In this chapter, clinical practice is addressed from three perspectives. First, what does good clinical practice in suicide prevention look like? Secondly, there are key matters pertaining to how we both maintain patient safety and avoid iatrogenic harm. These include: an excessive focus on risk; the way in which people can and do fall through gaps between services; the continued use of, contrary to evidence, guidance and humane clinical practice, of behavioural management approaches to self-harm and suicidality, and the risks to patients and service users of ‘group think’ and malignant alienation in clinical cultures. Finally, we will consider what needs to be done to maintain positive standards and values in clinical settings.

Suicide is a significant national and international public health issue. Each year an estimated 3300 Australians and approximately 650 New Zealanders die by suicide. While suicide is a behaviour not an illness, it can occur in the absence of mental illness. The determinants and precipitants of mental illness and suicide are interrelated and frequently associated with one another. The aim of this chapter is to discuss and describe demographic characteristics of suicide, key definitions and drivers of suicide, suicide risk factors, plus lived experience of suicide and suicide related harms through first person accounts. As with other forms of mental distress, people in suicide and self-harm crisis can be helped through compassionate and person-centred approaches.

Suicide is a significant national and international public health issue. Each year an estimated 3300 Australians and approximately 650 New Zealanders die by suicide. While suicide is a behaviour not an illness, it can occur in the absence of mental illness. The determinants and precipitants of mental illness and suicide are interrelated and frequently associated with one another. The aim of this chapter is to discuss and describe demographic characteristics of suicide, key definitions and drivers of suicide, suicide risk factors, plus lived experience of suicide and suicide related harms through first person accounts. As with other forms of mental distress, people in suicide and self-harm crisis can be helped through compassionate and person-centred approaches.