The Harvard Medical School Guide to Suicide Assessment and Intervention

This book is the first volume in a new series from Harvard Medical School. The main objective of the editor, an associate clinical professor of psychiatry at Harvard Medical School, is to be the definitive guide in handling the crucial life-and-death challenges presented by suicidal patients. The book primarily evolved out of a 2-day conference held at Harvard Medical School in 1997 on the topic of suicide. Many of the authors of chapters were active participants in this conference.

Although it is not meant to be considered as presenting the standard of care, this guide is designed to help clinicians in their assessment and care of suicidal patients. The book is quite voluminous and, therefore, has some overlaps among several of its chapters. It also has a unique feature that I very much liked: a section on “implications for the clinician” that appears at the end of every chapter. I found this unique feature of much interest and practicality, offering a succinct review of the clinical relevance of each chapter. This section is especially practical given the size of the book. I definitely found it very useful and creative.

The book is composed of three parts. Part 1, Assessment, comprises 13 chapters, all of which address important issues in the assessment of suicide, including epidemiology, community approaches, lethality, neurobiology, self-mutilation, and murder-suicide. Part 2, Intervention, is composed of 10 chapters addressing suicide interventions in different psychiatric disorders, suicide and trauma, ECT for suicidal patients, and the treatment of suicidal patients with pharmacological agents and in inpatient settings. Part 3, Special Issues, encompasses eight chapters focusing on suicide among children and adolescents and in the elderly as well as suicide prevention contracts, assisted suicide and euthanasia, liability issues, and suicide in medical settings and in primary care settings. Unfortunately, part 3 does not address the topic of suicide among ethnic minority populations in the United States, a topic that has recently been extensively brought into the medical literature and is relevant in view of the pluralistic aspects of U.S. society (1). This is certainly a major gap in this very comprehensive book.

In summary, I enjoyed reading this compendium of excellent clinical and investigative contributions made by a highly respected group of experts and scholars on the topic of suicide. It definitely should be read and kept handy in one’s library.