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Desperate cries

Suicidal children and Adolescents: Crisis and Preventive care By Sheila Rioch Celia Publications, 11 Mayorswell Close, Durham City DH1 1JU, #163;7.50 including p amp; p. 0 9523281 0 0.

There are some indications that suicide among young people is on the increase. There are few events more distressing to deal with, even for those who have had experience of suicidal children, so it is worth considering reading this book.

Sheila Rioch reviews the research and offers practical suggestions. Her extensive experience includes working as a nurse both in England and in several other countries. It is not clear how much she has specialised personally in adolescent problems, but she has digested the literature, and much of what she says would be of value to any professional trying to help a troubled adolescent. It is for professionals that she writes: parents and others will need to turn elsewhere.

In surveying the prevalence of suicide, she adds a new factor to the familiar causes of stress in modern life: parents are now giving much less time to their children than a generation ago. She also identifies behaviour which suggests that someone may be at risk, such as giving away possessions. In dealing with attempted suicide, the most important requirements may seem obvious, such as professional attention, patience with the young person, gentleness and an avoidance of condemnation, but these may be the hardest qualities to find in a crisis, or while waiting in a casualty department. The old advice that a suicide attempt is best seen as a cry for help is still true, along with the reminder that suicide attempts are not to be dismissed at "gestures": such gestures can still be fatal.

I find her better on crisis management than on prevention or after-care, where she does not relate risk factors sufficiently closely to handling the child, but in general this is a valuable book. Everyone who works with young people should take the short time it needs to read it because you never know when you may need it.

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