ABSTRACT
This chapter examines issues relating to ‘Self-Harm and Suicide’, starting with an anonymised clinical case history. It explores definitions of self-harm and suicide; suicide in the history of psychiatry; global rates of suicide over recent decades; and the impact of the Covid-19 pandemic. This chapter pays particular attention to the limited value of ‘risk assessment’, the use of evidence-based approaches to suicide prevention, and the broader social context in which self-harm and suicide occur and are managed around the world. Issues relating to suicide and the law are explored, including the decriminalisation of suicide and attempted suicide in various jurisdictions (e.g., in India's Mental Healthcare Act, 2017), the use of ‘risk’ of suicide in mental health legislation (commonly as part of criteria for admission or treatment without consent), and some of the issues surrounding physician-assisted suicide (PAS), which is a topic that commands increasing attention around the world. The chapter concludes with a consideration of useful directions for future research and service developments in this area.
