Suicide attempt

A suicide attempt is an attempt where a person tries to commit suicide but survives.[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.

Epidemiology

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]

In contrast to suicide mortality, rates of nonfatal self harm are consistently higher among females.[6]

Parasuicide and self-injury

Without commonly agreed-upon operational definitions, some suicidology researchers regard many suicide attempts as parasuicide or self-injurious behavior, rather than "true" suicide attempts, as in lacking suicide 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 self-poisoning, 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.[7]

Repetition

A nonfatal suicide attempt is the strongest known clinical predictor of eventual suicide.[8] Suicide risk among self-harm patients is hundreds of times higher than in the general population.[9] It is often estimated that about 10–15% of attempters eventually die by suicide.[10] The mortality risk is highest during the first months and years after the attempt: almost 1% of individuals who attempt suicide die within one year.[11]

Outcomes

Nonfatal suicide attempts can result in serious injury. 700,000 (or more) Americans survive a suicide attempt each year. People who attempt hanging and survive or charcoal grill carbon monoxide poisoning can face permanent brain damage due to cerebral anoxia. People who take an overdose and survive can face severe organ damage (e.g., liver failure). Individuals who jump from a bridge and survive may face the rupture of multiple organs and severe damage to the spine.

While a majority sustain injuries that allow them to be released following emergency department 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.[12]

Criminalization of attempted suicide

Historically in the Christian church, people who attempted suicide were excommunicated because of the religiously polarizing nature of the topic.[13] While previously criminally punishable, attempted suicide is no longer in most Western countries. It remains a criminal offense in most Islamic countries.[14] 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.[13] 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.[15]

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:[16][17]

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.[18]

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.[19]

As of 2013, attempted suicide is criminalized in Ghana.[20]

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

In Maryland, it is an open question as to whether suicide is illegal. In 2018, a Maryland man was convicted of attempted suicide.[21][22][23][24]

See also

References

  1. ↑ Danuta Wasserman (2016). Suicide: An unnecessary death. Oxford University Press. p. 63. ISBN 0191026840. Retrieved September 27, 2017.
  2. ↑ Rory C. O'Connor, Jane Pirkis (2016). The International Handbook of Suicide Prevention. John Wiley & Sons. pp. 13–14. ISBN 1118903234. Retrieved September 27, 2017.
  3. ↑ 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
  4. ↑ 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.
  5. ↑ "Suicide Statistics — AFSP". American Foundation for Suicide Prevention. Retrieved 3 September 2016.
  6. ↑ Nock et al. (2008). Suicide and suicide behavior. Epidemiologic Reviews, 30, 133–154. doi:10.1093/epirev/mxn002
  7. ↑ Schwartz, Allan N. (Apr 12, 2007), Guns and Suicide
  8. ↑ Harris EC, Barraclough B: Suicide as an outcome for mental disorders: a meta-analysis. Br J Psychiatry 1997; 170:205–228
  9. ↑ Owens D, Horrocks J, House A: Fatal and non-fatal repetition of self-harm: systematic review. Br J Psychiatry 2002; 181:193–199
  10. ↑ Suominen et al. (2004). Completed Suicide After a Suicide Attempt: A 37-Year Follow-Up Study. Am J Psychiatry, 161, 563–564.
  11. ↑ Hawton K, Catalan J. Attempted suicide: a practical guide to its nature and management, 2nd ed. Oxford, Oxford University Press, 1987.
  12. ↑ Stone, Geo (September 1, 2001). Suicide and Attempted Suicide. Da Capo Press. ISBN 0-7867-0940-5.
  13. 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.
  14. ↑ Aggarwal, N (2009). "Rethinking suicide bombing". Crisis. 30 (2): 94–7. doi:10.1027/0227-5910.30.2.94. PMID 19525169.
  15. ↑ Singapore Penal Code(Cap 224, Rev Ed 2008), s 309
  16. ↑ http://timesofindia.indiatimes.com/india/Government-decriminalizes-attempt-to-commit-suicide-removes-section-309/articleshow/45452253.cms
  17. ↑ http://zeenews.india.com/news/india/govt-decides-to-repeal-section-309-from-ipc-attempt-to-suicide-no-longer-a-crime_1512479.html
  18. ↑ http://lawcommissionofindia.nic.in/reports/report210.pdf
  19. ↑ http://msl.sagepub.com/content/52/3/148
  20. ↑ 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.
  21. ↑ http://www.baltimoresun.com/news/maryland/crime/bs-md-suicide-criminal-charge-20180222-story.html
  22. ↑ http://www.myeasternshoremd.com/stardem/news/local_news/rare-attempted-suicide-charge-goes-through-caroline-court/article_3e8f7813-a2c6-555c-a8cd-7876e09013e3.html
  23. ↑ http://www.dailymail.co.uk/news/article-5441037/Mentally-ill-Maryland-man-convicted-attempted-suicide.html
  24. ↑ http://www.stardem.com/opinion/columns/attempted-suicide-likely-not-a-crime/article_5cc4e7d0-ffbf-5cce-8eb4-bb7a503141ab.html
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