2- Letters


Addressing suicide DHH:8(4)

Authors are to be commended for taking on the most widely accepted and promulgated misconception in suicide prevention. Casting suicide as the outcome of medical pathology put suicidal persons at the mercy of psychiatry and the mental health system. Regardless of what precipitated their suicidality they were ipso facto mentally ill and assigned a psychiatric diagnosis. Those at high risk were placed in psychiatric hospitals that largely did nothing for what made them suicidal except in cases where depression or another disorder actually was involved. Even in these cases, diagnosis-oriented inpatient and outpatient care plans usually regarded suicidality as a symptom rather than the problem.

In suicide research and prevention, the mental health model, driven by psychological autopsy studies, seems to have attained “paradigm” status. As such, it binds researchers and advocates to a compelling body of empirical findings and commentaries, which, as Shahtahmasebi and Pridmore note, deter taking a wider look at other suicide risk factors and over-focusing on “more mental health” as an apparently evidenced-based but largely ineffectual panacea.

As noted by Kuhn, paradigms only change through radical and sudden shifts.

These occur when new discoveries, knowledge, or concepts arise which cannot be rejected or assimilated by the old paradigm. Hopefully, these developments will mount and eventually break the hold that the mental illness model has on suicide research and suicide prevention. We will need more objective reviews like this one to move us towards that eventuality.

Tony Salvatore

Montgomery County Emergency Service

Director of Suicide Prevention

(All comments are personal opinion)



you are absolutely right about suicide. My sister did not have a mental illness and should NEVER have been put in the Psychiatric Ward. She was a much loved school teacher.

Too late we understood why her future looked hopeless for her and her baby.  We were unaware that where she was staying had robbed her of all her savings from her marriage breakup to pay their debts and they then insisted she take out big loans ($10,000 plus) from the Bank to continue paying their debts. This left her feeling she had no future for her and her baby. It was a shameful scam what they did to her and left a big gap in our lives.

(Name and address supplied)