Abstract
If you must have a handbook on suicide, and it seems a self-respecting discipline must, this is the one. Seven hundred and fifty-five pages of well-written, wellreferenced and pretty well up-to-the-minute reporting of an active area of psychiatric investigation effort. All the known living names are here, with a very gratifyingyear 2000 Olympian representation of Australians. Goldney, on the advisory committee and very prominent contributor, Cantor opening the innings with epidemiology and others as well. Oi! Oi! Oi!
The book itself follows a conventional handbook pattern. Four sections deal with the knowledge base, suicide in specific populations, treatment and prevention. The reporting of the data is excellent and the opening chapters provide a three-course statistical meal. Causal analysis is inevitably weaker as the authors must stumble in the attempt to view suicide through the various lenses of psychiatry, biology, sociology, ethnology, genetics and so on. Unintentionally, the ‘understanding’ section shows the hopelessness of understanding the ‘causes of suicide’ as the complexity of individual motivation will not be finally tied to an understanding.
Most chapters are an enjoyable and interesting dip. (This reviewer enjoyed the chapters on mass media, suicide prevention in schools and on ethology.) It is also very comprehensive. I could not think of any angle on suicide which the handbook does not address comprehensively (70 pages on the labour market and suicide alone). However, as is appropriate for a Handbook, most chapters rehearse and flesh out the existing paradigm of suicide research which is ‘integration’ of knowledge to create a model or a pathway to suicide. It is centred on the identification and treatment of the suicidal person. No-one in this volume really lets their hair down into any radical challenge of the existing approach even though this paradigm has not been particularly successful as heuristic or theory. The programme of suicide research generally exemplifies Thomas Kuhn's assessment of activity and change in science.
Nothing in this volume shakes this reviewer's conviction that the present approach to suicide is misconceived. Suicide has been a popular research target because it is the only distinct event in psychiatry. Suicide is not a disease. It is not the endpoint of an identifiable causal pathway. It is a result of a myriad of influences, some which we will identify, some which we will not. It is not a good health target even though it is a very good health indicator. If attaining a Handbook gives suicide a status as a disease or even as a thing, then we may be moving backwards.
Notwithstanding this reviewer's cynical suspicion that such a volume may be a backward step, this is as good as such handbooks get and I am glad to have it on my shelf.