Citation

Jobes DA, Chalker SA. Int. J. Environ. Res. Public Health 2019; 16(19): e16193606.

Affiliation

Department of Psychology, The Catholic University of America, Washington, DC 20064, USA. 97chalker@cua.edu.

Copyright

(Copyright © 2019, MDPI: Multidisciplinary Digital Publishing Institute)

DOI

10.3390/ijerph16193606

PMID

31561488

Abstract

While the existence of mental illness has been documented for centuries, the understanding and treatment of such illnesses has evolved considerably over time. Ritual exorcisms and locking mentally ill patients in asylums have been fundamentally replaced by the use of psychotropic medications and evidence-based psychological practices. Yet the historic roots of mental health management and care has left a certain legacy. With regard to suicidal risk, the authors argue that suicidal patients are by definition seen as mentally ill and out of control, which demands hospitalization and the treatment of the mental disorder (often using a medication-only approach). Notably, however, the evidence for inpatient care and a medication-only approach for suicidal risk is either limited or totally lacking. Thus, the "one-size-fits-all" approach to treating suicidal risk needs to be re-considered in lieu of the evolving evidence base. To this end, the authors highlight a series of evidence-based considerations for suicide-focused clinical care, culminating in a stepped care public health model for optimal clinical of suicidal risk that is cost-effective, least-restrictive, and evidence-based.

Language: en

Keywords

stepped care; suicidal risk; suicide-focused clinical care