kill themselves give definite clues to their intentions. They leave numerous clues and warnings to others, although clues may be non-verbal of difficult to detect. -Remove lethal means for suicide from person’s home -Remind the person that depressed feelings do change with time; -Point out when death is chosen, it is irreversible; -Change of behavior (poor work or school performance) -Risk-taking behaviors -Increased use of alcohol or drugs -Social isolation -Developing a specific plan for suicide Myth: People who talk about suicide are only trying to get attention. They won’t really do it. Fact: Few commit suicide without first letting someone know how they feel. Those who are considering suicide give clues and warnings as a cry for help. Over 70% who do threaten to commit suicide either make an attempt or complete the act. -Express your concern for the person; -Develop a plan for help with the person; -Seek outside emergency intervention at a hospital, mental health clinic or call a suicide prevention center Myth: Don’t mention suicide to someone who’s showing signs of depression. It will plant the idea in their minds and they will act on it. Fact: Many depressed people have already considered suicide as an option. Discussing it openly helps the suicidal person sort through the problems and generally provides a sense of relief and understanding. Suicide is preventable. Most suicidal individuals desperately want to live; they are just unable to see alternatives to their problems. Most suicidal individuals give definite warnings of their suicidal intentions, but others are either unaware of the significance of these warnings or do not know how to respond to them. Talking about suicide does not cause someone to be suicidal; on the contrary the individual feel relief and has the opportunity to experience an empathic contact. Suicide profoundly affects individuals, families, workplaces, neighbourhoods and societies. The economic costs associated with suicide and self-inflicted injuries are estimated to be in the billions of dollars. Surviving family members not only suffer the trauma of losing a loved one to suicide, and may themselves be at higher risk for suicide and emotional problems. Mental pain is the basic ingredient of suicide. Edwin Shneidman calls such pain “psychache” [1], meaning an ache in the psyche. Shneidman suggested that the key questions to ask a suicidal person are ‘Where do you hurt?’ and ‘How may I help you?’. If the function of suicide is to put a stop to an unbearable flow of painful consciousness, then it follows that the clinician’s main task is to mollify that pain. Shneidman (1) also pointed out that the main sources of psychological pain, such as shame, guilt, rage, loneliness, hopelessness and so forth, stem from frustrated or thwarted psychological needs. These psychological needs include the need for achievement, for affiliation, for autonomy, for counteraction, for exhibition, for nurturance, for order and for understanding. Shneidman [2], who is considered the father of suicidology, has proposed the following definition of suicide: ‘Currently in the Western world, suicide is a conscious act of self-induced annihilation, best understood as a multidimensional malaise in a needful individual who defines an issue for which the suicide is perceived as the best solution’. Shneidman has also suggested that ‘that suicide is best understood not so much as a movement toward death as it is a movement away from something and that something is always the same: intolerable emotion, unendurable pain, or unacceptable anguish. Strategies involving restriction of access to common methods of suicide have proved to be effective in reducing suicide rates; however, there is a need to adopt multi-sectoral approaches involving other levels of intervention and activities, such as crisis centers. There is compelling evidence indicating that adequate prevention and treatment of depression, alcohol and substance abuse can reduce suicide rates. School-based interventions involving crisis management, self-esteem enhancement and the development of coping skills and healthy decision making have been demonstrated to reduce the risk of suicide among the youth. Worldwide, the prevention of suicide has not been adequately addressed due to basically a lack of awareness of suicide as a major problem and the taboo in many societies to discuss openly about it. In fact, only a few countries have included prevention of suicide among their priorities. Reliability of suicide certification and reporting is an issue in great need of improvement. It is clear that suicide prevention requires intervention also from outside the health sector and calls for an innovative, comprehensive multi-sectoral approach, including both health and non-health sectors, e.g., education, labour, police, justice, religion, law, politics, the media.

Boldly and eloquently contributing to the argument against the prison system in the United States, these provocative essays offer an ideological and practical framework for empowering prisoners instead of incarcerating them. Experts and activists who have worked within and against the prison system join forces here to call attention to the debilitating effects of a punishment-driven society and offer clear-eyed alternatives, emphasizing working directly with prisoners and their communities. The volume offers rhetorical and political analyses of police culture, the so-called drug war, media coverage of crime stories, and the public school- to-prison pipeline. The collection also includes case studies of successful prison arts and education programs in Michigan, California, Missouri, Wisconsin, and Pennsylvania that provide creative and intellectual resources typically denied to citizens living behind bars. Writings and artwork created by prisoners in such programs richly enhance the volume. Contributors are Buzz Alexander, Rose Braz, Travis L. Dixon, Garrett Albert Duncan, Stephen John Hartnett, Julilly Kohler-Hausmann, Daniel Mark Larson, Erica R. Meiners, Janie Paul, Lori Pompa, Jonathan Shailor, Robin Sohnen, and Myesha Williams. Stephen John Hartnett is an associate professor and chair of communication at the University of Colorado Denver. He is the author of Incarceration Nation: Investigative Prison Poems of Hope and Terror and Executing Democracy, Volume One: Capital Punishment and the Making of America, 1683–1807.

Since the publication of the Institute of Medicine (IOM) report Clinical Practice Guidelines We Can Trust in 2011, there has been an increasing emphasis on assuring that clinical practice guidelines are trustworthy, developed in a transparent fashion, and based on a systematic review of the available research evidence. To align with the IOM recommendations and to meet the new requirements for inclusion of a guideline in the National Guidelines Clearinghouse of the Agency for Healthcare Research and Quality (AHRQ), American Psychiatric Association (APA) has adopted a new process for practice guideline development. Under this new process APA's practice guidelines also seek to provide better clinical utility and usability. Rather than a broad overview of treatment for a disorder, new practice guidelines focus on a set of discrete clinical questions of relevance to an overarching subject area. A systematic review of evidence is conducted to address these clinical questions and involves a detailed assessment of individual studies. The quality of the overall body of evidence is also rated and is summarized in the practice guideline. With the new process, recommendations are determined by weighing potential benefits and harms of an intervention in a specific clinical context. Clear, concise, and actionable recommendation statements help clinicians to incorporate recommendations into clinical practice, with the goal of improving quality of care. The new practice guideline format is also designed to be more user friendly by dividing information into modules on specific clinical questions. Each module has a consistent organization, which will assist users in finding clinically useful and relevant information quickly and easily. This new edition of the practice guidelines on psychiatric evaluation for adults is the first set of the APA's guidelines developed under the new guideline development process. These guidelines address the following nine topics, in the context of an initial psychiatric evaluation: review of psychiatric symptoms, trauma history, and treatment history; substance use assessment; assessment of suicide risk; assessment for risk of aggressive behaviors; assessment of cultural factors; assessment of medical health; quantitative assessment; involvement of the patient in treatment decision making; and documentation of the psychiatric evaluation. Each guideline recommends or suggests topics to include during an initial psychiatric evaluation. Findings from an expert opinion survey have also been taken into consideration in making recommendations or suggestions. In addition to reviewing the available evidence on psychiatry evaluation, each guideline also provides guidance to clinicians on implementing these recommendations to enhance patient care.

There is no constitutional right to physician-assisted suicide says the U.S. Supreme Court. Most states have laws against it, but states can also allow it, as Oregon has done; others are considering legalization. Still very little guidance has been offered about its practice. Assisted Suicide: Finding Common Ground fills that void. A diverse group of experts—some for, some against—provide a framework for thinking about what assisted suicide, particularly physician-assisted suicide, is and how its legalized practice might be guided. The book does not take a position on the continuing debate about the morality or wisdom of legalizing assisted suicide. But physician-assisted suicide is now taking place, and the more pressing concerns are those pertaining to its implementation. Editors Lois Snyder and Art Caplan attempt to find common ground on those real-world concerns. Among the questions asked and answered are: What is assisted suicide? Is physician-assisted suicide different from refusal of treatment? Are there alternatives to assisted suicide? How useful are currently available guidelines for physician-assisted suicide? Who should have access to what? Does assisted suicide necessarily mean physician-assisted suicide? Can the practice be effectively and meaningfully regulated? How should physicians respond to requests for assisted suicide? Assisted suicide is one of the most ethically challenging issues in medicine and bioethics, defining who we are and want to be as individuals and as a society. This book takes a hard look at alternatives to the practice, the implications for the patient-physician relationship, who should write guidelines, and how to regulate physician-assisted suicide and establish safeguards so that it is voluntary and an option of last resort.

Annotation Few issues are as volatile or misunderstood as physician-assisted suicide and euthanasia. In The Case against Assisted Suicide: For the Right to End-of-Life Care, Drs. Foley and Hendin unravel why such principles as patient autonomy, compassion, and ratio.

After assessing the strengths and weaknesses of arguments for assisted suicide and euthanasia, Gorsuch builds a nuanced, novel, and powerful moral and legal argument against legalization, one based on a principle that, surprisingly, has largely been overlooked in the debate; the idea that human life is intrinsically valuable and that intentional killing is always wrong. At the same time, the argument Gorsuch develops leaves wide latitude for individual patient autonomy and the refusal of unwanted medical treatment and life-sustaining care, permitting intervention only in cases where an intention to kill is present.