Book Review: Suicide Risk Management A Manual for Health Professionals

Suicide Risk Management: A Manual for Health Professionals, by Stan Kutcher and Sonia Chehil is a good introduction to the subject of suicide assessment. This book in my view is geared to the beginning mental health professional. It is only 109 pages of well spaced text some of which is repeated in different layouts. Overall it is an extremely practical book which is written in easy to read language.

The book divides up into roughly four sections. The first section backgrounds and provides an  understanding of suicide. It has helpful little sections such as common myths about suicide. It covers a spectrum of disorders and situations where suicidal behaviour may be more prevalent and does a good job of covering and discussing a range of risk factors.

The second section looks directly at suicide risk assessment. They provide a practical four step process with a structured Suicide Risk Assessment Guide (SRAG) complete with flow diagrams to help you visualise each stage of this assessment process. I found this section quite useful even as an experienced clinician. Because I don’t deal with suicide on a daily basis in my practice it is easy to forget things and Kutcher and Chechil use of simple acronyms is very helpful. They emphasise the need to ask “the question” and provide a number of good ways to do this. Bottom line is you need to call a spade a spade but in a gentle and empathic way. Their suggestions include"

• Have you ever thought about harming yourself?
• Have you ever tried to do anything to yourself that could have seriously harmed you or killed you?
• Have you been thinking about killing yourself lately?

The third section deals with commonly encountered problems. This is one of the weaker sections in the book. It is only a few pages long and deals with complex issues such as countertransference and self harm or repeated low lethality clients in a brief and glib manner. Advice such as, avoid common traps such as manipulation and exploitation with no suggestion on how do this, is not helpful in my view.

The last section of the book focuses on what they call “Bringing it all together” and introduces a summary assessment tool on which to rate potential risk. Again they provide a nice structured way of doing this with their Tool for the Assessment of Suicide Risk (TASR). This is essentially a rating from for collating the information gathered with the Suicide Risk Assessment Guide (SRAG). Some practice using this with a range of vignettes is provided.

Overall a practical easy written book geared to the beginning professional. It is certainly a book I could recommend to my interns. Personally I would have liked more meat on the bones but then I don’t think I am necessarily this book's target market.

Received from the publisher 18^th December 2006.

Comments

[Nikeroo]

One problem I've often found with these books is that although they may raise a therapist's awareness of the suicide risk they don't offer much in the way of methodology for therapists helping someone reprogram themselves so they don't feel the need to go through with it.

Risk assessment is all very good and well but if there isn't an assistance plan available what's the point?

At one hospital I know of the doctors simply stitched up the potentially fatal knife wounds of the patient, keep them for observation for a couple of days and sent them home...despite the patient requesting no less than 5 times that they required psychiatric assistance.

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