Preventing suicide.

About 35,000 people commit suicide every year in the United States. Almost all are seriously, but treatably, mentally ill. Most come to the attention of a physician, in an emergency room, primary practice setting, or psychiatric hospital or office, during the days, weeks or months before they die. Since 1995, suicide has been the second most commonly reported of all Joint Commission hos- pital sentinel events (not just psychiatric events). Suicide is involved in the majority of psychiatric malpractice lawsuits. It takes life from patients, parents from children, children from families, and valuable people from society. Suicide is a terrible way to lose a relative or friend, leaving much greater damage than most natural or accidental death. This paper discusses four points to be considered by those who want to improve this situation: 1) Suicide is rarely "voluntary" in any clinical sense of the term; 2) A great many suicides are preventable once a clini- cian becomes involved; 3) Suicide is worth pre- venting; 4) There are practical approaches to prevention that work. (Journal of Psychiatric Practice 2010;16:120-124)