Suicide attempt

A suicide attempt is an attempt to die by suicide resulting in survival.[1] It may be referred to as a failed suicide attempt or nonfatal suicide attempt, but the latter terms are subject to debate among researchers.[2] Suicide attempts include parasuicide such as self-harm where there is no actual intention of killing oneself.

In the U.S., the NIMH reports there are 11 nonfatal suicide attempts for every suicide death.[3] The American Association of Suicidology reports higher numbers, stating that there are 25 suicide attempts for every suicide completion.[4] 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.[5] 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%.[6]

A 2008 review found that nonfatal self-injury is more common in women.[7] 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.[8]

Without commonly agreed-upon operational definitions, some suicidology researchers regard many suicide attempts as parasuicide (para=near)[9] or self harm behavior, rather than "true" suicide attempts, as in lacking suicidal intent.

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.[10]

A nonfatal suicide attempt is the strongest known clinical predictor of eventual suicide.[11] Suicide risk among self-harm patients is hundreds of times higher than in the general population.[12] It is often estimated that about 10–15% of attempters eventually die by suicide.[13] 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.[14] Recent meta-analytic evidence suggests that the association between suicide attempt and suicidal death may not be as strong as it was thought before.[15]

Suicide attempts can result in serious and permanent injuries and/or disabilities. 700,000 (or more) Americans survive a suicide attempt each year. People who attempt either hanging or charcoal grill 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 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.[16]

Historically in the Christian church, people who attempted suicide were excommunicated because of the religiously polarizing nature of the topic.[17] While previously criminally punishable, attempted suicide no longer is in most Western countries. It remains a criminal offense in most Islamic countries.[18] In the late 19th century in Great Britain, attempted suicide was deemed to be equivalent to attempted murder and could be punished by hanging.[citation needed] In the United States, suicide is not illegal and almost no country in Europe currently considers attempted suicide to be a crime.[17] 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.

Until 2020 in Singapore, a person who attempted to commit suicide could have been imprisoned for up to one year.[19]

In India, attempted suicide was an offense punishable under the following Section 309 of the Indian Penal Code until 7 July, 2018, when it was decriminalized by the Mental Healthcare Act, 2017:[20][21]

Attempt to commit suicide.—Whoever attempts to commit suicide and does any act towards the commission of such offence, shall be punished with simple imprisonment for a term which may extend to one year or with fine, or with both.[22][needs update]

In Japan it is illegal to attempt suicide but not punishable.[citation needed] In Cyprus, the only European country where it is illegal, attempted suicide constitutes a misdemeanour.[citation needed]

Many other countries still prosecute suicide (whether completed or not).[25]

In Maryland, it is an open question as to whether suicide is illegal. In 2018, a Maryland man was convicted of attempted suicide.[26][27][28]