Suicide and Attempted Suicide

To provide a broader perspective on suicide, this chapter has drawn on knowledge from population health, general psychiatry and consultation liaison psychiatry. Epidemiology of suicide and contextual factors are mentioned to set the scene. The science of suicide risk prediction is weak, but the art (the art of formulation) can be learned, and a framework to assist the person with suicidal thoughts is described in detail. Maintaining a clinical focus on symptom relief, improving quality of life and managing mental health comorbidity are cornerstones of management. The latter part of the chapter elaborates on the experiences of those bereaved after a suicide. The impact of suicide on clinicians is explored in some detail. The chapter ends with a discussion of the unspoken issue of physician suicide. Terms such as mental illness, psychiatric illness and psychiatric disorder will be used interchangeably. This chapter is best read alongside Chaps. 89 “Distinguishing and Managing Severe Psychological and Psychiatric Distress” and 95 “Requests for Assistance in Dying.” Self-harm (acute or chronic) and chronic suicidal ideation have been excluded from the chapter.