A specific program in Detroit has generated debate and pilot sites in the UK to develop a zero tolerance to suicide risk, and while aiming for zero suicides is an excellent ideal, it raises several important questions. Firstly, some people have made a clear and final decision to take their own lives for their own complex and personal reasons, so how will choice be respected within a zero tolerance approach? Will services be recognised for reductions in suicide rates or will the blame culture still focus on the diminishing few completed cases? Should any practitioners or advocates seriously question the ethos and intentions behind a zero tolerance approach?
Suicide risk factors from the known research are outlined, and the more personalised reflection of protective factors are highlighted. The emphasis on assessing and working with suicide risk is placed on the quality information through narrative approaches, not the more frequent bureaucratic requirement for ticking boxes.
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“Suicide is a permanent solution to a temporary problem.” [Phil Donahue].