Suicidal behaviour: a continuing cause for concern.

There is an increase in suicidal behaviour in the western world providing a major challenge to health care providers. There is an increase in the number of suicides among elderly people in Europe. The problem of suicides among elderly people is in itself a social problem, not solely a medical one. The general practitioner may be the only source of social contact for the elderly. Elderly individuals often present their problems to doctors as somatic complaints; these complaints must not be taken at face value but understood as expressions of psychosocial and social distress. The rise in suicide rates among young people is also alarming. The warning signs of escalating distress in adolescents are known and a treatment programme coordinating medical initiatives, such that recidivism of suicidal behaviour in adolescents is reduced, is necessary. The general practitioner is urged to sense when the problem presented by the individual stems from a source which is predominantly social, and to suggest an appropriate solution which may entail a family intervention. The general practitioner is in the front line of treatment and he or she may be better advised to treat both the social situation and the individual person in cases of attempted suicide. Medical initiatives must incorporate aspects of social medicine whereby community solutions are found for the management of individual distress. Social disruption, isolation, conflict and neglect are the doors to the house of despair. While medicine must respond to those who enter that house, it is the social level at which we must be the architects of change. People will die.(ABSTRACT TRUNCATED AT 250 WORDS)