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 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.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Acosta J, Ramchand R, Becker A (2017) Best practices for suicide prevention messaging and evaluating California’s “know the signs” media campaign. Crisis 38(5):287–299
Baca-Garcia E, Perez-Rodriguez M, Oquendo M et al (2011) Estimating risk for suicide attempt: are we asking the right questions? J Affect Disord 134(1–3):327–332. https://doi.org/10.1016/j.jad.2011.06.026
Barrigón M, Baca-García E (2018) Retos actuales en la investigación en suicidio. Revista de Psiquiatría y Salud Mental 11(1):1–3. https://doi.org/10.1016/j.rpsm.2017.10.001
Behere P, Sathyanarayana Rao T, Mulmule A (2015) Decriminalization of attempted suicide law: journey of fifteen decades. Indian J Psychiatry 57(2):122. https://doi.org/10.4103/0019-5545.158131
Belsher B, Smolenski D, Pruitt L (2019) Positive predictive values and potential success of suicide prediction models—reply. JAMA Psychiat 76(8):870
Benard V, Vaiva G, Masson M, Geoffroy P (2016) Lithium and suicide prevention in bipolar disorder. L'Encéphale 42(3):234–241. https://doi.org/10.1016/j.encep.2016.02.006
Bertolote JM, Fleischmann A (2002) Suicide and psychiatric diagnosis: a worldwide perspective. World Psychiatry 1(3):181–185
Betz M, Sullivan A, Manton AP, Espinola JA, Miller I, Camargo CA Jr, Boudreaux ED (2013) Knowledge, attitudes, and practices of emergency department providers in the care of suicidal patients. Depress Anxiety. https://doi.org/10.1002/da.22071
Blasco-Fontecilla H, Perez-Rodriguez MM, García-Nieto R et al (2012) Worldwide impact of economic cycles on suicide trends over 3 decades: differences according to level of development. A mixed effect model study. BMJ Open 2:e000785
Bridge J, Greenhouse J, Ruch D et al (2019) Association between the release of Netflix’s 13 reasons why and suicide rates in the United States: an interrupted times series analysis. J Am Acad Child Adolesc Psychiatry 59:236. https://doi.org/10.1016/j.jaac.2019.04.020
Cavanagh JT, Carson AJ, Sharpe M, Lawrie SM (2003) Psychological autopsy studies of suicide: a systematic review. Psychol Med 33(3):395–405
Centers for Disease Control and Prevention (2019) Web-based injury statistics query and reporting system. Cdc.gov. https://www.cdc.gov/injury/wisqars/nvdrs.html. Accessed 11 Aug 2019
Chakraborty R, El-Jawahri A, Litzow M, Syrjala K, Parnes A, Hashmi S (2017) A systematic review of religious beliefs about major end-of-life issues in the five major world religions. Palliat Support Care 15(5):609–622
Chang BP, Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM et al (2016) Biological risk factors for suicidal behaviors: a meta-analysis. Transl Psychiatry 6(9):e887
Courtet P, Gottesman I, Jollant F, Gould T (2011) The neuroscience of suicidal behaviors: what can we expect from endophenotype strategies? Transl Psychiatry 1(5):e7–e7
Czyz E, Horwitz A, Eisenberg D, Kramer A, King C (2013) Self-reported barriers to professional help seeking among college students at elevated risk for suicide. J Am Coll Heal 61(7):398–406. https://doi.org/10.1080/07448481.2013.820731
Eynan R, Reiss L, Links P, Shah R, Sathyanarayana Rao T, Parkar S et al (2015) Suicide prevention competencies among urban Indian physicians: a needs assessment. Indian J Psychiatry 57(4):397
Feldman M, Franks P, Duberstein P, Vannoy S, Epstein R, Kravitz R (2007) Let’s not talk about it: suicide inquiry in primary care. Ann Fam Med 5(5):412–418
Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X, Musacchio KM, Jaroszewski AC, Chang BP, Nock MK (2017a) Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull 143(2):187–232
Franklin JC, Ribeiro JD, Fox KR, Bentley KH, Kleiman EM, Huang X et al (2017b) Risk factors for suicidal thoughts and behaviors: a meta-analysis of 50 years of research. Psychol Bull 143(2):187–232
Glenn J, Werntz A, Slama S, Steinman S, Teachman B, Nock M (2017) Suicide and self-injury-related implicit cognition: a large-scale examination and replication. J Abnorm Psychol 126(2):199–211
Hauge L, Stene-Larsen K, Grimholt T, Øien-Ødegaard C, Reneflot A (2018) Use of primary health care services prior to suicide in the Norwegian population 2006–2015. BMC Health Serv Res 18(1):619
Hong V, Ewell Foster C, Magness C, McGuire T, Smith P, King C (2019) 13 reasons why: viewing patterns and perceived impact among youths at risk of suicide. Psychiatr Serv 70(2):107–114. https://doi.org/10.1176/appi.ps.201800384
Kleiman E, Nock M (2018) Real-time assessment of suicidal thoughts and behaviors. Curr Opin Psychol 22:33–37. https://doi.org/10.1016/j.copsyc.2017.07.026
Larsen M, Nicholas J, Christensen H (2016) A systematic assessment of smartphone tools for suicide prevention. PLoS One 11(4):e0152285. https://doi.org/10.1371/journal.pone.0152285
Law C, Sveticic J, De Leo D (2014) Restricting access to a suicide hotspot does not shift the problem to another location. An experiment of two river bridges in Brisbane, Australia. Aust N Z J Public Health 38(2):134–138. https://doi.org/10.1111/1753-6405.12157
Levy T, Azar S, Huberfeld R, Siegel A, Strous R (2012) Attitudes towards euthanasia and assisted suidice: a comparison between psychiatrists and other physicians. Bioethics 27(7):402–408. https://doi.org/10.1111/j.1467-8519.2012.01968.x
Littlewood D, Kyle S, Carter L, Peters S, Pratt D, Gooding P (2018) Short sleep duration and poor sleep quality predict next-day suicidal ideation: an ecological momentary assessment study. Psychol Med 49(3):403–411
Lopez-Castroman J, Blasco-Fontecilla H, Courtet P, Baca-Garcia E, Oquendo M (2015) Are we studying the right populations to understand suicide? World Psychiatry 14(3):368–369. https://doi.org/10.1002/wps.20261
O’Connor R, Portzky G (2018) Looking to the future: a synthesis of new developments and challenges in suicide research and prevention. Front Psychol 9:2139
Oquendo M (2016) Subtyping suicidal behavior. J Clin Psychiatry 77(06):813–814. https://doi.org/10.4088/jcp.16f10933
Oquendo M, Baca-Garcia E (2014) Suicidal behavior disorder as a diagnostic entity in the DSM-5 classification system: advantages outweigh limitations. World Psychiatry 13(2):128–130. https://doi.org/10.1002/wps.20116
Oquendo M, Bernanke J (2017) Suicide risk assessment: tools and challenges. World Psychiatry 16(1):28–29
Oquendo M, Sullivan G, Sudol K et al (2014) Toward a biosignature for suicide. Am J Psychiatr 171(12):1259–1277. https://doi.org/10.1176/appi.ajp.2014.14020194
Pérez Sales P (2004) Psicología y psiquiatría transcultural, 1st edn. Desclée de Brouwer, Bilbao
Petrik M, Gutierrez P, Berlin J, Saunders S (2015) Barriers and facilitators of suicide risk assessment in emergency departments: a qualitative study of provider perspectives. Gen Hosp Psychiatry 37(6):581–586. https://doi.org/10.1016/j.genhosppsych.2015.06.018
Phillips M, Cheng H (2012) The changing global face of suicide. Lancet 379(9834):2318–2319
Phillips MR, Yang G, Zhang Y et al (2002) Risk factors for suicide in China: a national case-control psychological autopsy study. Lancet 360:1728–1736
Quinlivan L, Cooper J, Davies L, Hawton K, Gunnell D, Kapur N (2016) Which are the most useful scales for predicting repeat self-harm? A systematic review evaluating risk scales using measures of diagnostic accuracy. BMJ Open 6(2):e009297
Roberts L, Berk M, Lane-McKinley K (2019) Ethical considerations in research on suicide prediction. JAMA Psychiat 76:883. https://doi.org/10.1001/jamapsychiatry.2019.1228
Saffer B, Klonsky E (2018) Do neurocognitive abilities distinguish suicide attempters from suicide ideators? A systematic review of an emerging research area. Clin Psychol Sci Pract 25(1):e12227. https://doi.org/10.1111/cpsp.12227
Sarchiapone M, Mandelli L, Iosue M, Andrisano C, Roy A (2011) Controlling access to suicide means. Int J Environ Res Public Health 8(12):4550–4562. https://doi.org/10.3390/ijerph8124550
Schadenberg A (2013) Exposing vulnerable people to euthanasia and assisted suicide. Ross Lattner, London
Schulberg H, Bruce M, Lee P, Williams J, Dietrich A (2004) Preventing suicide in primary care patients: the primary care physician’s role. Gen Hosp Psychiatry 26(5):337–345
Silverman M (2016) Challenges to defining and classifying suicide and suicidal behaviors. In: O’Connor R, Pirkins J (eds) The international handbook of suicide prevention. Wiley Blackwell, Oxford
Stone D, Crosby A (2014) Suicide Prevention. Am J Lifestyle Med 8(6):404–420. https://doi.org/10.1177/1559827614551130
Sulmasy D, Travaline J, Mitchell L, Ely E (2016) Non-faith-based arguments against physician-assisted suicide and euthanasia. Linacre Q 83(3):246–257. https://doi.org/10.1080/00243639.2016.1201375
Torous J, Larsen M, Depp C et al (2018) Smartphones, sensors, and machine learning to advance real-time prediction and interventions for suicide prevention: a review of current progress and next steps. Curr Psychiatry Rep 20(7). https://doi.org/10.1007/s11920-018-0914-y
Tran T, Luo W, Phung D, Harvey R, Berk M, Kennedy RL et al (2014) Risk stratification using data from electronic medical records better predicts suicide risks than clinician assessments. BMC Psychiatry 14:76
Valente S (2011) Nurses’ psychosocial barriers to suicide risk management. Nurs Res Pract 2011:1–4. https://doi.org/10.1155/2011/650765
Wagenaar A, Tobler A, Komro K (2010) Effects of alcohol tax and Price policies on morbidity and mortality: a systematic review. Am J Public Health 100(11):2270–2278. https://doi.org/10.2105/ajph.2009.186007
Zalsman G, Hawton K, Wasserman D, van Heeringen K, Arensman E, Sarchiapone M et al (2016) Suicide prevention strategies revisited: 10-year systematic review. Lancet Psychiatry 3:646–659. https://doi.org/10.1016/S2215-0366(16)30030-X
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 Springer Nature Switzerland AG
About this chapter
Cite this chapter
Oquendo, M.A., Porras-Segovia, A. (2020). Barriers for the Research, Prevention, and Treatment of Suicidal Behavior. In: Baca-Garcia, E. (eds) Behavioral Neurobiology of Suicide and Self Harm. Current Topics in Behavioral Neurosciences, vol 46. Springer, Cham. https://doi.org/10.1007/7854_2020_159
Download citation
DOI: https://doi.org/10.1007/7854_2020_159
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-57573-1
Online ISBN: 978-3-030-57574-8
eBook Packages: Biomedical and Life SciencesBiomedical and Life Sciences (R0)