The narrative crisis model of suicide: A review of empirical evidence for an innovative dynamic model of suicide and a comparison with other theoretical frameworks

Abstract

The Narrative Crisis Model of Suicide (NCM) is a dynamic multi-stage model that incorporates well-documented long- and short-term risk factors to conceptualize individuals’ progression to suicidal behavior. Comprising chronic long-term suicide vulnerabilities, subacute mental state of Suicidal Narrative, and acute Suicide Crisis Syndrome, the NCM emerged out of the urgent need to better understand, assess, and treat mental processes resulting in suicide with the ultimate goal of creating a comprehensive framework for suicide prevention. This paper conducts the first peer-reviewed critical review of the NCM. In the first section, we provide a comprehensive presentation of the NCM with emphasis on its innovative approach to address common pitfalls in clinical conceptualizations and assessment of suicidal mental states and suicide risk. Second, we present a narrative review of the empirical support for each NCM component and the emerging evidence for the whole model. Last, we compare the NCM to alternative models of suicide in order to highlight their shared features as well as the NCM’s unique contribution to risk assessment and prevention. By clarifying the tenets of the NCM, its emerging empirical support, and its relationships to the other models of suicide in the extant literature, this critical review paper sets the stage for future studies on the model.