Prevention and Treatment of Suicidal Behaviour is an accessible book that will appeal to those working in the field and those with a more casual interest. From the perspective of a trainee in psychiatry, it also clarifies the rationale behind the themes of the National Suicide Prevention Strategy for England (Department of Health, 2002). The editor, Keith Hawton, has drawn on the expertise of international authors; chapter by chapter they describe and critically appraise the evidence base, offer practical clinical guidance and identify areas in need of research.

Strategies for dealing with high-risk groups are addressed through the identification of risk factors for suicidal behaviour and chapters focusing on mental health service users, prisoners, and those who misuse substances. Qualitative research is used to identify population-based strategies for reducing suicide, which might also represent logical steps towards tackling mental illness in general. Other chapters explore the population-targeted interventions of restricted access to the means of suicide, the influence of the media's reporting, and controversies surrounding antidepressant use and suicide rates.

In addition to the two-pronged epidemiological approach to the level of intervention, the authors also present a biopsychosocial exploration of suicide prevention strategies. Psychologically, the ‘entrapment model’ and the role that traumatic stress has in suicidal behaviour are emphasised. Biologically, the focus shifts to descriptions of neurobiological and genetic aspects of the predisposition to suicidal behaviour. The growing concerns about self-harm and psychosocial interventions intended to reduce repetition are explored from adolescent, working-age and older-aged adult perspectives. To complete this 360-degree analysis, voluntary services and those bereaved by suicide are emotively discussed.

Keith Hawton has thoughtfully structured the book, allowing its themes to be developed in subsequent chapters and the authors to present differing critical appraisals. Midway through, I did become a little pessimistic about research into initiatives to prevent suicide, with the authors’ repeated criticism of the lack of randomised controlled trials and the unacceptably low power of the existing trials. However, some optimism is introduced with the stance that preventive initiatives that are not based on evidence from clinical trials can contribute to our understanding of this area.

Inevitably, those familiar with the International Handbook of Suicide and Attempted Suicide (Reference Hawton and Van HeeringenHawton & Van Heeringen, 2000) will find some themes repeated, but Prevention and Treatment of Suicidal Behaviour is by no means a concise or rehashed version of this earlier book; it is a useful text with important ethical, societal and psychiatric messages.