09/14/2026
He Said He Wasn’t Suicidal. What Else Should We Have Known?
Today I published the first **Clinical Case Note** in my Substack series, *Su***de, Law & Correctional Practice*.
A 32-year-old man enters a county jail and denies suicidal thoughts. Over the next 48 hours, however, things begin to change—opioid withdrawal, increasing isolation, behavioral deterioration, acute disappointment, a statement suggesting hopelessness, and eventually placement in a single cell.
He continues to say he is not suicidal.
The question for the clinician is no longer simply, Does he say he is suicidal?
It becomes:
**Does the total pattern indicate increasing vulnerability—and what should we do now?**
The case is designed to place the reader at the clinical decision point before providing my analysis.
After more than two decades of reviewing correctional su***des, one lesson remains especially important:
**The absence of suicidal ideation is not the absence of su***de risk.**
Read the new Case Note here:
https://danielsu***de.substack.com
***dePrevention
