Most Suicide Deaths Are on Initial Attempt; Most Who Survive a First Attempt Do Not Subsequently Die by Suicide

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 nonfatally, 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 underylying, 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.https://www.hsph.harvard.edu/means-matter/means-matter/survival/