salus - as one who has spent a lot of time with suicidal people... a lot of what you say is indeed right - they do lack meaning, purpose or the belief they can make things better.
I have had the misfortune of having a lot of experience with suicide with some very close vietnam vet mates who have moved on and a couple of patients over the years.
But the vast, vast majority who seek out help do in fact respond to therapy. Much of my success in this area lies in a technique that allows them to first >perceive AND then believe there is an alternative.
Many deeply depressed and suicidal people have lost their perspective and have tunnel vision - expanding their focus is often a very useful therapeutic device.
Having said that - there are those people that for me the option for suicide is one that is undestandable.
In fact much success is gained by acknowledging this issue with a patient. They've been probably getting nothing but carte-blanche condemnation of the act as a viable solution.
You may need to first acknowledge this with a patient in order to get the required rapport and establish the requisite therapeutic relationship to make gains at a later stage.
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