Suicidal behaviour occurs at the crossroads of the past and the future. The past exerts its influence in relation to recent, as well as more distant past, life events. As will be described in various chapters in this book, the past is particularly important in the development of suicidal behaviour by determining how these adverse events are perceived, and thus how individuals react. In other words, our past determines how we see the future, and thus determines to a large extent whether we will develop hopelessness when confronted with adverse events. An important impetus for editing this book is the fact that suicidal phenomena are commonly regarded as related to emotional problems, whether or not in the context of a psychiatric disorder, at a certain moment in a person's life. In this book it will be argued that this approach to the understanding of suicidal behaviour can only partially explain why suicidal behaviour occurs, and thus leads to the difficulties in predicting and preventing the occurrence of suicide with which clinicians are all familiar.
In spite of major research efforts to describe risk factors, develop treatment approaches and implement prevention strategies, suicidal behaviour continues to be an important public health problem. As far as the effectiveness of these approaches and strategies has been evaluated the results have not been particularly encouraging. Among the many potential reasons for this discrepancy there may be a lack of understanding of the causes and precipitants of (the repetition of) suicidal behaviour because of the fact that the process leading to suicidal behaviour has not been taken into account. This book will review the epidemiological, psychological and biological aspects of the suicidal process, thus providing potential new approaches to risk assessment, research and treatment.
The assessment of the risk of suicide is one of the most difficult and demanding skills, which (mental) health professionals have to acquire. Risk assessment is among the most difficult tasks because of the limited specificity of currently known risk factors, but also one of the most