Suicide and stigma: a review of the literature and personal reflections.

OBJECTIVE: The authors aim to educate mental health practitioners and trainees regarding the issues of stigma and suicide and how stigma impacts this diverse population of suicide attempters, completers, their families, friends, therapists, and others both personally and therapeutically. METHODS: The authors draw upon their own experiences as survivors and review pertinent literature illustrating the history and general impacts of this stigmatization. The authors present suggestions to diminish stigma both for survivors and the general public. RESULTS: Although there appears to have been some diminution in the stigmatization of the mentally ill over the past few decades, there appears to be less diminution in the stigma associated with suicide and suicide-survivorship. CONCLUSION: Mental illness, in general, has become less stigmatized in recent years, but suicide remains nearly as stigmatized as ever.

Deficiencies in suicide training in primary care specialties: a survey of training directors.

OBJECTIVE: A high percentage of suicide victims have seen a primary care physician in the months before committing suicide. Thus, primary care physicians may play an important role in suicide prevention. METHOD: The authors mailed a survey to directors of training programs in family practice, internal medicine, and pediatrics, and 50.5% responded. Data obtained were analyzed with WebStat. RESULTS: Training directors reported deficiencies in training in suicide and depression. Notably, less than half of the internal medicine and pediatrics training directors who replied reported that teaching about suicide was adequate. The majority of them indicated a need for standardized curricular materials on suicide and depression. CONCLUSIONS: Experts could provide standardized curricula to primary care residencies in the recognition and management of suicide and depression. More robust training about these vital mental health concerns in primary care could reduce morbidity and mortality.

Evidence-based practices project for suicide prevention.

Suicide continues to be a serious public health problem. In response to this problem, a myriad of suicide prevention programs have been developed and employed across the United States. Unfortunately, the effectiveness of many of these programs is unknown because they have not been evaluated using rigorous methods. The Evidence-Based Practices Project (EBPP) for suicide prevention was created in 2002 to identify and promote evidence-based suicide prevention programs. In this paper the process and outcomes of the initial EBPP project within the context of the broader evidence-based movement are described, and the EBPPs creation of a best practice registry for suicide prevention is previewed.

The media and suicide.

OBJECTIVE: The authors aim to inform readers of the theory that when newspapers, film, and television describe suicidal deaths, additional suicides may result by virtue of contagion or copy-cat effects; to review data that support and refute this theory; to present some promising and recommended ways to prevent copy-cat suicide; and to cite news-media examples of both particularly bad and good reporting. METHODS: A review of the literature on media-related suicide was conducted, which included reviewing materials published in scientific journals and data published by the U.S. Public Health Service, Centers for Disease Control, and materials from private, not-for-profit agencies. RESULTS: Data support an increased number of suicides resulting from media accounts of suicide that romanticize or dramatize the description of suicidal deaths. Specific guidelines for the media that may be able to decrease these additional deaths have been devised. CONCLUSION: Psychiatrists should be familiar with the harm that may result from improper reporting of suicide in the media since they may be called upon by reporters or family members following the suicide of one of their patients or following the suicide of a newsworthy person. Following the media guidelines available may prevent such contagion effects from occurring.