Nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date. This has been well-established in the suicidology literature. A literature review (Owens 2002) summarized 90 studies that have followed over time people who have made suicide attempts that resulted in medical care. Approximately 7% (range: 5-11%) of attempters eventually died by suicide, approximately 23% reattempted non-fatally, and 70% had no further attempts.
Even studies that focused on medically serious attempts–such as people who jumped in front of a train (O’Donnell 1994)–and studies that followed attempters for many decades found similarly low suicide completion rates. At least one study, published after the 90-study review, found a slightly higher completion rate. This was a 37-year follow-up of self-poisoners in Finland that found an eventual completion rate of 13% (Suominen 2004).
This relatively good long-term survival rate is consistent with the observation that suicidal crises are often short-lived, even if there may be underlying, more chronic risk factors present that give rise to these crises.
The relationship between suicide attempts and completions is a complex one.
- Most people who die by suicide in the U.S. did not make a previous attempt. Prevention efforts that focus only on those who attempt suicide will miss the majority of completers. An international review of psychological autopsy studies found that approximately 40% of those dying by suicide had previously attempted (Cavanagh 2003). The proportion was lower (25-33%) among studies of youth suicide in the U.S. (Brent 1993, Shaffer 1996). A history of previous attempts is lower among those dying by firearm suicide and higher among those dying by overdose (NVISS data).
- Most people who attempt suicide will not go on to complete suicide.
- Still, history of suicide attempt is one of the strongest risk factors for suicide. 5% to 11% of hospital-treated attempters do go on to complete suicide, a far higher proportion than among the general public where annual suicide rates are about 1 in 10,000.
- Approximately 50% of all people who die by suicide have previously self-harmed. One in 25 patients presenting to the hospital for self-harm will complete suicide in the next 5 years (Carroll 2014)
Carroll R, Metcalfe C, Gunnell D. Hospital presenting self-harm and risk of fatal and non-fatal repetition: systematic review and meta-analysis. PLoS One. 2014;9(2):e89944. Published 2014 Feb 28. doi:10.1371/journal.pone.0089944)
Cavanagh J, Carson A, Sharpe M, and Lawrie S. Psychological autopsy studies of suicide: a systematic review. Psychological Medicine. 2003;33:395-405.
Shaffer D, Gould M, Fisher P, et. al. Psychiatric diagnosis inchild and adolescent suicide. Archives of General Psychiatry. 1996;53(4):339-348.
Other studies (Longterm Survival among Nonfatal Suicide Attempters)