Suicide attempt

{{Short description|Act of trying to kill oneself which the person survives}}
{{about||relatives of suicide victims|suicide survivor|information on prevention|suicide prevention}}

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A '''[[suicide]] attempt''' is an act in which an individual tries to kill themselves but survives.<ref name="Wasserman">{{cite book|author=Danuta Wasserman|author-link=Danuta Wasserman|title=Suicide: An unnecessary death|publisher=[[Oxford University Press]]|isbn=978-0-19-102684-3|year=2016|page=63|access-date=September 27, 2017|url=https://books.google.com/books?id=qPIyCwAAQBAJ&pg=PT63}}</ref><ref>{{Cite web|url=https://www.cdc.gov/suicide/facts/index.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fviolenceprevention%2Fsuicide%2Ffastfact.html|title=Facts About Suicide|date=7 September 2021}}</ref> 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.<ref name="O'Connor">{{cite book |url=https://books.google.com/books?id=DzQWDQAAQBAJ&pg=PA14 |title=The International Handbook of Suicide Prevention |publisher=[[John Wiley & Sons]] |year=2016 |isbn=978-1-118-90323-0 |pages=13–14 |access-date=September 27, 2017 |author=Rory C. O'Connor |author2=Jane Pirkis }}</ref><ref>{{cite journal |last1=Sommer-Rotenberg |first1=D |date=1998 |title=Suicide and language |journal=[[Canadian Medical Association Journal]] |volume=159 |issue=3 |pages=239–240 |pmc=1229556 |pmid=9724978}}</ref><ref>{{cite web |last=Beaton |first=Susan |date=2013 |title=Suicide and language: Why we shouldn't use the 'C' word |url=https://www.psychology.org.au/publications/inpsych/2013/february/beaton |url-status=live |archive-url=https://web.archive.org/web/20210501201551/https://www.psychology.org.au/publications/inpsych/2013/february/beaton |archive-date=1 May 2021 |work=[[Australian Psychological Society]]}}</ref><ref>{{cite journal |last1=Silverman |first1=M. M. |date=2006 |title=The language of suicidology |journal=[[Suicide and Life-Threatening Behavior]] |volume=36 |issue=5 |pages=519–532 |doi=10.1521/suli.2006.36.5.519 |pmid=17087631}}</ref>

== Epidemiology ==
{{Globalize|section|date=August 2021}}
In the [[United States]], the [[National Institute of Mental Health]] reports there are 11 nonfatal suicide attempts for every suicide death.<ref>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</ref> The [[American Association of Suicidology]] reports higher numbers, stating that there are 25 suicide attempts for every suicide completion.<ref>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.</ref> The ratio of suicide attempts to suicide death is about 25:1 in youths, compared to about 4:1 in elderly.<ref>{{cite web|title=Suicide Statistics — AFSP|url=https://afsp.org/about-suicide/suicide-statistics/|website=American Foundation for Suicide Prevention|access-date=3 September 2016|archive-date=2 September 2016|archive-url=https://web.archive.org/web/20160902201450/https://afsp.org/about-suicide/suicide-statistics/}}</ref> A 2008 review found that nonfatal self-injury is more common in women,<ref>{{cite journal |last1=Nock |first1=M. K. |last2=Borges |first2=G. |last3=Bromet |first3=E. J. |last4=Cha |first4=C. B. |last5=Kessler |first5=R. C. |last6=Lee |first6=S. |title=Suicide and Suicidal Behavior |journal=Epidemiologic Reviews |date=14 May 2008 |volume=30 |issue=1 |pages=133–154 |doi=10.1093/epirev/mxn002|pmid=18653727 |pmc=2576496 }}</ref> 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.<ref>{{cite journal |last1=Crosby |first1=AE |last2=Han |first2=B |last3=Ortega |first3=LA |last4=Parks |first4=SE |last5=Gfroerer |first5=J |last6=Centers for Disease Control and Prevention |first6=(CDC). |title=Suicidal thoughts and behaviors among adults aged ≥18 years--United States, 2008-2009. |journal= MMWR. Surveillance Summaries |date=21 October 2011 |volume=60 |issue=13 |pages=1–22 |pmid=22012169}}</ref>

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%.<ref>{{cite journal |last1=Uddin|first1=R |last2=Burton |first2=NW |last3=Maple |first3=M |last4=Khan |first4=SR |last5=Khan |first5=A |date=2019 |title=Suicidal ideation, suicide planning, and suicide attempts among adolescents in 59 low-income and middle-income countries: a population-based study |journal=The Lancet Child & Adolescent Health |volume=3 |issue=4 |pages=223–233 |doi=10.1016/S2352-4642(18)30403-6 |pmid=30878117|hdl=10072/387579 |s2cid=81982117 |hdl-access=free }}</ref>

==Parasuicide and self-injury==
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{{main|Suicide terminology}}

Without commonly agreed-upon operational definitions, some [[suicidology]] researchers regard many suicide attempts as parasuicide (para- meaning near)<ref>{{Cite web|title=para- - Wiktionary|url=https://en.wiktionary.org/wiki/para-#English|access-date=August 18, 2020|publisher=[[Wiktionary]]}}</ref> or [[self harm]] behavior, rather than "true" suicide attempts, as in lacking suicidal intent.

==Methods==
Some [[suicide method]]s 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.<ref>{{citation|url=http://www.mentalhelp.net/poc/view_index.php?idx=119&d=1&w=5&e=28649|title=Guns and Suicide|author=Schwartz, Allan N.|date=Apr 12, 2007}}</ref>

== Repetition ==
A nonfatal suicide attempt is the strongest known clinical predictor of eventual suicide.<ref>Harris EC, Barraclough B: Suicide as an outcome for mental disorders: a meta-analysis. Br J Psychiatry 1997; 170:205–228</ref> Suicide risk among self-harm patients is hundreds of times higher than in the general population.<ref>Owens D, Horrocks J, House A: Fatal and non-fatal repetition of self-harm: systematic review. Br J Psychiatry 2002; 181:193–199</ref> It is often estimated that about 10–15% of people who attempt suicide eventually die by suicide.<ref>Suominen et al. (2004). Completed Suicide After a Suicide Attempt: A 37-Year Follow-Up Study. Am J Psychiatry, 161, 563–564.</ref> 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.<ref>Hawton K, Catalan J. Attempted suicide: a practical guide to its nature and management, 2nd ed. Oxford, Oxford University Press, 1987.</ref> Recent meta-analytic evidence suggests that the association between suicide attempt and suicidal death may not be as strong as it was thought before.<ref>{{cite journal |last1=Ribeiro |first1=JD |last2=Franklin |first2=JC |last3=Fox |first3=KR |last4=Bentley |first4=KH |last5=Kleiman |first5=EM |last6=Chang |first6=BP |last7=Nock |first7=MK | date=2016 |title=Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies |journal=Psychological Medicine |volume=46 |issue=2 |pages=225–236 |doi=10.1017/S0033291715001804 |pmid=26370729|pmc=4774896 }}</ref>

== 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.<ref>{{cite book|author=Stone, Geo|title=Suicide and Attempted Suicide|publisher=Da Capo Press|isbn=978-0-7867-0940-3|date=September 1, 2001}}</ref>

== Criminalization of attempted suicide ==
{{update|date=January 2014}}
{{anchor|Punishment for failed suicide attempts}}
{{main|Suicide legislation}}
Historically in the Christian church, people who attempted suicide were [[excommunication|excommunicated]] because of the religiously polarizing nature of the topic.<ref name=McL2007/> While previously criminally punishable, attempted suicide no longer is in most Western countries. It remains a criminal offense in most Islamic countries.<ref>{{cite journal|last=Aggarwal|first=N|title=Rethinking suicide bombing.|journal=Crisis|year=2009|volume=30|issue=2|pages=94–7|pmid=19525169|doi=10.1027/0227-5910.30.2.94}}</ref> In the late 19th century in Great Britain, attempted suicide was deemed to be equivalent to [[attempted murder]] and could be punished by hanging.<ref>{{Cite news|date=2011-08-03|title=When suicide was illegal|language=en-GB|work=BBC News|url=https://www.bbc.com/news/magazine-14374296|access-date=2021-12-08}}</ref> In the United States, suicide is not illegal and almost no country in Europe currently considers attempted suicide to be a crime.<ref name=McL2007>{{cite book|last=McLaughlin|first=Columba|title=Suicide-related behaviour understanding, caring and therapeutic responses|year=2007|publisher=John Wiley & Sons|location=Chichester, England|isbn=978-0-470-51241-8|page=24|url=https://books.google.com/books?id=I2FJRbekdC8C&pg=PA24}}</ref>

In India, attempted suicide was decriminalized by the [[Mental Healthcare Act, 2017]],<ref>{{cite web |url=https://timesofindia.indiatimes.com/india/Government-decriminalizes-attempt-to-commit-suicide-removes-section-309/articleshow/45452253.cms |title=Government decriminalizes attempt to commit suicide, removes section 309 |last=Jain |first=Bharti |date=11 December 2014 |work=[[The Times of India]] |archive-url=https://web.archive.org/web/20210108182624/https://timesofindia.indiatimes.com/india/Government-decriminalizes-attempt-to-commit-suicide-removes-section-309/articleshow/45452253.cms |archive-date=8 January 2021 |url-status=live}}</ref><ref>{{Cite web | url=http://zeenews.india.com/news/india/govt-decides-to-repeal-section-309-from-ipc-attempt-to-suicide-no-longer-a-crime_1512479.html | title=Govt decides to repeal Section 309 from IPC; attempt to suicide no longer a crime| date=2014-12-10}}</ref> while Singapore removed attempted suicide from their criminal code in 2020;<ref>{{cite web |last1=Ng |first1=Charmaine |title=Watch that cigarette butt and BBQ embers - firestarters to feel more heat from the law from Jan 1 |url=https://www.straitstimes.com/singapore/courts-crime/watch-that-cigarette-butt-and-bbq-embers-firestarters-to-feel-more-heat-from |website=The Straits Times |access-date=31 December 2019 |date=27 December 2019}}</ref> previously it had been punishable by up to one-year in prison.<ref>Singapore Penal Code(Cap 224, Rev Ed 2008), s 309</ref>

[[Suicide legislation#Laws in individual jurisdictions (table)|Many other countries]] still prosecute suicide attempts.<ref>{{Cite journal | doi=10.1016/j.ijlp.2015.08.032 |pmid = 26375452| title=The legal status of suicide: a global review| journal=International Journal of Law and Psychiatry| volume=44| pages=54–74| year=2016| last1=Mishara| first1=BL| last2=Weisstub| first2=DN| s2cid=205283662 }}</ref> As of 2012, attempted suicide is a criminal offense in [[Uganda]],<ref>{{Cite journal | doi=10.1258/msl.2012.011107|pmid = 22528562| title=Mental health workers' views on the criminalization of suicidal behaviour in Uganda| journal=Medicine, Science and the Law| volume=52| issue=3| pages=148–151| year=2012| last1=Hjelmeland| first1=Heidi| last2=Kinyanda| first2=Eugene| last3=Knizek| first3=Birthe Loa|s2cid = 7820312}}</ref> and as of 2013, it is criminalized in [[Ghana]].<ref>{{Cite journal
 | pmid = 24197485| year = 2014| last1 = Hjelmeland| first1 = H| title = The law criminalizing attempted suicide in Ghana: The views of clinical psychologists, emergency ward nurses, and police officers| journal = Crisis: The Journal of Crisis Intervention and Suicide Prevention| volume = 35| issue = 2| pages = 132–36| last2 = Osafo| first2 = J| last3 = Akotia| first3 = C. S.| last4 = Knizek | first4 = B. L.| doi = 10.1027/0227-5910/a000235}}</ref>

Despite having its own laws, [[Maryland]] still reserves the right to prosecute people under the English [[Common law]]s 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.<ref>{{cite web |url=https://www.myeasternshoremd.com/stardem/news/local_news/rare-attempted-suicide-charge-goes-through-caroline-court/article_3e8f7813-a2c6-555c-a8cd-7876e09013e3.html |title=Rare attempted suicide charge goes through Caroline court |last=Andrews |first=Abby |date=March 1, 2018 |work=[[Kent County News]] |archive-url=https://web.archive.org/web/20201202153144/https://www.myeasternshoremd.com/stardem/news/local_news/rare-attempted-suicide-charge-goes-through-caroline-court/article_3e8f7813-a2c6-555c-a8cd-7876e09013e3.html |archive-date=December 2, 2020 |url-status=live}}</ref><ref>{{cite web |url=https://www.stardem.com/opinion/columns/attempted-suicide-likely-not-a-crime/article_5cc4e7d0-ffbf-5cce-8eb4-bb7a503141ab.html |title=Attempted suicide likely not a crime |last=Dufour |first=Christine B. |date=March 7, 2018 |work=[[The Star Democrat]] |archive-url=https://web.archive.org/web/20210824154458/https://www.stardem.com/opinion/columns/attempted-suicide-likely-not-a-crime/article_5cc4e7d0-ffbf-5cce-8eb4-bb7a503141ab.html |archive-date=August 24, 2021 |url-status=bot: unknown |access-date=August 24, 2021 }}</ref><ref>{{cite web |url=https://www.baltimoresun.com/news/crime/bs-md-suicide-criminal-charge-20180222-story.html |title=Attempting suicide is not a crime under Maryland law. But an Eastern Shore man was convicted of it |last=Fenton |first=Justine |date=February 23, 2018 |work=[[The Baltimore Sun]] |archive-url=https://web.archive.org/web/20210624200430/https://www.baltimoresun.com/news/crime/bs-md-suicide-criminal-charge-20180222-story.html |archive-date=June 24, 2021 |url-status=live}}</ref>

==See also==
* [[International Survivors of Suicide Loss Day]]
* [[Mental health first aid]]
* [[Suicidal ideation]]
* [[Suicide crisis]]
* [[World Suicide Prevention Day]]

==References==
{{Reflist}}

{{Suicide navbox}}

[[Category:Suicide|Attempt]]
[[Category:Failure]]