Suicide Risk Documented During Veterans' Last Veterans Affairs Health Care Contacts Prior to Suicide

A total of 295 veterans who died by suicide in 2009 across 11 states and received Veterans Affairs (VA) health care in the 6 months prior to death were identified. The suicide risk factors documented and the care received at these veterans' last VA contacts are described, and the study explores whether veterans present differently to VA care (i.e., different risk factors documented or different care settings accessed) based on the proximity of their last contact to suicide. Many veterans were seen in primary care (n = 136; 46%) for routine follow‐up (n = 168; 57%). Fifty‐three (18%) were assessed for suicidal thoughts; 20 (38%) of whom endorsed such thoughts. Although higher frequencies of some risk factors at last contacts more proximal to suicide compared to those more distal were observed, findings overall highlight the challenges clinicians face detecting enhanced risk prior to suicide.     

Prevention Programs to Augment Family and Child Resilience Can Have Lasting Effects on Suicidal Risk

In this commentary, the effects of four family‐based preventive interventions designed to augment parent and child resilience, originally designed to prevent mental health and substance abuse, on suicide ideation and attempts are reviewed. Three of the preventive interventions showed a beneficial effect either on child suicide ideation or attempts, and one found a beneficial effect on parental suicidal ideation. The duration of effects in two of these studies was well longer than a decade. These studies suggest that interventions to augment family and child resiliency originally designed to prevent mental health and substance abuse disorders can also have beneficial, often long‐term, effects on suicidal ideation and behavior.     

Exploring the Phenomenology of Suicide

Phenomenology studies conscious experience as experienced from the subjective or first‐person point of view. This paper was developed with the aim of shedding light on the phenomenology of suicide; that is, to focus on suicide as a phenomenon affecting a unique individual with unique motives for the suicidal act. To explore this topic, the author looks back at the past centuries to understand why suicide was thought to be confined to psychiatric illness and to document the bias in studies supporting this notion. One major step forward in the conceptualization of suicide as a psychological disorder was provided by Edwin Shneidman, who focused on the pain of negative emotions. Such a radical approach is laudable in an era where diagnostic criterria and the need to cure are more important than understanding what is not working at the emotional level.