Suicide

An article in the New York Times Magazine suggests that a large portion of suicides in the U. S. are impulsive and challenges the notions that these people are suicidal for periods of days, weeks or months and that they will simply switch methods if their first choice becomes unavailable or more difficult:

The National Institute of Mental Health says that 90 percent of all suicide “completers” display some form of diagnosable mental disorder. But if so, why have advances in the treatment of mental illness had so little effect? In the past 40 years, whole new generations of antidepressant drugs have been developed; crisis hotline centers have been established in most every American city; and yet today the nation’s suicide rate (11 victims per 100,000 inhabitants) is almost precisely what it was in 1965.
...
in 2005, approximately 32,000 Americans committed suicide, or nearly twice the number of those killed by homicide.
...
In the late 1970s, Seiden set out to test the notion of inevitability in jumping suicides. Obtaining a Police Department list of all would-be jumpers who were thwarted from leaping off the Golden Gate between 1937 and 1971 — an astonishing 515 individuals in all — he painstakingly culled death-certificate records to see how many had subsequently “completed.” His report, “Where Are They Now?” remains a landmark in the study of suicide, for what he found was that just 6 percent of those pulled off the bridge went on to kill themselves. Even allowing for suicides that might have been mislabeled as accidents only raised the total to 10 percent.

“That’s still a lot higher than the general population, of course,” Seiden, 75, explained to me over lunch in a busy restaurant in downtown San Franciso. “But to me, the more significant fact is that 90 percent of them got past it. They were having an acute temporary crisis, they passed through it and, coming out the other side, they got on with their lives.”

In Seiden’s view, a crucial factor in this boils down to the issue of time. In the case of people who attempt suicide impulsively, cutting off or slowing down their means to act allows time for the impulse to pass — perhaps even blocks the impulse from being triggered to begin with. What is remarkable, though, is that it appears that the same holds true for the nonimpulsive, with people who may have been contemplating the act for days or weeks.

“At the risk of stating the obvious,” Seiden said, “people who attempt suicide aren’t thinking clearly. They might have a Plan A, but there’s no Plan B. They get fixated. They don’t say, ‘Well, I can’t jump, so now I’m going to go shoot myself.’ And that fixation extends to whatever method they’ve chosen.
...
In a 1985 study of 30 people who had survived self-inflicted gunshot wounds, more than half reported having had suicidal thoughts for less than 24 hours, and none of the 30 had written suicide notes. This tendency toward impulsivity is especially common among young people — and not only with gun suicides. In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.