Clinicians cannot go around labeling people who are not at risk as being such. Hence, the difficulty lies in finding the balance between sensitivity and specificity. Currently, we are unclear why some risk factors are actually risk factors. Urgent psychological research is required to unravel the complex association between psychosocial, clinical and psychological factors. In this way, we can gain further insight into how the traditional risk factors impact on an individual psychologically to precipitate suicidal behaviour.
Suicide is ultimately a psychological problem.
Furthermore, the vast majority of research in Northern Ireland is cross-sectional and epidemiological in nature. Longitudinal research is required on at least two levels if we are to go any way to reduce the prevalence of suicidal behaviour. Firstly, one must identify the psychological differences between first-time attempters, those who embark on suicidal careers and those who do not attempt suicide. This requires modification and enhancement. Secondly, the effectiveness of treatment outcome programmes needs to be assessed.