Suicide attempt

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A suicide attempt is an act in which an individual tries to kill themselves but survives. [1] [2] Mental health professionals discourage describing suicide attempts as "failed" or "unsuccessful", as doing so may imply that a suicide resulting in death is a successful or desirable outcome. [3] [4] [5] [6]

Contents

Epidemiology

In the United States, the National Institute of Mental Health reports there are 11 nonfatal suicide attempts for every suicide death. [7] The American Association of Suicidology reports higher numbers, stating that there are 25 suicide attempts for every suicide completion. [8] The ratio of suicide attempts to suicide death is about 25:1 in youths, compared to about 4:1 in elderly. [9] A 2008 review found that nonfatal self-injury is more common in women, [10] and a separate study from 2008/2009 found suicidal thoughts higher among females, as well as significant differences between genders for suicide planning and suicide attempts. [11]

Suicide attempts are more common among adolescents in developing countries than developed ones. A 12-month prevalence of suicide attempt in developing countries between 2003 and 2015 was reported as 17%. [12]

Parasuicide and self-injury

Without commonly agreed-upon operational definitions, some suicidology researchers regard many suicide attempts as parasuicide (para- meaning near) [13] or self harm behavior, rather than "true" suicide attempts, as in lacking suicidal intent.

Methods

Some suicide methods have higher rates of lethality than others. The use of firearms results in death 90% of the time. Wrist-slashing has a much lower lethality rate, comparatively. 75% of all suicide attempts are by drug overdose, a method that is often thwarted because the drug is nonlethal, or is used at a nonlethal dosage. These people survive 97% of the time. [14]

Repetition

A nonfatal suicide attempt is the strongest known clinical predictor of eventual suicide. [15] Suicide risk among self-harm patients is hundreds of times higher than in the general population. [16] However, it is estimated that only about 10–15% of suicide attempt survivors eventually die by suicide. [17] The mortality risk is highest during the first months and years after the attempt: almost 1% of individuals who attempt suicide will die by suicide if the attempt is repeated within one year. [18] Recent meta-analytic evidence suggests that the association between suicide attempt and suicidal death may not be as strong as it was thought before. [19]

Outcomes

Suicide attempts can result in serious and permanent injuries and/or disabilities. At least 700,000 Americans survive a suicide attempt each year. People who attempt either hanging or carbon monoxide poisoning and survive can face permanent brain damage due to cerebral anoxia. People who take a drug overdose and survive can face severe organ damage (e.g., liver failure). Individuals who jump from a height and survive may face irreversible damage to multiple organs, as well as the spine and brain.

While a majority sustain injuries that allow them to be released following emergency room treatment, a significant minority—about 116,000—are hospitalized, of whom 110,000 are eventually discharged alive. Their average hospital stay is 79 days. Some 89,000, 17% of these people, are permanently disabled. [20]

Criminalization of attempted suicide

Historically in the Christian church, people who attempted suicide were excommunicated because of the religiously polarizing nature of the topic. [21] While previously criminally punishable, attempted suicide is no longer illegal in most Western countries. It remains a criminal offense in most Islamic countries. [22] In the late 19th century in Great Britain, attempted suicide was deemed to be equivalent to attempted murder and could be punished by hanging. [23] In the United States, suicide is not illegal and almost no country in Europe currently considers attempted suicide to be a crime. [21]

In India, attempted suicide was decriminalized by the Mental Healthcare Act, 2017, [24] [25] while Singapore removed attempted suicide from their criminal code in 2020; [26] previously it had been punishable by up to one-year in prison. [27]

Many other countries still prosecute suicide attempts. [28] As of 2012, attempted suicide is a criminal offense in Uganda, [29] and as of 2013, it is criminalized in Ghana. [30]

Despite having its own laws, Maryland still reserves the right to prosecute people under the English Common laws that were in place when America declared independence in 1776. These laws were used to convict a man for attempted suicide in 2018, resulting in a three-year suspended sentence and two years of supervised probation. [31] [32] [33]

See also

Related Research Articles

<span class="mw-page-title-main">Self-harm</span> Intentional injury to ones body

Self-harm is intentional conduct that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury, and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. Common forms of self-harm include damaging the skin with a sharp object or by scratching, hitting, or burning. The exact bounds of self-harm are imprecise, but generally exclude tissue damage that occurs as an unintended side-effect of eating disorders or substance abuse, as well as societally acceptable body modification such as tattoos and piercings.

According to the Centers for Disease Control and Prevention, suicide is the second leading cause of death for adolescents between the ages of 10 and 14, and the third leading cause of death for those between 15 and 25

A suicide method is any means by which a person may choose to end their life. Suicide attempts do not always result in death, and a non-fatal suicide attempt can leave the person with serious physical injuries, long-term health problems, and brain damage.

<span class="mw-page-title-main">Suicide prevention</span> Collective efforts to reduce the incidence of suicide

Suicide prevention is a collection of efforts to reduce the risk of suicide. Suicide is often preventable, and the efforts to prevent it may occur at the individual, relationship, community, and society level. Suicide is a serious public health problem that can have long-lasting effects on individuals, families, and communities. Preventing suicide requires strategies at all levels of society. This includes prevention and protective strategies for individuals, families, and communities. Suicide can be prevented by learning the warning signs, promoting prevention and resilience, and committing to social change.

Suicide intervention is a direct effort to prevent a person or persons from attempting to take their own life or lives intentionally.

<span class="mw-page-title-main">Suicidal ideation</span> Thoughts, ideas, or ruminations about the possibility of ending ones life

Suicidal ideation, or suicidal thoughts, is the thought process of having ideas, or ruminations about the possibility of completing suicide. It is not a diagnosis but is a symptom of some mental disorders, use of certain psychoactive drugs, and can also occur in response to adverse life events without the presence of a mental disorder.

<span class="mw-page-title-main">Suicidology</span> Scientific study of suicide and self-destructive behaviors

Suicidology is the scientific study of suicidal behaviour, the causes of suicidalness and suicide prevention. Every year, about one million people die by suicide, which is a mortality rate of sixteen per 100,000 or one death every forty seconds. Suicidologists believe that suicide is largely preventable with the right actions, knowledge about suicide, and a change in society's view of suicide to make it more acceptable to talk about suicide. There are many different fields and disciplines involved with suicidology, the two primary ones being psychology and sociology.

Suicide risk assessment is a process of estimating the likelihood for a person to attempt or die by suicide. The goal of a thorough risk assessment is to learn about the circumstances of an individual person with regard to suicide, including warning signs, risk factors, and protective factors. Risk for suicide is re-evaluated throughout the course of care to assess the patient's response to personal situational changes and clinical interventions. Accurate and defensible risk assessment requires a clinician to integrate a clinical judgment with the latest evidence-based practice, although accurate prediction of low base rate events, such as suicide, is inherently difficult and prone to false positives.

Youth suicide is when a young person, generally categorized as someone below the legal age of majority, deliberately ends their own life. Rates of youth suicide and attempted youth suicide in Western societies and other countries are high. Youth suicide attempts are more common among girls, but adolescent males are the ones who usually carry out suicide. Suicide rates in youths have nearly tripled between the 1960s and 1980s. For example, in Australia suicide is second only to motor vehicle accidents as its leading cause of death for people aged 15 to 25.

<span class="mw-page-title-main">Suicide</span> Intentional act of causing ones own death

Suicide is the act of intentionally causing one's own death. Mental disorders, physical disorders, and substance abuse are risk factors.

<span class="mw-page-title-main">Gender differences in suicide</span>

Gender differences in suicide rates have been shown to be significant. There are different rates of suicides and suicidal behavior between males and females. While females more often have suicidal thoughts, males die by suicide more frequently. This discrepancy is also known as the gender paradox in suicide.

<span class="mw-page-title-main">IS PATH WARM?</span>

IS PATH WARM? is an acronym utilized as a mnemonic device. It was created by the American Association of Suicidology to help counselors and the general public "remember the warning signs of suicide."

Researchers study Social media and suicide to find if a correlation exists between the two. Some research has shown that there may be a correlation.

The Columbia Suicide Severity Rating Scale, or C-SSRS, is a suicidal ideation and behavior rating scale created by researchers at Columbia University, University of Pennsylvania, University of Pittsburgh and New York University to evaluate suicide risk. It rates an individual's degree of suicidal ideation on a scale, ranging from "wish to be dead" to "active suicidal ideation with specific plan and intent and behaviors." Questions are phrased for use in an interview format, but the C-SSRS may be completed as a self-report measure if necessary. The scale identifies specific behaviors which may be indicative of an individual's intent to kill oneself. An individual exhibiting even a single behavior identified by the scale was 8 to 10 times more likely to die by suicide.

Historically, suicide terminology has been rife with issues of nomenclature, connotation, and outcomes, and terminology describing suicide has often been defined differently depending on the purpose of the definition. A lack of agreed-upon nomenclature and operational definitions has complicated understanding. In 2007, attempts were made to reach some consensus. There is controversy regarding the phrase "to commit suicide" as some view it as implying negative moral judgment and having an association with criminal or sinful activity.

In colleges and universities in the United States, suicide is one of the most common causes of death among students. Each year, approximately 24,000 college students attempt suicide while 1,100 students succeed in their attempt, making suicide the second-leading cause of death among U.S. college students. Roughly 12% of college students report the occurrence of suicide ideation during their first four years in college, with 2.6% percent reporting persistent suicide ideation. 65% of college students reported that they knew someone who has either attempted or died by suicide, showing that the majority of students on college campuses are exposed to suicide or suicidal attempts.

Suicide awareness is a proactive effort to raise awareness around suicidal behaviors. It is focused on reducing social stigmas and ambiguity by bringing attention to suicide statistically and sociologically, and by encouraging positive dialogue and engagement to prevent suicide. Suicide awareness is linked to suicide prevention as both address suicide education and the dissemination of information to ultimately decrease the rate of suicide. Awareness is the first stage that can ease the need for prevention. Awareness signifies a fundamental consciousness of the threat, while prevention focuses on stopping the act. Suicide awareness is not a medical engagement but a combination of medical, social, emotional and financial counseling. Suicide awareness in adolescents focuses on the age group between 10–24 years, beginning with the onset of puberty.

Suicide and trauma is the increased risk of suicide that is caused by psychological trauma.

Youth suicide in India is when young Indian people deliberately end their own life. People aged 15 to 24 years have the highest suicide rate in India, which is consistent with international trends in youth suicide. 35% of recorded suicides in India occur in this age group. Risk factors and methods of youth suicide differ from those in other age groups.

David A. Jobes is an American clinical psychologist. He is currently serving as a Professor of Psychology, Director of the Suicide Prevention Laboratory, and Associate Director of Clinical Training at The Catholic University of America. His areas of focus are on Clinical psychology, Suicide prevention, Clinical Suicidology, Ethics and Risk Management, and clinical risk assessment. In August 2022, he was awarded the Alfred Wellner Award for Lifetime Achievement by The National Register of Health Service Psychologists.

References

  1. ↑ Danuta Wasserman (2016). Suicide: An unnecessary death. Oxford University Press. p. 63. ISBN   978-0-19-102684-3 . Retrieved September 27, 2017.
  2. ↑ "Facts About Suicide". 7 September 2021.
  3. ↑ Rory C. O'Connor; Jane Pirkis (2016). The International Handbook of Suicide Prevention. John Wiley & Sons. pp. 13–14. ISBN   978-1-118-90323-0 . Retrieved September 27, 2017.
  4. ↑ Sommer-Rotenberg, D (1998). "Suicide and language". Canadian Medical Association Journal . 159 (3): 239–240. PMC   1229556 . PMID   9724978.
  5. ↑ Beaton, Susan (2013). "Suicide and language: Why we shouldn't use the 'C' word". Australian Psychological Society . Archived from the original on 1 May 2021.
  6. ↑ Silverman, M. M. (2006). "The language of suicidology". Suicide and Life-Threatening Behavior . 36 (5): 519–532. doi:10.1521/suli.2006.36.5.519. PMID   17087631.
  7. ↑ Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Web-based Injury Statistics Query and Reporting System (WISQARS): https://www.cdc.gov/ncipc/wisqars
  8. ↑ USA suicide 2006 Official final data: JL McIntosh for the American Association of Suicidology 2009. Many figures there taken from Reducing suicide: a national imperative, Goldsmith SK, Pellmar TC, Kleinman AM, Bunney WE, editors.
  9. ↑ "Suicide Statistics — AFSP". American Foundation for Suicide Prevention. Archived from the original on 2 September 2016. Retrieved 3 September 2016.
  10. ↑ Nock, M. K.; Borges, G.; Bromet, E. J.; Cha, C. B.; Kessler, R. C.; Lee, S. (14 May 2008). "Suicide and Suicidal Behavior". Epidemiologic Reviews. 30 (1): 133–154. doi:10.1093/epirev/mxn002. PMC   2576496 . PMID   18653727.
  11. ↑ Crosby, AE; Han, B; Ortega, LA; Parks, SE; Gfroerer, J; Centers for Disease Control and Prevention, (CDC). (21 October 2011). "Suicidal thoughts and behaviors among adults aged ≥18 years--United States, 2008-2009". MMWR. Surveillance Summaries. 60 (13): 1–22. PMID   22012169.
  12. ↑ Uddin, R; Burton, NW; Maple, M; Khan, SR; Khan, A (2019). "Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study" (PDF). The Lancet Child & Adolescent Health. 3 (4): 223–233. doi:10.1016/S2352-4642(18)30403-6. hdl: 10072/387579 . PMID   30878117. S2CID   81982117.
  13. ↑ "para- - Wiktionary". Wiktionary . Retrieved August 18, 2020.
  14. ↑ Schwartz, Allan N. (Apr 12, 2007), Guns and Suicide
  15. ↑ Harris EC, Barraclough B: Suicide as an outcome for mental disorders: a meta-analysis. Br J Psychiatry 1997; 170:205–228
  16. ↑ Owens D, Horrocks J, House A: Fatal and non-fatal repetition of self-harm: systematic review. Br J Psychiatry 2002; 181:193–199
  17. ↑ Suominen et al. (2004). Completed Suicide After a Suicide Attempt: A 37-Year Follow-Up Study. Am J Psychiatry, 161, 563–564.
  18. ↑ Hawton K, Catalan J. Attempted suicide: a practical guide to its nature and management, 2nd ed. Oxford, Oxford University Press, 1987.
  19. ↑ Ribeiro, JD; Franklin, JC; Fox, KR; Bentley, KH; Kleiman, EM; Chang, BP; Nock, MK (2016). "Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies". Psychological Medicine. 46 (2): 225–236. doi:10.1017/S0033291715001804. PMC   4774896 . PMID   26370729.
  20. ↑ Stone, Geo (September 1, 2001). Suicide and Attempted Suicide. Da Capo Press. ISBN   978-0-7867-0940-3.
  21. 1 2 McLaughlin, Columba (2007). Suicide-related behaviour understanding, caring and therapeutic responses. Chichester, England: John Wiley & Sons. p. 24. ISBN   978-0-470-51241-8.
  22. ↑ Aggarwal, N (2009). "Rethinking suicide bombing". Crisis. 30 (2): 94–7. doi:10.1027/0227-5910.30.2.94. PMID   19525169.
  23. ↑ "When suicide was illegal". BBC News. 2011-08-03. Retrieved 2021-12-08.
  24. ↑ Jain, Bharti (11 December 2014). "Government decriminalizes attempt to commit suicide, removes section 309". The Times of India . Archived from the original on 8 January 2021.
  25. ↑ "Govt decides to repeal Section 309 from IPC; attempt to suicide no longer a crime". 2014-12-10.
  26. ↑ Ng, Charmaine (27 December 2019). "Watch that cigarette butt and BBQ embers - firestarters to feel more heat from the law from Jan 1". The Straits Times. Retrieved 31 December 2019.
  27. ↑ Singapore Penal Code(Cap 224, Rev Ed 2008), s 309
  28. ↑ Mishara, BL; Weisstub, DN (2016). "The legal status of suicide: a global review". International Journal of Law and Psychiatry. 44: 54–74. doi:10.1016/j.ijlp.2015.08.032. PMID   26375452. S2CID   205283662.
  29. ↑ Hjelmeland, Heidi; Kinyanda, Eugene; Knizek, Birthe Loa (2012). "Mental health workers' views on the criminalization of suicidal behaviour in Uganda". Medicine, Science and the Law. 52 (3): 148–151. doi:10.1258/msl.2012.011107. PMID   22528562. S2CID   7820312.
  30. ↑ Hjelmeland, H; Osafo, J; Akotia, C. S.; Knizek, B. L. (2014). "The law criminalizing attempted suicide in Ghana: The views of clinical psychologists, emergency ward nurses, and police officers". Crisis: The Journal of Crisis Intervention and Suicide Prevention. 35 (2): 132–36. doi:10.1027/0227-5910/a000235. PMID   24197485.
  31. ↑ Andrews, Abby (March 1, 2018). "Rare attempted suicide charge goes through Caroline court". Kent County News . Archived from the original on December 2, 2020.
  32. ↑ Dufour, Christine B. (March 7, 2018). "Attempted suicide likely not a crime". The Star Democrat . Archived from the original on August 24, 2021. Retrieved August 24, 2021.{{cite web}}: CS1 maint: bot: original URL status unknown (link)
  33. ↑ Fenton, Justine (February 23, 2018). "Attempting suicide is not a crime under Maryland law. But an Eastern Shore man was convicted of it". The Baltimore Sun . Archived from the original on June 24, 2021.
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