Preventing Patient Suicide: Clinical Assessment and Management, by Robert I. Simon,  American Psychiatric Publishing, Washington, DC, 2011,  221 + xiii pp.

Plenty of books describing suicide risk assessment and the best methods for the care and treatment of suicidal patients are now available, but Preventing Patient Suicide is concise, clear, and altogether outstanding. One author, not a cadre of contributors, has written it. Repetition is minimized, and there is the welcome unity of a single voice.

Robert Simon (Professor, Georgetown University School of Medicine) has written extensively about suicide before, sometimes collaborating with Robert E. Hales (University of California, Davis). Their co-edited volumes on the clinical assessment and management of suicide are well known. (Candor requires I disclose here that I have been one of the contributors to their books.) In Preventing Patient Suicide, Simon condenses and unites much he has published before, offering the distillate of many years' experience and study.

The first half of the book deals with suicide risk assessment, emphasizing “evidence-based” methods. Simon emphasizes the importance of weighing “protective factors” against suicide, devoting an entire chapter to this topic. He details almost all of the other important particulars in assessing risk, including the many risk factors statistically associated with suicide so exhaustively studied in recent years. Diagnosis is certainly accorded its place. Out of the long list of risk factors, he selects certain ones for special attention, especially reminding the reader it is important to take into account the elevated suicide risk associated with deliberate self-harm, anxiety, a history of childhood abuse, impulsivity aggressivity comorbid diagnoses, and the easily overlooked but deadly finding of melancholia.

In the second half of the book Simon discusses several of the more common mistakes in caring for suicidal patients. In particular he addresses the futility of “no suicide contracts” so commonly referenced in psychiatric records and seemingly beloved in many inpatient units. Of course, asking a patient to prom