This book is intended for anyone with either an interest in suicide or suicidal behaviour. It is not aimed solely at the professional psychotherapist but at a broad range of professionals who encounter suicidal people in their work. It is also intended for those of us who have been touched by suicide personally. The book approaches suicide from the point of view of the suicidal state of mind and is intended to help us understand more about this condition. In its essence suicide is examined as a largely unconscious aggressive act having its roots in a perceived or real experience of thwarted childhood needs. The wounds of the suicidal person are often long held and deep. The suicidal person is pursued by haunting losses and the suicidal act comes from deep disturbance created by this and from the idea of death as an acting out of some form of suicidal fantasy. The quasi delusional and split quality of the act is examined - namely that suicide is both an act for and against the self.

This book is intended for anyone with either an interest in suicide or suicidal behaviour. It is not aimed solely at the professional psychotherapist but at a broad range of professionals who encounter suicidal people in their work. It is also intended for those of us who have been touched by suicide personally. The book approaches suicide from the point of view of the suicidal state of mind and is intended to help us understand more about this condition. In its essence suicide is examined as a largely unconscious aggressive act having its roots in a perceived or real experience of thwarted childhood needs. The wounds of the suicidal person are often long held and deep. The suicidal person is pursued by haunting losses and the suicidal act comes from deep disturbance created by this and from the idea of death as an acting out of some form of suicidal fantasy. The quasi delusional and split quality of the act is examined - namely that suicide is both an act for and against the self.

The aim of the book is to introduce the case for the management of psychological therapy services in the NHS as a result of the recent and very significant changes in primary care commissioning and mental health strategy. The historical context of the book is the development of counseling provision within the NHS and the introduction of Primary Care Organisations as a result of the U.K. government's NHS plan (2000) together with the National Service Framework for Mental Health (1999). The book is intended to be practical and accessible and is written in short easy-to- access sections. The chapters contain practical guidance and real information drawn from the authors' considerable experience in NHS counseling. The introductory and final chapters put the need for a managed service model of psychological therapy provision in the context of today's NHS from the perspective of clinical governance and professional quality standards and development. With the background of an ever-changing NHS, there is also a look to the future direction of the provision of psychological therapy in the shape of integrated managed teams in primary care and parallel professions. This volume will be relevant not just to NHS managers and practitioners, but also to other counseling organizations and clinicians, since many of the structural and clinical issues raised will be applicable in a wider context.