Abstract
Choice of suicide method can strongly influence the outcome of suicidal behaviour, and is an important aspect of the process and planning involved in a suicide attempt. Yet, the reasons why individuals consider, choose or discard particular methods are not well understood. This is the first study to explore method choices among people with a history of suicidal behaviour and individuals who have experienced, but not enacted, suicidal thoughts. Via an online survey, we gathered open-ended data about choice of methods in relation to suicidal thoughts and behaviours, including reasons for and against specific means of harm. A total of 712 respondents had attempted suicide, and a further 686 experienced suicidal thoughts (but not acted on them). Self-poisoning was the most commonly contemplated and used method of suicide, but most respondents had considered multiple methods. Method choices when contemplating suicide included a broader range of means than those used in actual attempts, and more unusual methods, particularly if perceived to be lethal, 'easy', quick, accessible and/or painless. Methods used in suicide attempts were, above all, described as having been accessible at the time, and were more commonly said to have been chosen impulsively. Key deterrents against the use of specific methods were the presence of and impact on other people, especially loved ones, and fears of injury and survival. Exploration of method choices can offer novel insights into the transition from suicidal ideation to behaviour. Results underscore the need for preventative measures to restrict access to means and delay impulsive behaviour.
Highlights
Choice of suicide method can strongly influence the outcome of suicidal behaviour, and is an important aspect of the process and planning involved in a suicide attempt
In England, the 2014 Adult Psychiatric Morbidity Survey found that a fifth of adults (20.6%) reported thoughts of taking their own life at some point, and one person in 15 (6.7%) has made a suicide attempt.[2]
Choice of method is one of the most important determinants of whether suicidal behaviour is fatal, and a key aspect of the process and planning involved in a suicide attempt
Summary
Suicide is a leading cause of death worldwide.[1]. In England, the 2014 Adult Psychiatric Morbidity Survey found that a fifth of adults (20.6%) reported thoughts of taking their own life at some point, and one person in 15 (6.7%) has made a suicide attempt.[2]. Epidemiological studies have shown that different methods, and combinations of methods, vary in relation to lethality, and in the extent to which they predict subsequent suicidal behaviour and ‘method switching’.6–10 Their wider impact can vary, not least by virtue of the exposure and potential clustering/‘contagion’ effects associated with more public, unusual and ‘newsworthy’ methods.[11] avoiding ‘excessive detail of the method [...] to prevent simulative acts’ remains to date the only official regulation for the reporting of suicide in the UK.[12]. This clearly points to the importance of better understanding the cultural and cognitive availability of different methods of suicide. A study in Austria showed that, despite method switching between episodes of self-harm being common, choice of means in the time immediately preceding a suicide attempt is often stable, and focused on a single method.[8]
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