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August 1965

The End of Hope: A Social-Clinical Theory of Suicide.

Arch Gen Psychiatry. 1965;13(2):192-194. doi:10.1001/archpsyc.1965.01730020094016

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One puts down this valuable book with a sense of having learned a great deal about the extremely refractory psychiatric problem of suicide—enough, in fact, to feel dissatisfied and wish it had been an even better book. Such a feeling is perhaps inevitable: the subject itself leads immediately to man's ultimate dilemmas, and defies satisfactory solution by anyone.

The special, even extraordinary, contribution of The End of Hope lies in its documentation of the phenomenon of the "suicidal epidemic": a series of four suicides among hospital patients over a period of six months, three of them within three weeks, after a period of nine years during which there had only been one suicide in the same hospital. In responding directly to a specific opportunity presented by a particular environment—in this case an opportunity born of tragedy—the authors display a form of initiative all too rare in psychiatric

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