Barriers for the Research, Prevention, and Treatment of Suicidal Behavior
Efforts in research, prevention, and treatment of suicidal behavior have produced mixed results. One of the main barriers to combating suicidal behavior lies in the very conceptualization of suicide, a phenomenon that is at once sociological, psychiatric,
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Contents 1 Introduction 2 Issues in the Conceptualization of Suicidal Behavior 2.1 Suicidal Behavior as a Mental Disorder 2.2 Subgroups of Suicidal Behavior 3 Social Barriers to Suicide Prevention 4 Suicide as a Global Challenge 5 Barriers to the Prediction of Suicide 5.1 Lack of Short-Term Risk Factors 5.2 Lack of Protective Factors 5.3 Lack of Specific Risk Factors 6 Barriers to the Development of Treatments for Suicidal Behavior 7 Difficulties in the Management of Suicidal Behavior in the Clinical Practice 7.1 Suicide Risk Assessment Tools 7.2 Medicolegal Aspects in Suicide Risk Assessment 7.3 Healthcare Professionals’ Skills and Attitudes 8 Conclusions References
Abstract Efforts in research, prevention, and treatment of suicidal behavior have produced mixed results. One of the main barriers to combating suicidal behavior lies in the very conceptualization of suicide, a phenomenon that is at once sociological, psychiatric, and even philosophical, and one that has not always been included in the field of health care. There are also many barriers at the social level, ranging from stigma against people with suicidal behavior to stigma towards psychiatric care, as well as the controversial role of the media. The media plays an important role in society and depending on its attitude it can be either beneficial or harmful in our fight against suicidal behavior. Differences between countries – in the provision of M. A. Oquendo (*) Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA e-mail: [email protected] A. Porras-Segovia Instituto de Investigación Sanitaria Fundación Jiménez Díaz, Madrid, Spain © Springer Nature Switzerland AG 2020 Curr Topics Behav Neurosci https://doi.org/10.1007/7854_2020_159
M. A. Oquendo and A. Porras-Segovia
resources, in the way of understanding the phenomenon or in the manner of providing official figures – pose an additional challenge to suicide prevention on a global level. In the field of research, predicting suicidal behavior by identifying effective risk markers is severely hampered by the low occurrence of suicide in the population, which limits the statistical power of studies. The authors recommend combining various risk factors to build predictive models. This, in addition to employing increasingly precise machine learning techniques, is a step in the right direction, although there is still a long way to go before the expected results can be obtained. Finally, adequate training of health professionals, both specialized and non-specialized, as well as gatekeeper training, is crucial for implementing suicide prevention strategies in the population. Keywords Suicide · Suicide attempt · Suicidal behavior · Suicide prevention
1 Introduction Suicidal behavior is a public health challenge that resists the various efforts made toward its prevention and treatment. Suicide is one of the few leading causes of death that has not diminished in the USA in the past 10 years, whereas Eastern European and Asian countries exhibit the highest suicide rates worl
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