Handwashing and Changing the Status Quo

This chapter focuses on the mental healthcare system, which has been surprisingly slow to adopt the treatments and interventions that are most likely to reduce the probability that someone will attempt suicide. In many respects, the current state of mental health treatment to prevent suicidal behaviors mirrors the context of the 19th century. Two hundred years ago, the causes of puerperal fever among women giving birth were unknown to the medical community, but evidence from multiple different sources suggested that handwashing could reduce fever-related deaths much better than status quo practices. Today, the causes of suicide are similarly unknown, but evidence from multiple sources suggests that certain types of treatments and interventions can reduce suicidal behaviors better than status quo practices, which often conceptualize suicide as a symptom or outcome of mental illness. The chapter then looks at two treatments in particular: dialectical behavior therapy (DBT) and cognitive behavioral therapy for suicide prevention (CBT-SP). It assesses why suicide-focused treatments work better than status quo treatments.