ABSTRACT
The possibility of someone committing suicide is a major psychiatric emergency. All mental health clinicians encounter this emergency at some point or other in their practice. They feel challenged, threatened, scared, and—at times—shaken to their core by such an experience. The psychodynamics of suicidal threats and acts, like all other mental phenomena, is multiply-determined. A single cause is hardly ever sufficient to result in suicide. In almost all instances, a number of variables are simultaneously active in causing suicidal behavior. Assessment of suicide risk is not an easy matter. Even the ‘standard’ suicide risk factors have ‘high sensitivity in identifying suicidal patients but low specificity in determining which patients will commit suicide’. The consequence of all this is that perfect suicide risk assessment is not possible. Yet an evaluation of suicidality must be done in order to decide upon further steps in treatment of patients in acute turmoil.
