Preface

This book is the third book, or trilogy, in a series of textbooks published by Bentham Science that I have written that features the ethic of care as the theoretical premise (Stephany, 2012; Stephany, 2015). The ethic of care emphasizes the interconnectedness of all of life and values lived experience with specific emphasis on the important relationship between the caregiver and patient. The ethic of care involves the action of caring for and about others, demonstrating compassion and doing what we can to end human suffering (Stephany, 2012; Stephany, 2015). This current book is also the second book that features empathy as an important therapeutic tool (Stephany, 2015). Empathy is closely aligned with the ethic of care (Stephany, 2015). Empathy is the capacity to understand and to identify with the experiences felt by another person (Shafir, 2008; Stephany, 2015). In this current textbook, the ethic of care in conjunction with empathetic responses coming from caregivers are presented as a tool for suicide intervention.

My interest in the important topic of suicide prevention began when I was working as a Coroner in charge of Special Investigations for the Office of the Chief Coroner in the province of British Columbia (BC). A Coroner is a death investigator. A Coroner’s job is to identify the deceased and their cause of death (BC Coroner’s Service (BCCS), 2015). However, another integral role of the Coroner is to make recommendations to prevent death under similar circumstances based on the evidence gathered during the investigation (BCCS, 2015). One of my roles in this position as a Coroner was to lead investigations into deaths due to suicide. Over the course of time what became evident in my research was that many adults reached out to a health care professional shortly before taking their life, often within 72 hours prior to death (Stephany, 2007). As a result I began my journey to find out, what if anything, could the health professional have done differently, to help to change the suicidal person’s mind about wanting to die. The beginning of my inquiry came up with a surprising result. Many of these individuals (68 % of 118 cases over the course of a decade) had admitted to someone close to them, prior to taking their life, that they did not feel cared for by the professional they reached out to for help (Stephany, 2007). Some of these suicidal people also disclosed that they felt judged by the care provider (Stephany, 2007). This finding was consistent with the findings of other researchers (Bailey, 1994; Gairin et al., 2003; Pompili et al., 2005; Betz et al., 2013). Therefore, I decided to conduct further research into what health professionals were doing well and what they could do better to prevent death by suicide. What I discovered was that, even though people who are suicidal often reach out to health professionals for help before taking their life, there is evidence that we often do not adequately train practitioners in how to intervene in these situations (Feldman & Freedenthal, 2006; Schmitz, et al., 2012; Motto & Bostrom, 2014). In fact there are gaps in the curriculum for many health professionals in the area of suicide prevention (WHO, 2012). This book has been written to address some of those gaps in information and the application of knowledge. The content is aimed at teaching everyone who cares for suicidal people to better understand the mindset of the suicidal person and how to help them to choose life.

Why did I write this book? I wrote this book because what it proposes is important information for caregivers to know, especially if they want to help prevent some people from ending their lives through suicide. Traditionally there has been a greater focus in the literature on risk factors for suicide with less emphasis on strategies of intervention (Gairin et al., 2003; Betz et al., 2013; Pompili, 2015). We now know that the essential component of the suicidal person’s state of crisis is psychological and emotional. Therefore, we need to acknowledge and address those aspects of their experience especially if we want to gain their trust and help them (Shneidman, 1998; Pompili, 2015). In fact, approaches that focus on suicide prevention that do not address the despairing emotional mind set of the suicidal person, may not be as helpful as ones that do (Shneidman, 1998; Pompili, 2015).

Throughout this book, I share heart felt stories. What these people had to tell me was extremely informative and can assist us in doing a better job of helping others to climb out of their psychological dungeon of despair. Useful information was derived from narrative case studies and psychological autopsies. Practice exercises and simulation were also included to help the care provider to practice how to be more empathetic. (Note that all the names of the people in this book and many details of the cases have been altered to preserve confidentiality).

This book is ideal for any student or practicing professional who is confronted with trying to help people who are suicidal. Family members and others who have lost someone close to them due to suicide may also experience a sense of solace in some of the contents of this book. The recommended readership for this book may include students or actual practitioners in the following disciplines and vocations.

• Medicine
• Psychiatry
• Nursing
• Psychiatric Nursing
• Psychology
• Counselling
• Teaching
• Social Work
• The Military
• The Police Force
• Paramedics
• Other first responders (e.g., Fire Fighters)
• Volunteers
• Outreach Workers