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- Page navigation anchor for Suicide prevention in young people: optimising primary careSuicide prevention in young people: optimising primary careThis is an excellent ‘big picture’ article on suicidality. I’ve lost much sleep and hair colour working in this area in the past. In one psychotherapy session my 17-year-old patient seemed to me suicidal, but stoutly denied any such wish or intention, never mind plan. In the following session he admitted to having had a full plan and intention consistent with my therapeutic sense at the time.My points are these:1. No amount of joined up high quality primary care provision will save those who don’t want to be saved. They see suicide as their only escape from unbearable mental suffering.2. GPs have no useful model of the mind that they can apply efficaciously in minutes to highly distressed patients. I highly recommend the work of Dr Richard Schwartz PhD, Harvard Medical School, who has discovered through working with extreme eating disordered patients that the mind is a complex system (just like everything else in the body and in the universe). Dr Schwartz calls his model Internal Family Systems (IFS) and he proposes an undamaged and undamageable ‘Self’ at our core, surrounded by a multitude of ‘parts’ (everyone we ever were), some wounded by adversity and the others protecting them, to allow engagement with life despite the pain.1 We all have these parts and if a suicidal young person can conceptualise wanting to die...Show MoreCompeting Interests: None declared.