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Rethinking Suicide: Why Prevention Fails, and How We Can Do Better
An examination of how suicide prevention efforts largely fail due to the mistaken assumption that greater mental health awareness is the key to saving lives.
Over the last two decades, the US suicide rate has steadily grown despite extensive awareness campaigns, wide implementation of suicide prevention programs and initiatives, and increased mental health advocacy. To the confusion and frustration of researchers, healthcare providers, and many others, these efforts have largely failed to reverse the trend. Why do suicide rates continue to climb despite our best efforts? Why aren't we better at this? What are we doing wrong?
Rethinking Suicide is a critical examination of what we think we know about suicide, with particular focus on the assumed role of mental illness. Craig J. Bryan, a leading expert on suicide prevention, argues that most prevention efforts have failed because they disproportionately emphasize mental health-focused solutions such as access to treatment and crisis services. Instead of classifying suicide as a mental health issue, careful analysis of research findings suggest it should instead be seen as a highly complex problem with many risk factors - from personal decision-making styles, to the availability of lethal means, to financial uncertainty. As such suicide rates will not be curtailed by conventional solution-oriented thinking; rather, we need process-based thinking that may, in some cases, defy or contradict many of our long-held assumptions about suicide. Rethinking Suicide interweaves the author's firsthand experiences with explanations of scientific findings to reveal the
limitations of widely-used practices and to introduce new perspectives that may trigger a paradigm shift in how we understand and prevent suicide.
Over the last two decades, the US suicide rate has steadily grown despite extensive awareness campaigns, wide implementation of suicide prevention programs and initiatives, and increased mental health advocacy. To the confusion and frustration of researchers, healthcare providers, and many others, these efforts have largely failed to reverse the trend. Why do suicide rates continue to climb despite our best efforts? Why aren't we better at this? What are we doing wrong?
Rethinking Suicide is a critical examination of what we think we know about suicide, with particular focus on the assumed role of mental illness. Craig J. Bryan, a leading expert on suicide prevention, argues that most prevention efforts have failed because they disproportionately emphasize mental health-focused solutions such as access to treatment and crisis services. Instead of classifying suicide as a mental health issue, careful analysis of research findings suggest it should instead be seen as a highly complex problem with many risk factors - from personal decision-making styles, to the availability of lethal means, to financial uncertainty. As such suicide rates will not be curtailed by conventional solution-oriented thinking; rather, we need process-based thinking that may, in some cases, defy or contradict many of our long-held assumptions about suicide. Rethinking Suicide interweaves the author's firsthand experiences with explanations of scientific findings to reveal the
limitations of widely-used practices and to introduce new perspectives that may trigger a paradigm shift in how we understand and prevent suicide.
232 pages, Hardcover
Published November 1, 2021
80 people are currently reading
513 people want to read
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Displaying 1 - 30 of 34 reviews
October 20, 2024
This didn’t have a ton of reviews so I didn’t know what to think but this book is REALLY good! This book is so unbelievably mind-blowingly good that I can’t believe more people read it. If you’re on the fence- yes. Read this. It’s incredibly scientific but in the best way. It breaks down everything that society is doing wrong. All therapists, counselors, and people who care should read this. I’m pretty stingy with my stars but this is 5 stars, no question.
December 31, 2021
Overall I think there was a lot of good information and ideas in this book - I'm happy to "rethink" just about anything in mental health (I am a therapist). The reason I didn't give 5 stars is because (1) he leans way too heavily on his analogies - they are helpful, but he goes too far with them and exposes their weaknesses; and (2) as it goes along it's clear that he is still very attached to the "medical model" of mental health (he is a clinical psychologist, so I guess that isn't a big surprise).
Having said that, I think between this book and a recent webinar he did there was a lot of good ideas in terms of addressing suicidal thinking in different ways to try to improve outcomes, so it's very worth a read!
Having said that, I think between this book and a recent webinar he did there was a lot of good ideas in terms of addressing suicidal thinking in different ways to try to improve outcomes, so it's very worth a read!
November 18, 2025
I loved this book, and only wish it was more easily accessible for those not already working in the mental health or suicide prevention fields. I’ve read reviews by those who have lost a loved one to suicide and found the book extremely helpful, but in terms of recommending it to others I must admit it’s a science heavy book. Dr. Bryan is a fantastic scholar, researcher, and clinician (I feel particularly confident about this after having worked in his research institute during my doctoral internship year) and this book definitely feels like it’s primarily coming from the perspective of a research clinician. The content is both innovative and deeply rooted in empirical research. It took me two years out from my internship year to be ready to read a book on suicide for fun but I’m very glad this eventually floated to the top of my to-read list.
The best endorsement I can give is that if more people actually followed the conclusions argued for in this book (which Dr. Bryan and his colleagues are doing to the extent possible by individual clinicians) rather than the status quo approaches to suicide prevention we’ve seen for the last 20+ years without much to show for it, I think we would lose fewer people to suicide and more people would be empowered to lead lives worth living while managing the distress that is common to the human experience.
The best endorsement I can give is that if more people actually followed the conclusions argued for in this book (which Dr. Bryan and his colleagues are doing to the extent possible by individual clinicians) rather than the status quo approaches to suicide prevention we’ve seen for the last 20+ years without much to show for it, I think we would lose fewer people to suicide and more people would be empowered to lead lives worth living while managing the distress that is common to the human experience.
February 16, 2025
I wish I would have read this one hard copy instead of listening to it. I would have flipped around, looked at charts, and reread passages. It was very good though.
July 21, 2025
“Suicide prevention being everyone’s business, doesn’t mean that everyone needs to be conducting suicide risk screenings and repeatedly imploring people to pursue mental health treatment. Rather, it means that we should be working together on a daily basis to create lives worth living”
As someone who has been involved in suicide prevention work for close to 10 years now, this book was helpful to reground my thinking about suicide prevention.
As someone who has been involved in suicide prevention work for close to 10 years now, this book was helpful to reground my thinking about suicide prevention.
February 4, 2025
I am glad I checked out this book on a whim. What a great, short, packed, but digestible book. So good I even bought a personal copy.
April 12, 2024
My wife died by suicide 10 months ago. I've read many books about suicide, from family members whose loved one completed suicide, or books about what one might experience when someone they love dies this way. This is the best I've read, because it addresses the matter of what brings a person to this point where she attempts suicide. Loved ones are left with lots of guilt. The spouse of the person who died by suicide is most often blamed, so I had a lot that could cause me further guilt. This book has helped me understand that prevention is possible if we make environmental changes or use means restriction to prevent the deadliest forms of suicide (firearms leading the list).
Bryan takes time to consider what mental illness may or may not have to do with completed suicides. This was a place the majority of people felt comfortable in speaking of my spouse as being "mentally ill." And I am certain they are wrong. Blaming suicide on mental illness does not actually go anywhere toward helping prevent suicides.
This was a very difficult book to read, but so well researched. I found the objectivity he tackles this sensitive issue to be helpful to me in my own struggles with guilt and wishes that I could have done more. I could not have stopped my wife's death. I'm certain of this. The only way I could have known what she was thinking is if she told me. She did not. This book has assisted me in grieving. I'm grateful for it.
Bryan takes time to consider what mental illness may or may not have to do with completed suicides. This was a place the majority of people felt comfortable in speaking of my spouse as being "mentally ill." And I am certain they are wrong. Blaming suicide on mental illness does not actually go anywhere toward helping prevent suicides.
This was a very difficult book to read, but so well researched. I found the objectivity he tackles this sensitive issue to be helpful to me in my own struggles with guilt and wishes that I could have done more. I could not have stopped my wife's death. I'm certain of this. The only way I could have known what she was thinking is if she told me. She did not. This book has assisted me in grieving. I'm grateful for it.
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May 6, 2022When you read a lot, you start to realize that many books fall into a common pattern. They offer small enhancements on what you already know – that is, until you find the book that causes you to rethink what you know. That’s what Rethinking Suicide: Why Prevention Fails, and How We Can Do Better does. It questions what we know about preventing suicide, including how we identify those at risk and what we do to treat those who we believe are at risk. Taking a slightly heretical view, Craig Bryan walks through what we know – and what we don’t but assume we know.
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May 8, 2024
Craig Bryan takes an admirably pragmatic, empirical approach to suicide prevention, debunking some myths about suicide causes and providing a light overview of the scientific data on the subject. It was especially fascinating to hear about the statistical errors and confirmation bias which hamper conventional suicide prevention efforts.
That said, as an intermittently suicidal person myself, there's something cold and dehumanising about being boiled down to a statistic, with the whole rationale behind helping me (and people like me) essentially amounting to "make death numbers go down". Nothing is said about the philosophy of suicide, or the more specific reasons one may hold overwhelmingly negative views about themselves or the world. Every motivation for suicide is flattened into a "risk factor"; the whole issue is treated like a mathematical probability problem.
The final chapter, "Creating Lives Worth Living", rings especially hollow. While Bryan makes a passing attempt to address the social causes of suicide (mentioning air pollution, minimum wages, lack of affordable health insurance, lack of support from friends and family, etc.), which I certainly appreciate, most of his focus is on local, individual contexts. Perhaps it's beyond the scope of his research, but no mention is made of young people's rising anxiety about wider political problems, such as climate change, plastic waste and economic exploitation of third world countries. A lot of the suicide prevention methods endorsed in this final chapter (keeping reminders of reasons for living, focusing on positive experiences, etc.) feel very akin to the typical platitudes and mantras of conventional self-help and psychotherapy, which I thought the book was criticising. Yes, we may learn mechanisms to cope with the stress of life, but is it worth living in a world where we produce tonnes and tonnes of plastic waste everyday, while children in the Congo are forced to mine coltan for our smartphones? The anxiety caused by these pervasive, international issues cannot be fixed by raising the minimum wage or giving people access to parks.
Even so, the book is solid; I don't consider the above omission to be a serious problem, as it doesn't undermine Bryan's thesis and arguments about the inadequacies of conventional suicide prevention. Well worth reading.
That said, as an intermittently suicidal person myself, there's something cold and dehumanising about being boiled down to a statistic, with the whole rationale behind helping me (and people like me) essentially amounting to "make death numbers go down". Nothing is said about the philosophy of suicide, or the more specific reasons one may hold overwhelmingly negative views about themselves or the world. Every motivation for suicide is flattened into a "risk factor"; the whole issue is treated like a mathematical probability problem.
The final chapter, "Creating Lives Worth Living", rings especially hollow. While Bryan makes a passing attempt to address the social causes of suicide (mentioning air pollution, minimum wages, lack of affordable health insurance, lack of support from friends and family, etc.), which I certainly appreciate, most of his focus is on local, individual contexts. Perhaps it's beyond the scope of his research, but no mention is made of young people's rising anxiety about wider political problems, such as climate change, plastic waste and economic exploitation of third world countries. A lot of the suicide prevention methods endorsed in this final chapter (keeping reminders of reasons for living, focusing on positive experiences, etc.) feel very akin to the typical platitudes and mantras of conventional self-help and psychotherapy, which I thought the book was criticising. Yes, we may learn mechanisms to cope with the stress of life, but is it worth living in a world where we produce tonnes and tonnes of plastic waste everyday, while children in the Congo are forced to mine coltan for our smartphones? The anxiety caused by these pervasive, international issues cannot be fixed by raising the minimum wage or giving people access to parks.
Even so, the book is solid; I don't consider the above omission to be a serious problem, as it doesn't undermine Bryan's thesis and arguments about the inadequacies of conventional suicide prevention. Well worth reading.
November 30, 2025
3.5 stars rounded down for density
This would be a must-read for healthcare providers (and/or others who might be deeply interested/invested in the nuances of the current state of evidence and approach to suicidal it) *if* the core message had been more effectively distilled and more clearly delivered. The level of detail and meticulousness is striking and impressive, but makes the information carry less of a punch and the guidance becomes muddied.
The book is written as a counter to the general delivery of medical care, and the public perception of suicidality as a medical problem, though in Bryan's effort to make his case, attempts to take on the medical establishment with data and evidence - a fair approach generally speaking, but in the age of the doomscroll and inept attentional capacities, undermines his primary aim - to illuminate alternative frameworks. An appendix with a detailed breakdown of the data behind his approach and proposed frameworks may have allowed him to retain the medical takedown while increasing readability and clarity.
The most significant misstep is excluding a more thoughtful and nuances history of suicide across time and culture, to help provoke reflection on the *how we got here*.
Nonetheless, the formulation Bryan presents is damning; politicians, insurance providers, and the lay public need to take note. Hopefully, psychiatry, psychology, social work, and nursing training have already started to include portions of Bryan's work (or at least the evidence therein) into their teachings.
This would be a must-read for healthcare providers (and/or others who might be deeply interested/invested in the nuances of the current state of evidence and approach to suicidal it) *if* the core message had been more effectively distilled and more clearly delivered. The level of detail and meticulousness is striking and impressive, but makes the information carry less of a punch and the guidance becomes muddied.
The book is written as a counter to the general delivery of medical care, and the public perception of suicidality as a medical problem, though in Bryan's effort to make his case, attempts to take on the medical establishment with data and evidence - a fair approach generally speaking, but in the age of the doomscroll and inept attentional capacities, undermines his primary aim - to illuminate alternative frameworks. An appendix with a detailed breakdown of the data behind his approach and proposed frameworks may have allowed him to retain the medical takedown while increasing readability and clarity.
The most significant misstep is excluding a more thoughtful and nuances history of suicide across time and culture, to help provoke reflection on the *how we got here*.
Nonetheless, the formulation Bryan presents is damning; politicians, insurance providers, and the lay public need to take note. Hopefully, psychiatry, psychology, social work, and nursing training have already started to include portions of Bryan's work (or at least the evidence therein) into their teachings.
February 2, 2024
A very educative read about suicide and suicidal thoughts. It dives deep into research and compares traditional methods for sucicidal prevention to more recent methods such as CBT, DBT and CRP.
The reason I picked up this book is that I work as an EMT and I've noticed over the past few years how self-harming, suicidal thoughts and suicide attempts have increased. In my training we didn't get a very good training on dealing with these things and over all how to deal with mental illnesses and behavior. I wanted to get a better understanding on what is happening and how the healthcare system deals with these cases. After reading this book I do have more understanding about this problem and I'm sure it will help me to be more useful to those I attend to. However, I don't work as a therapist and much of the material in this book won't be of use to me.
My expectation for this book was really to learn more practical ways to deal with individuals that are having emotional distress, suicidal thoughts, self harm and have attempted suicide. I wanted to learn more about what I can do, what questions to ask, what to recommend.
This is a good book for those who work with people who are having suicidal thoughts and especially useful for those who are in charge of mental illness treatments.
The reason I picked up this book is that I work as an EMT and I've noticed over the past few years how self-harming, suicidal thoughts and suicide attempts have increased. In my training we didn't get a very good training on dealing with these things and over all how to deal with mental illnesses and behavior. I wanted to get a better understanding on what is happening and how the healthcare system deals with these cases. After reading this book I do have more understanding about this problem and I'm sure it will help me to be more useful to those I attend to. However, I don't work as a therapist and much of the material in this book won't be of use to me.
My expectation for this book was really to learn more practical ways to deal with individuals that are having emotional distress, suicidal thoughts, self harm and have attempted suicide. I wanted to learn more about what I can do, what questions to ask, what to recommend.
This is a good book for those who work with people who are having suicidal thoughts and especially useful for those who are in charge of mental illness treatments.
November 27, 2022
This is an excellent book! It was written by a military officer. Obviously, our typical treatments for suicide are not very effective. Some key points: Robin Williams had lewy body disease which very well could have caused his "suicide." Therefore, we shouldn't always assume a person who has suicidal thoughts is mentally ill. Sometimes, it is a physical issue that clouds a person's judgement. In fact, the majority of suicide victims have no mental illness history. Access to guns, is a huge contributing factor. Often suicide victims are impulsive so limiting firearms, locking up firearms, separating ammunition from the guns, holding/storing firearms for stressed friends/family, etc. are effective. Creating a "life worth living" is also key. This includes raising minimum wage. In addition, having access to health insurance is very important. Studies have shown, not necessarily using insurance, but having it is a good way to prevent suicide. He compares all the measures in driving for example, that not only help the individual but help society in general. This book has made me rethink many of my previous assumptions.
October 7, 2022
Good exploration using meta-analysis
This book offers a comprehensive look at suicide related behaviors and the associated research. It provides analogies that help the reader connect with the science and revisits the themes throughout the book connecting all the dots at the end. The downside is that the book never mentions the importance of spirituality nor does it reference the science associated with the fact that spirituality is the number one protective factor against suicide. Dr. Lisa Miller’s book, The Science of Spirituality, looks at how spirituality, and a community of like minded people who practice their spirituality, protects against suicidality at 50-80%. The book mentions many spiritual concepts but does not outright call them as such.
This book offers a comprehensive look at suicide related behaviors and the associated research. It provides analogies that help the reader connect with the science and revisits the themes throughout the book connecting all the dots at the end. The downside is that the book never mentions the importance of spirituality nor does it reference the science associated with the fact that spirituality is the number one protective factor against suicide. Dr. Lisa Miller’s book, The Science of Spirituality, looks at how spirituality, and a community of like minded people who practice their spirituality, protects against suicidality at 50-80%. The book mentions many spiritual concepts but does not outright call them as such.
December 17, 2024
Very good summary of the current approaches to suicide prevention and why they’re not working to reduce the rates. This is the primary focus, and a much smaller amount of time is spent focusing on what needs to change. I believe this is because the status quo is so extremely entrenched. It is going to be a very long and difficult process undoing current structures and implementing the changes the research demonstrates is needed. Political intervention and public health approaches are going to need to be involved, and the willingness to promote and fund what it’s going to take to reduce the suicide rates doesn’t seem likely given the current political climate. It’s heavy on research content, but this is an important read for all those who care about suicide prevention.
March 6, 2022
Well thought out and a valuable read. First part of the book is overly heavy with statistics but they are used to show important point on the deficiencies of current common trends in suicide prevention. The last two chapter are the best with recommended approaches that increase the effectiveness of suicide prevention efforts. That being said they do stand on the previous chapters. Having dealt with suicides in the military the book is timely and applicable. That being said the authors application of complexity theory and description of suicide as a wicked problem points the lack of pat answers in a critical topic. Worth the read.
January 11, 2023
This is a must-read for a more in-depth understanding of what factors lead to Suicide. I believe Dr. Craig Bryan, who served as a military officer, is spot on with his findings and information in this book. Unfortunately, I have a lot of experience with this topic, and I am working on a campaign to support efforts to educate others on rethinking Suicide. In this book, he brings out the idea of seeking to change environmental and contextual hazards that contribute to Suicide rather than trying to change the individual. He also discusses preventing Suicide by making it harder to die by Suicide by educating people on safety measures involving firearms.
October 9, 2022
This book is written by a former US Air Force psychologist and contains an excellent mix of the latest research and personal experience working as a therapist. He questions the common belief that all suicides are caused by mental illness and that we stop all suicides by identifying people having suicidal ideation and intervening. The author also displays his dismay that many mental health professionals are not using scientifically proven therapies like Cognitive Behavioural Therapy. I studied suicide prevention systems using System Dynamics and found this book helpful.
March 10, 2022
A new approach to preventing suicide. It is all hands on deck to love this "Wicked Problem".
Everything that must be done involves us all. It is more than just talk to people about their suicidal ideations. It is teaching how to tap the brakes on those thoughts. It is about creating a society where we can all flourish without worry about health care costs ruining us, without food insecurity, and with respect for all.
Everything that must be done involves us all. It is more than just talk to people about their suicidal ideations. It is teaching how to tap the brakes on those thoughts. It is about creating a society where we can all flourish without worry about health care costs ruining us, without food insecurity, and with respect for all.
October 28, 2024
In the midst of literature reviews and current research, the reader is exposed to practical practices to help those in need. Much information floods the mental health space that is simply not grounded in evidence based research. This is a worthwhile read for anyone connected to healthcare, but especially helpful for military leaders and healthcare professionals.
December 15, 2024
The conclusions in this extraordinary book should be eye-opening to everyone who accepts the deeply flawed current factors used to predict the likelihood of suicide. It should be a priority to take this a step further to examine violence in our society, especially what is driving people to commit mass murders.
This entire review has been hidden because of spoilers.
February 3, 2022
Good book. Well researched and annotated. The author has good ideas and concepts. Definitely not for every reader. I would say people working in the mental health fields would benefit from this whereas the audience beyond that is limited.
September 29, 2022
Craig Bryan's book is timely and so needed in the field of suicide prevention. His use of research, case studies and metaphors makes this book accessible to more than just research professionals. He lights the way to concrete actions that can make a difference for individuals and communities.
September 29, 2024
Every year I feel as though there are one or two nonfiction books I read that genuinely shift my thinking. This year 'Rethinking Suicide' is definitely one of them. Well researched and thoughtfully laid out. A must read for anyone working in suicide prevention.
August 11, 2025
4.5 estrellas
Solo no le puse 5 estrellas porque no fue mindblowing, son cosas que sí conocía.
Gran libro sobre este tema. Este junto con el de Marsha Linehan son excelente material actual para temas de suicidio. Gran combo. Leeré más sobre este autor también.
Solo no le puse 5 estrellas porque no fue mindblowing, son cosas que sí conocía.
Gran libro sobre este tema. Este junto con el de Marsha Linehan son excelente material actual para temas de suicidio. Gran combo. Leeré más sobre este autor también.
November 13, 2022
Read for work. Total slog to get through.
November 29, 2023
Food for thought, should be read by all therapists.
March 26, 2024
This was an interesting take and a different perspective. However, using the word "wicked" so often created a huge distraction for me.
December 30, 2024
DNF. I think this is probably a great book, full of wisdom. It’s too academic for me right now, hence the neutral rating. I probably should double back and try again one day, but I probably won’t.
December 31, 2024
Very engaging read for those wanting to tackle the question of and issues connected to suicide. Highly recommended for those working in counseling and mental support fields.
May 2, 2025
Phenomenal. A must read for anyone working in the suicide prevention world, regardless of role.
Displaying 1 - 30 of 34 reviews