Until recently, our inner mental lives have enjoyed a considerable degree of natural protection from others’ gaze and influence. Third parties are sometimes able to attribute particular mental states to us on the basis of our behaviour, particularly if they know us well. These parties are also often able to influence our mental states by means of rational persuasion or manipulation. But our thoughts, desires and emotions have typically had some defence against others’ access and influence by virtue of the fact that these mental phenomena play out in our brains, shielded by a solid skull.

States are increasingly thought to have a duty to enable convicted persons’ rehabilitation, with some seeing this duty as grounded in convicted persons’ right to rehabilitation. This rights-based argument for rehabilitation emerged alongside the increase in rights litigation for carceral populations within the United States in the 1970s, and the contemporaneous development of the idea of imprisoned persons as “Rechtsburgers” or rights bearers in Europe.

Admittedly, legal recognition of a right to rehabilitation is not universal. Many countries present rehabilitation as a “guiding concept” rather than a right that can be enforced against the state. The United States had also considered it necessary to re-emphasise the importance its criminal justice system attaches to the goals of retribution, deterrence and incapacitation, following their ratification of the International Covenant on Civil and Political Rights (ICCPR) – which highlights the need for rehabilitative treatment within prison settings in Article 10 ICCPR.

Suicide is not simply a typology of violence. All forms of violence are interrelated, and preventative action should tackle the common antecedents to all. Understanding what these are, and how they differ between regions and cultures, is key to developing effective violence prevention strategies that extend beyond suicide. In this chapter we discuss the relationship between suicide and other forms of violence including analysis of data from the World Health Organization. We then consider factors influencing volume and direction of violence including gender, poverty, drug and alcohol misuse, adverse childhood experiences, war, and natural disasters. Before finally moving on to preventative action that considers all forms of violence under the same framework. Throughout the chapter real-world examples will be given for important concepts with particular reference to self-immolation in South Asia and the Eastern Mediterranean Region as it is the authors’ area of research expertise.

This chapter considers the potential of neurorehabilitation to interfere with a person’s identity, and hence its potential to infringe human rights that protect (different aspects of) personal identity. It builds upon previous arguments and suggestions in the literature that some forms of interference with the brain, such as the use of brain stimulation techniques, can cause psychological changes that disrupt a person’s identity. Until now, this debate has focused strongly on the side effects of brain stimulation for therapeutic purposes, such as DBS in the treatment of Parkinson’s disease. We extrapolate this discussion to the context of criminal justice. In addition to earlier ethical evaluations of brain stimulation vis-à-vis personal identity, scholars are now considering the legal protection that should be offered to personal identity in this context, particularly through human rights. Some have argued for the introduction of a specific human right for this purpose: a right to psychological continuity.

This chapter describes the Mental Health Gap Action Programme (mhGAP) and the mhGAP-Intervention Guide (mhGAP-IG) developed by the World Health Organization (WHO), aimed at scaling up suicide prevention and management services to bridge unmet need.The mhGAP-IG is an evidence-based tool for mental disorders with structured and operationalised guidelines for clinical decision-making targeting non-specialist community and primary care workers in low and middle-income countries (LMICs).

The aim of this book is to provide evidence to inform the development and implementation of suicide prevention globally. It covers a range of topics that are relevant from local to national levels. It has an unapologetic emphasis on social determinants of suicide and a global perspective, with utility across the world as a primary resource by practitioners and policymakers. It aims at accessibility, with an emphasis on what can be achieved given the current knowledge base.

A central message of this book is the importance of using rigorous evidence to guide suicide prevention, whilst recognising that the best evidence is always partial. Key research is cited in the text and readers are, in places, directed to public-domain digital resources. The book aims to have relevance in low- and middle-income countries, as well as in high-income countries. It is not a country-by-country international overview.

This chapter considers neuroscience translations and attempts to apply our knowledge of the nervous system in practical approaches. I start by discussing the traditional areas of translation, neurology and psychiatry, and the extent to which a focus on neurobiological aspects can help in addressing these conditions. I then turn to more recent claims that neuroscience can inform educational practice, including claims of pharmacological cognitive enhancement, and neurocriminology claims that we will be able to predict and prevent criminal behaviour by identifying the neural mechanisms involved. The discussion covers brain imaging and heritability approaches that try to identify biological bases that can be targeted in translations and interventions, highlighting the caveats associated with these approaches and the claims made from them.

Beyond the demographic factors of socio-economic disadvantage, inequality and unemployment, some occupations have been historically linked with higher rates of suicide deaths. These include: the armed forces, farmers, healthcare workers (including doctors), and “blue light” emergency workers, or “first responders,” for example, police, ambulance, rescue and fire personnel. Where available, the chapter draws upon systematic reviews and meta-analyses to discuss the evidence in specific occupational groups; the risk indicators and protective factors for suicide at individual, organisational and systemic level; and potential interventions over the course of a worker’s career. Understanding occupational risk factors over the career span from recruitment, self-selection and selection, through work environments and cultures, occupational trauma and stresses, could yield strategies for more generalisable suicide prevention at a population level as well as reducing rates in specific occupations.

This chapter considers new tools introduced in neuroscience over the past thirty years and claims that these tools will overcome traditional limitations. Some claim that tools lead scientific advances; I question this claim, not by negating the utility of new tools, but highlighting that they have to be applied to relevant concepts. Tool development has been and maintains a major aspect of neuroscience, with the US BRAIN initiative investing over a billion dollars by the end of the decade to develop new tools. I cover computer modelling, molecular genetics, connectomics, calcium and voltage imaging, optogentics and neural pixel probes. I highlight the advantages of each approach, but then discuss various caveats that should be highlighted to promote attempts to address them and improve the insight that the techniques can give.

Postvention describes the support offered after suicide bereavement to mitigate the risk of suicide in those affected by the loss. In this chapter we describe the international epidemiological evidence about the impact of suicide on relatives, friends, and other close contacts of the deceased. This includes an elevated risk of depression and suicide, and other adverse physical health and social outcomes. We describe the practice of postvention as it applies to recommended responses to suicide in clinical and community settings, and the evidence to support this. Whilst there is a lack of evidence to support the effectiveness of postvention in preventing suicide specifically, there is evidence that it improves the mental health and social outcomes likely to mediate suicide risk. Clinicians who encounter suicide-bereaved individuals should be aware of resources available to people affected by suicide loss, described here, including digital resources in the public domain.

As discussed in Chapter 1, the primary focus of this book is on the potential of neurotechnology to support the rehabilitation of convicted persons by improving risk assessment and risk management – rather than on its potential for diagnosing and treating mental or brain disorders. Still, in some cases, neurorehabilitation might well become conducive or even crucial to the improvement of mental health in forensic populations. Brain stimulation to attenuate aggressive impulses might serve to reduce the mental distress experienced by some persons subject to these impulses. Furthermore, aggression can be a symptom of a recognised mental illness, such as a psychotic disorder, or may be a core feature of a disorder, as in intermittent explosive disorder. Diminishing aggression using neurotechnology could in such cases be relevant to the person’s mental health, which appears to be an interest protected by human rights law. For example, Article 12 of the International Covenant on Economic, Social and Cultural Rights (ICESCR) recognises a “right to the highest attainable standard of physical and mental health”.

Suicide is a global phenomenon, with implications for HICs and LMICs alike, bec,ause of interconnectedness. Social injustice increases societies’ suicide risk and it is easily and frequently exported. Suicide is preventable but not always individually. Suicide prediction is difficult or impossible, so those measures that effect everyone work best. Hence assuring good quality, timely mental health coverage for the whole population is important. Those with the least resources must be targeted, as they are at greatest risk..

This brief chapter considers what we mean by knowledge, explanation and understanding, aspects that have and remain areas of debate in the philosophy of science. Despite scientists referring to these aspects routinely in ways that suggest their meaning is clear, examples are given that suggest the terms can actually be used in various ways by different people. It is important to consider what is being claimed and why in a claimed explanation or a claim to understanding, because the terms carry different weights and subjectively mean different things. This can lead to confusion and errors of reasoning that can constrain a field.

Suicide prevention requires a systematic approach to develop a framework that brings together different elements of a prevention strategy, including surveillance, mental health service access, restriction of lethal means, and public awareness campaigns. Originating with Finland's pioneering efforts in the 1980s, such strategies have since expanded worldwide, driven by the World Health Organization's call for action and alignment with the Sustainable Development Goals. It is imperative that these programmes/strategies are evidence-based, informed by local research, continuously monitored and regularly evaluated for effectiveness. By developing suicide prevention programmes/strategies, governments around the world show their commitment to mitigating preventable deaths, underscoring the need for sustained funding, leadership, and research-driven implementation.