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Douglas G. Jacobs, MD, Discussant

JAMA. 2000;283:2693-2699.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

DR PARKER: Mr D is a 52-year-old man who, in despair, almost jumped in front of a moving train. He attributes this episode to gambling debts piled up in the prior 6 months and the ensuing conflict with his family. He is a resident of Boston and has health insurance through his blue-collar job.

Mr D describes a history of depression dating to his youth. He grew up in a "tough" family, with a father who gambled and drank and brothers who used drugs and alcohol. He has had suicidal thoughts on many occasions but strongly contemplated suicide only once before when he was briefly held in solitary confinement while in jail for a minor crime.

Despite attending a gambling addiction program, he relapsed and lost several thousand dollars gambling. His problem was magnified because he lost another individual's money as well. A family member . . . [Full Text of this Article]

MR D: HIS UNDERSTANDING AND PERCEPTIONS

AT THE CROSSROADS: QUESTIONS TO DR JACOBS

Suicide Risk Assessment

Screening for Depression

Specific Suicide Inquiry

Determining Appropriate Intervention Based on Suicide Risk

The Importance of Primary Care Intervention

The Role of Medications

Risk Assessment and Documentation

Recommendations for Mr D

QUESTIONS AND DISCUSSION

Author Affiliation: Dr Jacobs is Associate Clinical Professor of Psychiatry, Harvard Medical School, Boston, and Executive Director, Screening for Mental Health, Wellesley Hills, Mass.

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