You seem to be vastly generalizing the “trauma” of hospitalization. Having placed teens, both voluntarily and involuntarily, in psychiatric facilities, I can tell you that the “trauma of hospitalization” to which you repeatedly refer is a rare phenomenon. Most clients experience a sense of relief, they relish the “powerlessness” to which you refer. I think you’re forgetting that our decision-making is impacted by our mental states and vice versa. Having decisions made for us, having a routine, and having order allows us to put down what, by the time hospitalization is warranted, is often a very heavy and unsustainable pattern of self-destructive or self-sabotaging behaviors. Next, the idea that it is “well documented” that antidepressants and antipsychotics can induce suicidal ideation or action is once again a broad, overreaching generalization. Yes, SSRIs can induce mania in persons with bi-polar disorders, which may in turn lead to an increase in suicidal ideation, but you’re hanging on to old data with regard to SSRI induced teen suicide. The FDA review that led to the black box warning was amazingly small, 2200 cases, and its results were generalized far beyond what they should have been given the limitations of the review. Subsequent studies have analyzed upwards of 60,000 cases and found no significant increase in SI after beginning SSRIs. Research has also shown a marked decrease in completed teen suicides where SSRIs are more readily prescribed to teens. Lastly, I’m not sure if you’re a clinician or not… maybe you’re new to the field, but if you don’t understand why addressing the ACT of suicide must take precedence, I’m just not sure what to tell you. There are, at times, alternatives to hospitalization… and we use these when they’re available. If you have, for example, a family who you know with certainty will provide supervision and secure the home of lethal objects (pills, knives, etc), then yes, you can contract with that family to ensure the safety of their teen. But this is seldom the case. So if hospitalization is what I have at my disposal to keep someone safe, that’s what I’ll use. When someone is actively suicidal, I’m not going to try “understanding our clients and by revising and reforming our institutions so that trauma is less common and easier to talk about with authorities and less traumatic to resolve”… I’m going to be solely focused on preventing that person’s death. Your attack on this author is completely baseless.