[Suicide prevention and the role of the psychiatrist]

Suicide is a major public health issue with a huge number of unnecessary deaths. Suicide prevention is still a recent endeavor but despite the great production of research in the field there is no real impact on death rates. Scholars worldwide have puzzled over what makes a person suicidal and what individuals who die by suicide have in their minds. Most often the focus is not on the motives for suicide, nor on the phenomenology of this act. Psychiatrists are very often involved in the assessment and management of suicide risk. However, the search for psychiatric disorders as the key factor in energizing suicidality is now challenged by new models for describing suicide. Unbearable psychological pain is a common denominator in serious suicide risk. It is an escape from intolerable suffering; and this construct views suicide not as a movement toward death but a remedy to escape from intolerable emotion, unendurable, or unacceptable anguish. The author proposes reflections for aiding psychiatrists in broadening their view when assessing suicide risk.