Effectiveness of Close Watch Precautions in Suicidal Patients

In this letter to the editor, Aldrich comments on an article by Busch et al (2003) on inpatient suicide. He discusses the apparent ineffectiveness of close watch precautions & no-suicide contracts for suicidal patients. He asserts the frequent failure of these procedures is due in part to their self-fulfilling prophecy that suicidal patients have already found a way to die. The reply of Busch & her colleagues follows.