June 27 this year was the day that funding was approved for San
Francisco's Golden Gate Bridge physical suicide deterrent barrier
(www.ggbsuicidebarrier.org). This follows over 1400 suicides since
the bridge's opening in 1937: a morbid record 46 were in 2013 alone,
possibly exacerbated by the global economic crisis. The barrier is in place
to prevent the end-point of suicidal behaviour (physically preventing
suicide) but how much effort is going into the examination of the external
factors that drive such behaviour? Aleman & Denys argue that psychiatry
has failed to tackle suicide as a disease entity in its own right, instead
relegating the act of deliberately ending one's life to a symptom or
consequence of an underlying psychiatric illness. They note that in DSM-5
suicidality is only mentioned as a symptom of borderline personality
disorder and mood disorders, despite this presenting as the most prominent
psychiatric emergency. They argue for a more experimental approach based on
the National Institute of Mental Health's Research Domain Criteria (www.nimh.nih.gov/research-priorities/rdoc/index.shtml) that
emphasises the study of psychiatric phenomena with reference to their
underlying mechanisms: in this case, processing of negative valence, context
and response selection, and mechanisms to regulate arousal.