Crisis Intervention in the Context of Outpatient Treatment of Suicidal Patients (IN: Assessment, Treatment, and Prevention of Suicidal Behavior, edited by R I Yufit & D Lester)

This chapter outlines a framework for crisis intervention in suicide management that is guided by a basic conceptualizaton of suicide that incorporates crisis intervention principles & goals. Additional variables that are critical to clinically sound outpatient management of suicidal patients & issues that tend to be underemphasized by therapists in working with suicidal patients are […]

A Process Model for Clinical Decision Making in High-Risk Outpatient Situations: the Therapeutic Alliance and Suicide

When a client is at risk for suicide, important counselling decisions must be made. This article presents a process model for decision making in high-risk outpatient situations. It is proposed that counsellors attend to 2 key dimensions of these situations: the strength of the therapeutic alliance & the degree of suicide risk. Therapeutic actions are […]

Improving Support of Residents After a Patient Suicide: a Residency Case Study

Each of the authors experienced the suicide of one patient during their residencies at Columbia & discovered several deficiencies in their methods of dealing with them. In this article, they describe the interventions developed at Columbia University, including curricular changes, development of a crisis support team, & a formal review of the event. Other constructive […]

Counselling Suicidal Clients

This book is written for counsellors & psychotherapists, & for any professional who uses counselling skills when supporting suicidal people. It has 6 main parts: the changing context of suicide; the prediction-prevention model, policy, & ethics; the influence of the organization; the client process; the practitioner process; & the practice of counselling with suicidal clients. […]

Ethical and Legal Issues in Suicide Research

Moralist, libertarian, & relativist ethical positions concerning suicide & its prevention are presented in order to clarify premises upon which ethical issues in suicide research may be resolved. Ethical concerns are differentiated from legal considerations & the implications of the vulnerability of suicidology research participants are discussed. Specific issues that arise in design, choice of […]

Barriers to Effective Mental Health Interventions That Reduce Suicide by Police Officers (In: Suicide and Law Enforcement, edited by D C Sheehan & J I Warren)

Suicide by officers became the genesis of a confidential counselling program for officers & their families. However, 10 years after these deaths, a confidential counselling service was shifted to a gatekeeper, nonconfidential service delivery model. Within 2 years, three more officers had died by suicide. This agency provided a near-perfect A-B-A research design where the […]

Suicide Prevention Among Older Adults: a Guide for Family Members

This guide was designed for family members & other people who provide social support to older adults. The purpose of the guide is to help individuals recognize suicide risk factors & warning signs, & to know what to do if an older adult is at risk for suicide. JA

Principles for Developing Organisational Policies and Protocols for Responding to Clients at Risk of Suicide and Self-Harm

A Model for an In-House Program to Assist Despairing and Suicidal Detainees/Institutional Residents

This presentation focussed on the experience of starting & continuing the Lifeline Suicide Intervention Program at the Suffolk County Jail in Boston. One of the aims of the presentation was to demonstrate a peer-level program can be supportive of, & cooperative with, professional staff & consultants at the institution. A profile of the 60+ detainne […]

Counseling Suicidal Adolescents Within Family Systems: Ethical Issues


Ethical Suicide Research: a Survey of Researchers


National Survey of Counseling Center Directors 2003. 2003 Survey Highlights

Among other things, this 2003 survey (333 respondents) of American counseling center directors indicates there were 160 college/university student suicides in the past year; 31 of these were current or former counselling centre clients. When clients were considered at risk of suicide but not to the extent involuntary hospitalization was required, 38.2% of centers reported […]

National Survey of Counseling Center Directors 2005 (Monograph Series Number 8O)

This 2005 survey includes data provided by directors from 366 counselling centres representing institutions from numerous American states & Canadian provinces. Respondents reported 154 student suicides in the previous year, 27 of them current or former counselling centre clients. 75% of victims were males, 83% were undergraduates, & most occurred off-campus. 32% were known to […]

National Survey of Counseling Center Directors 2006 (Monograph Series Number 8P)

The 2006 survey includes data provided by directors from 367 American & Canadian counselling centres. Directors reported 142 student suicides in the past year, 14 of these were current or former counselling centre clients. The majority of victims were males, most were undergraduates, & most of the suicides occurred off-campus. 88.3% of directors reported an […]

National Survey of Counseling Center Directors 2007 (Mongraph Series Number 8Q)

272 American & Canadian directors responded to the 2007 survey of counselling centres. 105 student suicides in the past year were reported, 22% of these were current or former clients of the counselling centres. 85% of directors reported increased levels of concern regarding liability risks. 70% of schools have a policy in place, or directors […]

National Survey of Counseling Center Directors 2008 (Monograph Series Number 8Q)

284 counselling centre directors from Canada & the United States participated in the 2008 survey. 118 student suicides were reported in the past year, 13.6% of these were current or former centre clients. 73% of victims were males, 78% were undergraduates, & 55% of the suicides occurred off-campus. 73% of directors indicated they would seek […]

Notifying Parents Following a College Student Suicide Attempt: a Review of Case law and FERPA, and Recommendations for Practice

Decisions by university officials not to notify a student’s parents following a suicide attempt on campus have been severely criticized by some observers. Although courts have not imposed a parental notice requirement, the practice is advantageous to students in many situations. The author recommends a system of notification that relies primarily upon nonmedical student affairs […]

Assessing and Managing Suicide Risk: Guidelines for Clinically Based Risk Management


Writing Progress Notes: 10 Dos and Don’ts. What to Include in – and Exclude From – Patients’ Medical Records

This article provides a summary of what information psychiatrists should include in a patients’ progress notes. Psychiatrists are advised to be concise but to include details that explain treatment decisions such as discontinuing suicide precautions or not hospitalizing the outpatient who expresses suicide ideation. Psychiatrists should also provide sufficient detail for other caregivers who will […]

Confidentiality and the Suicidal Client

This article discusses the circumstances under which clinicians are justified in breaking confidentiality when assessing & treating suicidal adults. Clients’ rights to confidentiality are protected by case law & ethical codes but these rights are not absolute. The author offers some suggestions for dealing with issues concerning informed consent, confidentiality, & the release of information.

Sources of Strength: Facilitators Guide. Suicide Prevention – Peer Gatekeeper Curriculum

This document is the facilitator’s guide for peer gatekeeper training. The training is designed for peer leaders from middle school to college. This program has three phases – the associated activities for each are included in the guide: peer gatekeeper training; peer-to-peer education; & ongoing focused teen-led prevention.

When Students Kill Themselves, Colleges may get the Blame

This publication discusses the most common claims against American colleges & universities with respect to student suicides. The most common claims have been: the institution put the student in harm’s way; the institution failed to recognize suicide warning signs; & the institution failed to respond appropriately to warning signs. It is stated that, legally, the […]

Adolescent Substance use and Abuse: Recognition and Management

This article examines substance use & abuse among American adolescents. Topics discussed include: scope & prevalence; etiology & pathophysiology; screening & diagnosis; confidentiality; treatment; & the assessment of suicide risk. Ongoing suicide assessment is recommended throughout treatment, including asking about ideation, intention, & planning. Adolescents who are intoxicated are at high risk of dying by […]