Multidisciplinary Approach Used

Yeates Conwell, M.D.'s, research on suicide does not stand alone at the University of Rochester. The Department of Psychiatry is home to the Center for the Study and Prevention of Suicide, a multidisciplinary research locus.

Drawing on resources from sociology, psychology, and law, as well as psychiatry, members of the center and other university researchers look at suicidality from several points of view.

"The data told us to go out and look in communities," department chair Eric Caine, M.D., told Psychiatric News. "You have to look beyond the acute episode to get insights into prevention."

Sociologist Robert Bossarte, Ph.D., for example, works to define communities—not as simple a process as it might seem.

"Is the boundary geography or is it some common interest like ethnicity or other minority status?" he said.

Ideas of connectedness and the protection that connectedness may hypothetically confer might be accurate for older people, but not for younger rural ones, he explained.

Demonstrating effects isn't easy either. Gathering suicide data from county medical examiners might seem easy, but decisions made on classifying deaths can be subject to the social, cultural, and political interests of the person making the decision, he noted.

Another researcher, Catherine Cerulli, J.D., Ph.D., has been applying public-health models to the legal process to tease out relationships to suicidality. For instance, she said, suicidal thinking in men who are placed under protective orders may be dangerous not only for the men but also for former partners and children if the men decide to kill them as well.

Cerulli has also found high rates of suicidal thoughts among victims of domestic violence along with a reduced likelihood they will seek out health care, including mental health care.

As a result, she opened a court-based mental health clinic in which a psychiatric social worker tries to initiate a therapeutic alliance and then refer individuals to mental health and social services, as needed.

She worked with Policy Research Associates of Delmar, N.Y., to create a curriculum to train attorneys to recognize signs of suicidal thoughts among their clients.

Integrating these multiple research tracks is the center's goal, said Caine.

"There are similar risk factors for suicide, homicide, and motor-vehicle accidents," he said. "People harm themselves or others or end up in jail. We may be suicide researchers, but from a publichealth point of view, we'd be just as happy lessening the incidence of suicide, homicide, and motorvehicle accidents."

More about the Center for the Study and Prevention of Suicide is posted at <www.urmc.rochester.edu/psychiatry/csps>.