No-Suicide Contracts and No-Suicide Agreements: A Controversial Life

Objective: In this paper we describe the origins of suicide prevention contracting, identify the historical factors that led to the adoption of the intervention, and describe legal tensions that have emerged during its use. Conclusions: It would appear that one of the most frequently used clinical interventions for responding to suicidality has established a place in clinical practice without evidence attesting to its efficacy. We develop some propositions about how and why this clinical technique has been able to consolidate its place in mental health practice and, in so doing, suggest that the original technique was able to secure a clinical place without much apparent resistance because of the confluence of a number of emerging theories and community trends.