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Robert I. Simon, M.D., a preeminent psychiatrist and prolific author on the subject of law and psychiatry, offers a pragmatic and empathic guide for clinicians grappling with that most critical of questions: How can I protect my patients from themselves? Though even the most conscientious psychiatrist cannot prevent every suicide, suicide risk can be assessed, managed, and reduced. Dr. Simon acknowledges that the professional environment in which clinicians now practice is often inhospitable to the time-consuming task of understanding the patient; yet Know thy patient is his theme and imperative. Readers will benefit from the instructive case examples and commentary. Suicide risk assessment is a core competency that draws on both art and science. In Preventing Patient Suicide: Clinical Assessment and Management, Dr. Simon synthesizes his clinical experience, the shared clinical experiences of colleagues, and the evidence-based psychiatric literature to create an insightful guide which should be an essential component in any practicing psychiatrist s library.
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Preventing Patient Suicide Clinical Assessment and Management
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Preventing Patient Suicide Clinical Assessment and Management ROBERT I. SIMON, M.D. Clinical Professor of Psychiatry and Director, Program in Psychiatry and Law Georgetown University School of Medicine, Washington, D.C. Chairman, Department of Psychiatry, Suburban Hospital, Johns Hopkins Medicine, Bethesda, Maryland
Washington, DC London, England
Note: The authors have worked to ensure that all information in this book is accurate at the time of publication and consistent with general psychiatric and medical standards, and that information concerning drug dosages, schedules, and routes of administration is accurate at the time of publication and consistent with standards set by the U.S. Food and Drug Administration and the general medical community. As medical research and practice continue to advance, however, therapeutic standards may change. Moreover, specific situations may require a specific therapeutic response not included in this book. For these reasons and because human and mechanical errors sometimes occur, we recommend that readers follow the advice of physicians directly involved in their care or the care of a member of their family. Books published by American Psychiatric Publishing, Inc., represent the views and opinions of the individual authors and do not necessarily represent the policies and opinions of APPI or the American Psychiatric Association. Copyright © 2011 American Psychiatric Publishing, Inc. ALL RIGHTS RESERVED Manufactured in the United States of America on acid-free paper 14 13 12 11 10 5 4 3 2 1 First Edition Typeset in Adobe’s Baskerville and Myriad American Psychiatric Publishing, Inc. 1000 Wilson Boulevard Arlington, VA 22209-3901 www.appi.org Library of Congress Cataloging-in-Publication Data Simon, Robert I. Preventing patient suicide : clinical assessment and management / by Robert I. Simon. — 1st ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-58562-934-3 (pbk. : alk. paper) 1. Suicide—Prevention. 2. Suicide—Risk factors. 3. Suicidal behavior—Risk factors. I. Title. [DNLM: 1. Suicide-—prevention & control. 2. Mental Disorders—complications. 3. Mentally Ill Persons—psychology. 4. Patients—psychology. 5. Risk Assessment—methods. WM 165] RC569.S557 2011 616.85′8445--dc22 2010026853 British Library Cataloguing in Publication Data A CIP record is available from the British Library.
Care more for the individual patient than for the special features of the disease. William Osler (1849–1919)
This book is dedicated to all clinicians who undertake the awesome responsibility of saving the lives of those despairing of living.
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