A suicide attempt is an attempt where a person tries to die by suicide but survives. It may be referred to as a failed suicide attempt or nonfatal suicide attempt, but the latter terms are subject to debate among researchers. Suicide attempts include parasuicide such as self-harm where there is no actual intention of killing oneself.
Epidemiology
In the U.S., the NIMH reports there are 11 nonfatal suicide attempts for every suicide death. The American Association of Suicidology reports higher numbers, stating that there are 25 suicide attempts for every suicide completion. By these numbers, approximately 92–95% of suicide attempts end in survival. In the United States, ratio of suicide attempts to suicide death is about 25:1 in youths, compared to about 4:1 in elderly. Compared to adolescents in developed countries, suicide attempt is more common among adolescents in developing countries where the 12-month prevalence of suicide attempt was reported as 17%. A 2008 review found that nonfatal self-injury is more common in women. A study in the United States of the 2008/2009 time period found suicidal thoughts higher among females, as well as significant differences between genders for suicide planning and suicide attempts.
Parasuicide and self-injury
Without commonly agreed-upon operational definitions, some suicidology researchers regard many suicide attempts as parasuicide 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.
Repetition
A nonfatal suicide attempt is the strongest known clinical predictor of eventual suicide. Suicide risk among self-harm patients is hundreds of times higher than in the general population. It is often estimated that about 10–15% of attempters eventually die by suicide. The mortality risk is highest during the first months and years after the attempt: almost 1% of individuals who attempt suicide are successful in ending their lives if the attempt is repeated within one year. Recent meta-analytic evidence suggests that the association between suicide attempt and suicidal death may not be as strong as it was thought before.
Outcomes
Suicide attempts can result in serious and permanent injuries and/or disabilities. 700,000 Americans survive a suicide attempt each year. People who attempt either hanging or charcoal grillcarbon 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. Individuals who jump from a bridge 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, restricted in their ability to work. Suicide attempts are also present in some subcultures. In recent times for example in the emo subculture. The qualitative research has shown emo respondents reported “attitudes including high acceptance for suicidal behavior and self-injury”. And concluded: “The identification with the emo youth subculture is considered to be a factor strengthening vulnerability towards risky behaviors.”
Criminalization of attempted suicide
Historically in the Christian church, people who attempted suicide were excommunicated because of the religiously polarizing nature of the topic. While previously criminally punishable, attempted suicide no longer is in most Western countries. It remains a criminal offense in most Islamic countries. In the late 19th century in Great Britain, attempted suicide was deemed to be equivalent to attempted murder and could be punished by hanging. In the United States, suicide is not illegal and almost no country in Europe currently considers attempted suicide to be a crime. In some cases of completed suicide, the person's property can be seized by the government and bills for treatment of the corpse can be sent to the person's survivors or living family members. In Singapore, a person who attempts to commit suicide can be imprisoned for up to one year. In India, attempted suicide was an offense punishable under the following Section 309 of the Indian Penal Code until December 2014, when it was repealed: In Japan it is illegal to attempt suicide but not punishable. In Cyprus, the only European country where it is illegal, attempted suicide constitutes a misdemeanour. As of 2012, attempted suicide is a criminal offense in Uganda. As of 2013, attempted suicide is criminalized in Ghana. Many other countries still prosecute suicide. In Maryland, it is an open question as to whether suicide is illegal. In 2018, a Maryland man was convicted of attempted suicide.
