Course Website Locator: hpm529-01

Harvard School of Public Health

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Spring 2 2010

Dr. M. Miller
2.5 credits
Seminars. One 3-hour session each week

On an average day in the United States 85 people die by suicide; over half use guns. In 2005, the latest year for which data are available, 32,637 Americans took their own lives and more than half a million received emergency treatment after attempting suicide. For Americans 40 years of age and younger, suicide is the second leading cause of death.

The search for the causes of suicide has historically focused on identifying mental illnesses that are disproportionately common among suicide decedents. In the three decades since diagnostic psychiatry displaced dynamic psychiatry, hundreds of epidemiologic studies have found strong and consistent evidence that discrete diagnoses of mental illness (e.g., major depression) are associated with an increased risk of suicide. These studies have not, however, explained why some populations have higher suicide rates than others, why male suicide rates are so much higher than female suicide rates in the United States and most other developed countries but not in China, Cuba or Sri Lanka, or why rates of suicide are twice as high for white Americans compared to African Americans, children in the United States compared to children in other Western countries, and members of the baby-boomer cohort compared to members of the cohort born during the Great Depression. These questions, about the distribution and frequency of suicide within and between populations are the kind of questions that a public health approach believes are vital to understanding and preventing suicide -and tries to answer. These are the type of questions that this course will begin to address.

The class will make use of close readings of the empirical literature, interactive class discussion, and examination of a large data set of suicides to illustrate the magnitude and scope of suicide as a public health problem, the evidentiary basis (or lack thereof) for existing prevention strategies, and the social and cultural impediments to more effective interventions.

Instruction is through interactive lectures with a significant amount of class discussion.

Course Note: No previous background in medicine, psychiatry or evaluative sciences is necessary; enrollment limited. Audit only permitted with signature of instructor.


Spring 2 2009

Dr. M. Miller
2.5 credits
Seminars. One 3-hour session each week

On an average day in the United States 85 people die by suicide; over half use guns. In 2005, the latest year for which data are available, 32,637 Americans took their own lives and more than half a million received emergency treatment after attempting suicide. For Americans 40 years of age and younger, suicide is the second leading cause of death.

The search for the causes of suicide has historically focused on identifying mental illnesses that are disproportionately common among suicide decedents. In the three decades since diagnostic psychiatry displaced dynamic psychiatry, hundreds of epidemiologic studies have found strong and consistent evidence that discrete diagnoses of mental illness (e.g., major depression) are associated with an increased risk of suicide. These studies have not, however, explained why some populations have higher suicide rates than others, why male suicide rates are so much higher than female suicide rates in the United States and most other developed countries but not in China, Cuba or Sri Lanka, or why rates of suicide are twice as high for white Americans compared to African Americans, children in the United States compared to children in other Western countries, and members of the baby-boomer cohort compared to members of the cohort born during the Great Depression. These questions, about the distribution and frequency of suicide within and between populations are the kind of questions that a public health approach believes are vital to understanding and preventing suicide -and tries to answer. These are the type of questions that this course will begin to address.

The class will make use of close readings of the empirical literature, interactive class discussion, and examination of a large data set of suicides to illustrate the magnitude and scope of suicide as a public health problem, the evidentiary basis (or lack thereof) for existing prevention strategies, and the social and cultural impediments to more effective interventions.

Instruction is through interactive lectures with a significant amount of class discussion.

Course Note: No previous background in medicine, psychiatry or evaluative sciences is necessary; enrollment limited. Audit only permitted with signature of instructor.


Spring 2 2008

Dr. M. Miller
2.5 credits
Seminars. One 3-hour session each week

On an average day in the United States 85 people die by suicide; over half use guns. In 2005, the latest year for which data are available, 32,637 Americans took their own lives and more than half a million received emergency treatment after attempting suicide. For Americans 40 years of age and younger, suicide is the second leading cause of death.

The search for the causes of suicide has historically focused on identifying mental illnesses that are disproportionately common among suicide decedents. In the three decades since diagnostic psychiatry displaced dynamic psychiatry, hundreds of epidemiologic studies have found strong and consistent evidence that discrete diagnoses of mental illness (e.g., major depression) are associated with an increased risk of suicide. These studies have not, however, explained why some populations have higher suicide rates than others, why male suicide rates are so much higher than female suicide rates in the United States and most other developed countries but not in China, Cuba or Sri Lanka, or why rates of suicide are twice as high for white Americans compared to African Americans, children in the United States compared to children in other Western countries, and members of the baby-boomer cohort compared to members of the cohort born during the Great Depression. These questions, about the distribution and frequency of suicide within and between populations are the kind of questions that a public health approach believes are vital to understanding and preventing suicide -and tries to answer. These are the type of questions that this course will begin to address.

The class will make use of close readings of the empirical literature, interactive class discussion, and examination of a large data set of suicides to illustrate the magnitude and scope of suicide as a public health problem, the evidentiary basis (or lack thereof) for existing prevention strategies, and the social and cultural impediments to more effective interventions.

Instruction is through interactive lectures with a significant amount of class discussion.

Course Note: No previous background in medicine, psychiatry or evaluative sciences is necessary; enrollment limited, instructor's signature required; no auditors.


Spring 2 2007

Dr. M. Miller
2.5 credits
Seminars. One 3-hour session each week

In contrast to the significant reductions in rates of medical illness and unintentional injuries over the past half century, largely attributed to public health rather than medical interventions, rates of suicide in the United States remain at levels similar to those in the 1950s. This course explores the as yet unmet promise of a public health approach to preventing suicide through a combination of close readings of the empirical literature and interactive class discussion. Among the questions explored are: What acts qualify as suicide? What are the roles of impulse and deliberation in suicidal acts, by age (e.g. youth vs. elderly suicides,) gender, and circumstance (e.g. a crisis involving intimate partner conflict vs. physical illness?) How does physician-assisted suicide differ from suicide generally? Is sexual orientation an independent risk factor for suicide? What is the evidentiary basis for existing prevention strategies? What social and cultural impediments stand in the way of effective interventions?

Instruction is through interactive lectures with a significant amount of class discussion.
Course Note: No previous background in medicine, psychiatry or evaluative sciences is necessary; enrollment limited, instructor's signature required; no auditors.

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