Screening may not reduce suicide in later life

doi:10.1136/bmj.330.7481.43

BMJ 2005;330:43 (1 January), doi:10.1136/bmj.330.7481.43

Letter

Screening may not reduce suicide in later life

The first 150 words of the full text of this article appear below.

EDITOR—O'Connell et al are wise to warn against a reductionistapproach to the complex topic of suicide in older people sincean epidemiological perspective makes older people who commitsuicide into objects of disease processes rather than subjectsstruggling to control their lives.¹ They also prescribe vigorousscreening and aggressive treatment despite the difficultiesin reaching the highest risk group, reluctance to accept stigmatisinglabels, and the limited efficacy of available interventions.

Much seems to depend on the meaning of problems for individualpeople. Proud but rather rigid people who would rather not liveif unable to do so with their normal vigour may opt for suicide,especially if depressed mood alters their judgment about theirillness or disability. Older men living alone whose lives arechanged for the worse by loss may be the highest risk group,but they may also be those least likely to engage . . . [Full text of this article]

Steve Iliffe, reader in general practice

Department of Primary Care and Population Sciences, Royal Free and UCL Medical School, London NW3 2PF s.iliffe@pcps.ucl.ac.uk

Jill Manthorpe, professor of social work

Social Care Workforce Research Unit, King's College, London SE1 9NN Jill.Manthorpe@kcl.ac.uk

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