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The Harvard Medical School Guide to Suicide Assessment and Intervention

ISBN: 978-0-7879-4303-5
736 pages
December 1998, Jossey-Bass
The Harvard Medical School Guide to Suicide Assessment and Intervention (0787943037) cover image


This vital resource--edited by Harvard Medical School's Douglas Jacobs, a nationally recognized expert on suicide and depression--is the definitive guide for helping mental health professionals determine the risk for suicide and appropriate interventions for suicidal or at-risk patients. Created primarily for mental health clinicians (with several chapters directed toward primary care physicians), the book is a hands-on guide for those who are often the first line of defense for assessing if a patient or client is suicidal.

Comprehensive in scope, the book offers a wealth of information about such useful topics as inpatient and outpatient issues, psychopharmacology, and advice about working with special populations. Most importantly, the book's contributors detail effective techniques for intervention and offer a model of suicide assessment that focuses on predisposing conditions, potentiating conditions, and specific suicide inquiries. As a special feature, the book also includes a helpful section on contracts--agreements made with the patient not to harm themselves--and useful facts about the subsequent liability issues. In addition, there is a compelling analysis of the controversial issues surrounding assisted suicide as well as an honest personal account of suicidality from a professional who has experienced it for herself.
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Table of Contents

Foreword, Joseph T. Coyle, M.D.

Preface, Douglas G. Jacobs, M.D.


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 Assessment and 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 for Patients in Treatment (M. Linehan).

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

Excerpts from Academic Conference and Recognition of Suicidal Risks Through 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).


Suicide and Manic-Depressive Illness: An Overview and Personal Account (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).


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

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

Suicide-Prevention Contracts: Advantages, Disadvantages, and and Alternative 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, and Treatment for Suicidality.

Appendix B: Risk Management Foundation of the Harvard Medical Institutions.


About the Authors.

Name Index.

Subject Index.
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Author Information

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.
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"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)
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