Suicide Prevention in Older Adults
ABSTRACT Older adults have high rates of suicide in the United States and worldwide; rates vary markedly by gender, race, and ethnicity. Ceropsychology practice guidelines (e.g., American Psychological Association [APA], 2004) indicate the need for assessment and treatment practices specific to older adults, as the phenomenology of mental disorders and psychotherapeutic change processes may shift across the lifespan. Inadequacies in the available knowledge base and in the education and training of clinicians have slowed progress in suicide research and hindered the development of a healthcare workforce that is deeply dedicated to suicide prevention. Inadequate knowledge stems from inattention to demographic differences, definitional imprecision and conceptual conflation, lack of research focus on older adults, and the exclusion of at-risk patients from clinical trials. The near absence of rigorous training and education in suicidology among clinical psychologists amplifies these problems. This article also reviews the empirical literature on suicide risk, noting in particular the roles of mood disorders, suicidal ideation and behavior, adjustment to life events, lack of social integration, personality traits, and access to lethal means. Suggestions are offered for improving risk assessment, the treatment of at-risk patients, and the development of prevention programs. Implications for training and education in clinical psychology are briefly discussed, and directions for future research are offered.