Suicide

Suicide (from Latin sui caedere, to kill oneself) is the act of willfully ending one's own life. Suicide can also refer to the individual who has committed or attempted the act.

Terminology

Suicidal ideation

Suicidal ideation is a common medical term for thoughts about suicide, which may be as detailed as a formulated plan, without the suicidal act itself. Although most people who undergo suicidal ideation do not commit suicide, some go on to make suicide attempts or take their own lives. The range of suicidal ideation varies greatly from fleeting to detailed planning, role playing and unsuccessful attempts, which may be deliberately constructed to fail or be discovered or may be fully intended to succeed but not actually do so.

Parasuicide

Many suicidal people participate in suicidal activities that do not result in death. These activities fall under the designation attempted suicide or parasuicide. Those with a history of such attempts are almost 23 times more likely to eventually end their own lives than those who don't participate in such activites.

Suicidal gestures and attempts

Sometimes, a person will make actions resembling suicide attempts while not being fully committed, or in a deliberate attempt to have others notice. This is called a suicidal gesture (also known as a "cry for help"). Prototypical methods might be a non-lethal method of self-harm that leaves obvious signs of the attempt, or simply a lethal action at a time when the person considers it likely that he/she will be rescued or prevented from fully carrying it out.

On the other hand, a person who genuinely wishes to die may fail, due to lack of knowledge about what they are doing, unwillingness to try methods that may end in permanent damage if they fail or harm others, or an unanticipated rescue, among other reasons. This is referred to as a suicidal attempt.

Distinguishing between a suicidal attempt and a suicidal gesture may be difficult. Intent and motivation are not always fully discernible since so many people in a suicidal state are genuinely conflicted over whether they wish to end their lives. One approach, assuming that a sufficiently strong intent will ensure success, considers all near-suicides to be suicidal gestures. This however does not explain why so many people who fail at suicide end up with severe injuries, often permanent, which are most likely undesirable to those who are making a suicidal gesture. Another possibility is those wishing merely to make a suicidal gesture may end up accidentally killing themselves, perhaps by underestimating the lethality of the method chosen or by overestimating the possibility of external intervention by others. Suicide-like acts should generally be treated as seriously as possible because if there is an insufficiently strong reaction from loved ones from a suicidal gesture, this may motivate future, and ultimately more committed attempts.

In the technical literature the use of the terms parasuicide, or deliberate self-harm (DSH) are preferred – both of these terms avoid the question of the intent of the actions.

Self-harm

An important difference to note is that self-harm is not a suicide attempt. There is a non-causal correlation between self-harm and suicide; individuals who suffer from depression or other mental health issues are also more likely to choose suicide. Deliberate self-harm (DSH) is far more common than suicide, and the majority of DSH participants are females aged under 35. They are usually not physically ill and while psychological factors are highly significant, they are rarely clinically ill and severe depression is uncommon. Social issues are key as DSH is most common among those living in overcrowded conditions, in conflict with their families, with disrupted childhoods and history of drinking, criminal behavior, and violence. Individuals under these stresses become anxious and depressed and then, usually in reaction to a single particular crisis, they attempt to harm themselves. The motivation may be a desire for relief from emotional pain or to communicate feelings, although the motivation will often be complex and confused. DSH may also result from an inner conflict between the desire to end life and the desire to continue living.

Suicide note

A written message left by someone who attempts or commits suicide is known as a suicide note. The practice is fairly common, occurring in approximately one out of three suicides.[2] Motivations for leaving one range from seeking closure with loved ones to exacting revenge against others by blaming them for the decision.

Combination of homicide and suicide

Since crime just prior to suicide is often perceived as being without consequences, it is not uncommon for suicide to be linked with homicide. Motivations may range from guilt to evading punishment, insanity, and killing others as part of a suicide pact.

Assisted suicide

A suicidal individual who lacks the physical capacity to take their own life may enlist someone else to carry out the act on their behalf, frequently a family member or physician. This may or may not be considered a form of suicide according to different moral views of the practice, with opponents regarding it instead as akin to murder. Assisted suicide is a contentious moral and political issue in many countries.

Methods

In countries where firearms are readily available, many suicides involve the use of firearms. In fact, just over 55% of suicides committed in the United States in 2001 were by firearm. Asphyxiation methods (including hanging) and toxification (poisoning and overdose) are fairly common as well. Each comprised about 20% of suicides in the US during the same time period. Other methods of suicide include blunt force trauma (jumping from a building or bridge, or stepping in front of a train, for example), exsanguination or bloodletting (slitting one's wrist or throat), self-immolation, electrocution, car collision and intentional starvation.

A suicide method is any means by which someone purposely kills himself/herself. Methods that have been used to commit suicide include:

Bleeding

Exsanguination is a method of death which is caused by blood loss. It is usually the result of damage inflicted on arteries. The carotid, radial, ulnar or femoral arteries would be targeted.

Cutting the carotid artery

Cutting through the throat is one method of exsanguination. Damage is inflicted to the carotid artery which carries blood to the brain, and it takes no longer than a few minutes to lose enough blood for death to occur, although death could also be caused by blood clogging the trachea.

It was also practiced as a ritual suicide method in Japan, by noble women for the same purposes as seppuku was used by men.

Burning (self-immolation)

Self-immolation is the act of setting oneself on fire; an accelerant such as gasoline is frequently used to hasten death.

There are many documented cases of this method as a public and often spectacular method of protest, particularly but not exclusively within or against repressive regimes. Thích Quảng Ðức, a Buddhist monk, burned himself alive in 1963 in protest against the oppression of Buddhism by the administration of Vietnamese Prime Minister Ngô Đình Diệm. The BBC has reported that there have been a significant number of cases among Afghan women.

Burning to death can take several minutes to several hours, making this a painful way to expire. Death may result from smoke inhalation, shock, or, after a period of days, systemic failure. A person who survives self-immolation may still suffer extensive burns.

Drowning

Suicide by drowning is the act of deliberately submerging oneself in water or other liquid and staying there long enough to prevent breathing and deprive the brain of oxygen. Genuine cases of drowning are determined by whether the victim's lungs are filled with water. As with other deaths by suffocation, if the drowning is stopped before death, oxygen deprivation can cause brain damage.

Drug overdosing

Suicide by pharmaceuticals ("overdosing") is a method which involves taking medication in doses of several times greater than the indicated levels, or in a combination which will enhance each drug's effect. Due to the unpredictability of dosing requirements, death is uncertain, and an attempt may leave a person alive but with severe organ damage. Drugs taken orally may also be vomited back out before being absorbed.

Painkiller overdoses are among the most common due to easy availablilty of over-the-counter substances..

Overdosing may also be performed by mixing medications in a cocktail with one another or with alcohol or illegal drugs. This method may leave confusion over whether the death was a suicide or accidental.

Electrocuting

Suicide by electrocution involves using a lethal electric shock to kill oneself. A high enough voltage can overcome the high resistance of the skin and pass a sizable current through the trunk. A large alternating current through the body can seriously disrupt nerve signals and can cause the heart to go into fibrillation.

Hanging

Suicide by hanging.

The traditional death penalty of hanging by gallows consist of a rope is tied to some fixed object (i.e. the gallows), with one end tied into a noose and put around the neck. The person falls through the release of a trap door (or jumps, in the case of suicide) from a height, and death is instantaneous due to breaking of the neck. If the neck is not broken, asphyxiation due to the obstructed trachea ultimately leads to death.

Jumping

Jumping from a great height can shatter organs and tissues. If a person jumps from a tall bridge into water, the person may die by impact rather than by drowning. Such jumpings off the Golden Gate Bridge, of which there have been 1,300 between 1937 and 2006, were depicted in the documentary film The Bridge.

The 68.6 metre plunge from the bridge has proven to be fatal in 98% of cases. The jumper would hit the water at 120 km/h. Most die violently of internal bleeding due to broken ribs which pierce the heart, lungs, liver or spleen. Survivors, who would have hit the water feet-first, would often have had their femurs shattered.

Poisoning

Suicide can be committed by using fast-acting poisons, or substances which are known for their high levels of toxicity to humans. For example, the people of Jonestown, in northwestern Guyana, all died when the leader of a religious sect organised a mass suicide by drinking a cocktail of diazepam and cyanide in 1978.

Suicide by cop

The term "suicide by cop" is used to describe situations where an individual behaves in a manner intended to provoke an armed law enforcement officer into use of lethal force against that individual, by placing the officer in a position where they believe they must shoot them in order to protect their own life or that of others.

Seppuku

Seppuku (a.k.a. harakiri) is a Japanese ritual method of suicide, practiced mostly in the medieval era, though some isolated cases appear in modern times. For example, Yukio Mishima committed seppuku in 1970 after a failed coup d'etat intended to restore full power to the Japanese Emperor.

Contrary to other methods of suicide, this was regarded as a way of preserving one's honour. The ritual is part of bushido, the code of the Samurai.

Dressed ceremonially, with his sword placed in front of him and sometimes seated on special cloth, the warrior would prepare for death by writing a death poem. With a selected attendant (kaishakunin, his second) standing by, he would open his kimono, take up his wakizashi (short sword), fan, or a tanto (knife) and plunge it into his abdomen, making first a left-to-right cut and then a second slightly upward stroke. On the second stroke, the kaishakunin would perform daki-kubi, when the warrior is all but decapitated, leaving a slight band of flesh attaching the head to the body.

Shooting

File:Suicide rates by methods, aged 15-19 (1992-2001).gif

Methods of suicide among person aged 15-19. The use of a firearm is the leading method in the United States.

This method involves using a firearm to cause a fatal injury to oneself. It is used more frequently in countries where firearms are easier to obtain, and is the leading method in the United States. It is debatable, however, if that increases the number of suicides in general. It might be that it just increases the number of people choosing this method. In countries where firearms are harder to obtain, this method is sometimes still used, especially by people who use firearms in their work (e.g., soldiers or police).

Brain or heart damage kills a person most quickly; however, the gun must be powerful enough for that to succeed. Mortality also depends on where the shot is aimed, usually the side of forehead (temple) or in the mouth (both ways ultimately aimed at the brain). In some cases the heart is chosen as a target, but it is harder to aim correctly. Being shot in other parts of the anatomy may not result in death or lethal damage. There are many cases of brain damage and severe physical trauma that do not result in loss of life.

Some studies have shown that in Western nations, men tend to use this method of suicide more often than women, which has been cited as one potential reason for the higher suicide success rate among men. Though most men shoot themselves in the head, women tend to shoot themselves in the heart.

Carbon monoxide poisoning

A particular type of asphyxia is via inhalation of high levels of Carbon monoxide.

Death usually occurs through hypoxia. In most cases carbon monoxide (CO) is used for this, as it is easily available as a product of combustion; for example, it can be released by cars and some types of heaters where there has been incomplete combustion.

Carbon monoxide is a colourless and odourless gas, so its presence cannot be detected. It is harmful to the human organism as the CO molecules attach themselves irreversibly to hemoglobin in the blood, displacing oxygen molecules and progressively lowering the body's oxygenation, eventually resulting in death.

In the past, before air-quality regulations and catalytic converters, suicide by carbon monoxide poisoning would be achieved by running a car's engine in a closed space such as a garage, or by redirecting a running car's exhaust back inside the cabin with a hose. However, the incidence of suicide by carbon monoxide poisoning through burning fossil fuel or charcoal (charcoal-burning suicide) within a confined space appears to have risen.

In cases where levels of Carbon monoxide are not high enough to induce asphyxia, secondary poisoning may result in death.

Suicide attack

A suicide attack is an attack in which the attacker (attacker being either an individual or a group) intends to kill others and intends to die in the process of doing so. In a suicide attack in the strict sense the attacker dies by the attack itself, for example in an explosion or crash caused by the attacker. The term is sometimes loosely applied to an incident in which the intention of the attacker is not clear though he is almost sure to die by the defense or retaliation of the attacked party.

Such attacks are typically motivated by religious or political ideologies and have been carried out using numerous methods. For example, attackers might attach explosives directly to their bodies before detonating themselves close to their target, or they may use car bombs or other machinery to cause maximum damage (e.g. Japanese kamikaze pilots during World War II). Some sources refer to this as a "homicide attack," to emphasize the idea that killing other people is usually the primary purpose of such an attack. However, this usage is ambiguous since the word "homicide" already refers to unlawful killing and the key aspect of a suicide attack that distinguishes it from other forms of homicide is the death of the perpetrator.

Islamist extremist terrorists have engaged in suicide attacks numerous times in the Arab-Israeli conflict, and also against the West at other times. Perpetrators believe that the gains to others, or to a religious, political or moral cause, outweigh their personal loss and/or that they will be rewarded in the afterlife.

The September 11, 2001 attacks by Al-Qaeda using civilian aircraft on the World Trade Center and The Pentagon are examples of suicide attacks.

Reasons for suicide

Causes of suicide

No single factor has gained acceptance as a universal cause of suicide. However, depression is a common phenomenon amongst those who commit suicide. Other factors that may be related are as follows (Note that this is not meant as a comprehensive list, but rather as a summary of notable causes):

• Pain (e.g. physical or emotional agony that is not correctable)
• Stress (e.g. Grief after a death)
• Crime (e.g. escaping judicial punishment and dehumanisation, boredom of incarceration)
• Mental illness and disability (e.g. depression, bipolar disorder, trauma, and schizophrenia)
• Catastrophic Injury (e.g. paralysis, disfigurement, loss of limb)
• Substance abuse
• Adverse environment (e.g. sexual abuse, poverty, homelessness, discrimination, bullying, fear of murder and/or torture)
• Financial loss (e.g. gambling addiction, loss of job/assets, stock market crash, debts)
• Unresolved sexual issues (e.g. sexual orientation, unrequited love, aftermath of a break up)
• To avoid shame or dishonour (e.g. Under the Bushido ideal, if a samurai failed to uphold his honour, he could regain it by performing seppuku.)
• Curiosity (e.g. The need to know what comes after life.)
• Boredom (e.g. The dissatisfaction with life has resulted in more calculated and planned suicides)
• Terrorism can also be a motive for suicide, especially when related to the following:
  • Religion (e.g., suicide bombings, Heaven's Gate)
  • Extreme nationalism (e.g., the Kamikaze, Selbstopfer, and Kaiten suicide weapons)

Epidemiology

File:Edouard Manet 059.jpg

Edouard Manet: Suicide, 1877

According to official statistics, about a million people commit suicide annually, more than those murdered or killed in war. . As of 2001 in the USA, suicides outnumber homicides by 3 to 2 and deaths from AIDS by 2 to 1

Gender and suicide: In the Western world, males die much more often than females by suicide, while females attempt suicide more often. Some medical professionals believe this is due to the fact that males are more likely to end their life through violent means (guns, knives, hanging, drowning, etc.), while women primarily overdose on medications or use other ineffective methods. Others ascribe the difference to inherent differences in male/female psychology, with men having more of an operational mindset and women being more aware of social nuance. Greater social stigma against male depression and a lack of social networks of support and help with depression is often identified as a key reason for men's disproportionately higher level of suicides, since "suicide as a cry for help" is not seen as an equally viable option by men. Typically males die from suicide 3 to 4 times as often as females, and not unusually 5 or more times as often.

Excess male mortality from suicide is also evident from data from non-western countries. In 1979-81, 74 countries reported one or more cases of suicides. Two of these reported equal rates for the sexes: Seychelles and Kenya. Three countries reported female rates exceeding male rates: Papua-New Guinea, Macao, French Guiana. The remaining 69 countries had male suicide rates greater than female suicide rates.

Barraclough found that the female rates of those aged 5-14 equaled or exceeded the male rates only in 14 countries, mainly in South America and Asia.

National suicide rates sometimes tend to be stable. For example, the 1975 rates for Australia, Denmark, England, France, Norway, and Switzerland, were within 3.0 per 100,000 of population from the 1875 rates (Australian Bureau of Statistics, 1983; Lester, Patterns, 1996, p. 21). The rates in 1910-14 and in 1960 differed less than 2.5 per 100,000 of population in Australia, Belgium, Denmark, England & Wales, Ireland, Japan, New Zealand, Norway, Scotland, South Africa, Spain, Sweden, and The Netherlands (Lester, Patterns, 1996, p. 22).

There are considerable differences between national suicide rates. Findings from two studies showed a range from 0.0 to more than 40 suicides per 100,000 of population.

National suicide rates, apparently universally, show an upward secular trend. This trend has been well documented for European countries. The trend for national suicide rates to rise slowly over time might be an indirect result of the gradual reduction in deaths from other causes, i.e. falling death rates from causes other than suicide uncover a previously hidden predisposition towards suicide.

Race and suicide. At least in the USA, Caucasians commit suicide more often than African Americans do. This is true for both genders. Non-Hispanic Caucasians are nearly 2.5 times more likely to kill themselves than are African Americans or Hispanics.

Age and suicide At least in the USA, males over 70 commit suicide more often than younger males. There is no such trend for females. Older non-Hispanic Caucasian men are much more likely to kill themselves than older men or women of any other group, which contributes to the relatively high suicide rate among Caucasians. Caucasian men in their 20s, conversely, kill themselves only slightly more often than African American or Hispanic men in the same age group.

Season and suicide People commit suicide more often during spring and summer. The idea that suicide is more common during the winter holidays (including Christmas in the northern hemisphere) is a common misconception.

Other reasons

Suicide as a form of defiance and protest

Heroic suicide, for the greater good of others, is often celebrated. For instance, Mahatma Gandhi went on a hunger strike to prevent fighting between Hindus and Muslims, and, although he was stopped before dying, it appeared he would have willingly succumbed to starvation. This attracted attention to Gandhi's cause, and generated a great deal of respect for him as a spiritual leader. In the 1960s, Buddhist monks, most notably Thích Quảng Đức, in South Vietnam drew Western attention to their protests against President Ngô Đình Diệm by burning themselves to death. Similar events were reported during the Cold War in eastern Europe, such as the death of Jan Palach following the Soviet invasion of Czechoslovakia, or Romas Kalanta's self-immolation in the main street of Kaunas, Lithuania in 1972. More recently, (November 2006) an American anti-war activist, Malachi Ritscher committed suicide by self-immolation as a protest against the Iraq war. Critics may see such suicides as counter-productive, arguing that these people would probably achieve a comparable or greater result by spending the rest of their lives in active struggle. Suicide or attempted suicide as a means of effecting social or political change is related to martyrdom.

Military suicide

In the desperate final days of World War II, many Japanese pilots volunteered for kamikaze missions in an attempt to forestall defeat for the Empire. In Nazi Germany; Luftwaffe squadrons were formed to smash into American B-17s during daylight bombing missions, in order to delay the highly-probable Allied victory, although in this case, inspiration was primarily the Soviet and Polish taran ramming attacks, and death of the pilot was not a desired outcome. The degree to which such a pilot was engaging in a heroic, selfless action or whether they faced immense social pressure is a matter of historical debate. The Japanese also built one-man "human torpedo" suicide submarines.

However, suicide has been fairly common in warfare throughout history. Soldiers and civilians committed suicide to avoid capture and slavery (including the wave of German and Japanese suicides in the last days of World War II). Commanders committed suicide rather than accept defeat. Behaviour that could be seen as suicidal occurred often in battle. For instance, soldiers under cannon fire at the Battle of Waterloo took fatal hits rather than duck and place their comrades in harm's way. The Charge of the Light Brigade in the Crimean War, Pickett's Charge at Gettysburg in the American Civil War , and the charge of the French cavalry at the Battle of Sedan in the Franco-Prussian War were assaults that continued even after it was obvious to participants that the attacks were unlikely to succeed and would probably be fatal to most of the attackers. Japanese infantrymen usually fought to the last man, launched "banzai" suicide charges, and committed suicide during the Pacific island battles in World War II. In Saipan, Okinawa, civilians joined in the suicides. Suicidal attacks by pilots were common in the 20th century: the attack by U.S. torpedo planes at the Battle of Midway was very similar to a kamikaze attack. Also, it could be argued that it is an action of military suicide to fall on a grenade, the action of throwing oneself onto a grenade, hoping to shield one's platoon from the shrapnel and/or explosion but most certainly losing one's own life in the process.

This particular reference to suicide is also what leads to the everyday usage of the term when indicating a hopeless situation, often in business, such as "it would be suicide for us to go to market without a viable product."

Impact of suicide

It is estimated that an average of six people are suicide "survivors" for each suicide that occurs in the United States. It is important to note that in the context of suicide, the word "survivors" refers to the family and friends of the person who has died by suicide; this figure therefore does not represent the total number of people who may be affected. For example, the suicide of a child may leave the school and their entire community left to make sense of the act.

As with any death, family and friends of a suicide victim feel grief associated with loss. These suicide survivors are often overwhelmed with psychological trauma as well, depending on many factors associated with the event. This trauma can leave survivors feeling guilty, angry, remorseful, helpless, and confused. It can be especially difficult for survivors because many of their questions as to why the victim felt the need to take his or her own life are left unanswered. Moreover, survivors often feel that they have failed or that they should have intervened in some way. Given these complex sets of emotions associated with a loved one's suicide, survivors usually find it difficult to discuss the death with others, causing them to feel isolated from their own network of family and friends and often making them reluctant to form new relationships as well. .

"Survivor groups" can offer counseling and help bring many of the issues associated with suicide out into the open. They can also help survivors reach out to their own friends and family who may be feeling similarly and thus begin the healing process. In addition, counseling services and therapy can provide invaluable support to the bereaved. Some such groups can be found online, providing a forum for discussion amongst survivors of suicide (see Support Groups for Survivors section below).

As well as providing counseling for the grief-stricken, survivor groups have also attempted to change the language used to describe suicide. Believing that the term "commit" attaches criminal implications to suicide, they have pushed for alternative terms that remove this meaning including "attempting" suicide, or "died by" suicide^{[citation needed]}.

Medical views of suicide

Modern medicine treats suicide as a mental health issue. Overwhelming suicidal thoughts are considered a medical emergency. Medical professionals advise that people who have expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially important if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Special consideration is given to trained personnel to look for suicidal signs in patients. Depressive people are considered a high-risk group for suicidal behavior. Suicide hotlines are widely available for people seeking help. However, the negative and often too clinical reception that many suicidal people receive after relating their feelings to health professionals (threats of institutionalization, simply increasing dosages of medication, the stigmatization of suicide as a topic of discussion, etc), often causes them to keep their suicidal thoughts to themselves.

Suicide intervention or suicide crisis intervention is direct effort to stop or prevent persons attempting or contemplating suicide from killing themselves. Current medical advice concerning people who are attempting or seriously considering suicide is that they should immediately go or be taken to the nearest emergency room, or emergency services should be called immediately by them or anyone aware of the problem. Modern medicine treats suicide as a mental health issue. According to medical practice, severe suicidal ideation, that is, serious contemplation or planning of suicide, is a medical emergency and that the condition requires immediate emergency medical treatment.

In the United States, individuals who express the intent to harm themselves are automatically determined to lack the present mental capacity to refuse treatment, and can be transported to an emergency department against their will. An emergency physician there will determine whether or not inpatient care at a mental health care facility is warranted. This is sometimes referred to as being "committed." If the doctor determines involuntary commitment is needed, the patient is hospitalized and kept under observation until a court hearing is held to determine the patient's competence.

Individuals suffering from depression are considered a high-risk group for suicidal behavior. When depression is a major factor, successful treatment of the depression usually leads to the disappearance of suicidal thoughts.^{[citation needed]} However, medical treatment of depression is not always successful, and lifelong depression can contribute to recurring suicide attempts.

Medical personnel frequently receive special training to look for suicidal signs in patients. Suicide hotlines are widely available for people seeking help. However, the negative and often too clinical reception that many suicidal people receive after relating their feelings to health professionals (e.g. threats of institutionalization, increased dosages of medication, the social stigma) may cause patients to remain more guarded about their mental health history or suicidal urges and ideation.^{[citation needed]}

First aid for suicide ideation

Medical professionals advise that people who have expressed plans to kill themselves be encouraged to seek medical attention immediately. This is especially relevant if the means (weapons, drugs, or other methods) are available, or if the patient has crafted a detailed plan for executing the suicide. Mental health practitioners (MHPs) suggest that people who know a person whom they suspect to be suicidal can assist him or her by asking directly if the person has contemplated committing suicide and made specific arrangements, has set a date, etc. Posing such a question does not render a previously non-suicidal person suicidal^{[citation needed]}. According to this advice, the person questioning should seek to be understanding and sympathetic above all else since a suicidal person will often already feel ashamed or guilty about contemplating suicide so care should be taken not to exacerbate that guilt.

MHPs suggest that an affirmative response to these questions should motivate the immediate seeking of medical attention, either from that person's doctor, or, if unavailable, the emergency room of the nearest hospital.

If the prior interventions fail, MHPs suggest involving law enforcement officers. While the police do not always have the authority to stop the suicide attempt itself, in some countries including some jurisdictions in the US, killing oneself is illegal.

In most cases law enforcement does have the authority to have people involuntarily committed to mental health wards. Usually a court order is required, but if an officer feels the person is in immediate danger she can order an involuntary commitment without waiting for a court order. Such commitments are for a limited period, such as 72 hours – which is intended to be enough time for a doctor to see the person and make an evaluation. After this initial period, a hearing is held in which a judge can decide to order the person released or can extend the treatment time. Afterwards, the court is kept informed of the person's condition and can release the person when they feel the time is right to do so. Legal punishment for suicide attempts is extremely rare^{[citation needed]}.

Mental health treatment

Treatment, often including medication and psychotherapy, is directed at the underlying causes of suicidal thinking. Clinical depression is the most common treatable cause, with alcohol or drug abuse being the next major categories^{[citation needed]}.

Other psychiatric disorders associated with suicidal thinking include bipolar disorder, schizophrenia, Borderline personality disorder, Gender identity disorder and eating disorders. Suicidal thoughts provoked by crises will generally settle with time and counseling. Severe depression can continue throughout life even with treatment and repetitive suicide attempts or suicidal ideation can be the result.

Methods for disrupting suicidal thinking include having family members or friends tell the person contemplating suicide about who else would be hurt by the loss, citing valuable and productive aspects of the patient's life, and provoking simple curiosity about the victim's own future^{[citation needed]}.

During the acute phase, the safety of the person is one of the prime factors considered by doctors, and this can lead to admission to a psychiatric ward or even involuntary commitment.

According to a 2005 randomized controlled trial by Gregory Brown, Aaron Beck and others, cognitive therapy can reduce repeat suicide attempts by 50%.

Suicide prevention

Various suicide prevention strategies are suggested by Mental Health professionals^{[citation needed]}:

• Promoting mental resilience through optimism and connectedness.
• Education about suicide, including risk factors, warning signs, and the availability of help.
• Increasing the proficiency of health and welfare services in responding to people in need. This includes better training for health professionals and employing crisis counseling organizations.
• Reducing domestic violence and substance abuse are long-term strategies to reduce many mental health problems.
• Reducing access to convenient means of suicide (e.g., toxic substances, handguns).
• Reducing the quantity of dosages supplied in packages of non-prescription medicines e.g., aspirin.
• Interventions targeted at high-risk groups.

Research on suicide prevention

Research into suicide is published across a wide spectrum of journals dedicated to the biological, economic, psychological, medical and social sciences. In addition to those, a few journals are exclusively devoted to the study of suicide (suicidology), most notably, Crisis, Suicide and Life Threatening Behavior, and the Archives of Suicide Research.

The American Foundation for Suicide Prevention is dedicated to funding research on suicide and its prevention.

Cultural views of suicide

In the Warring States Period and the Edo period of Japan, samurai who disgraced their honor chose to end their own lives by harakiri (hara = stomach, kiri = cut) or seppuku, a method in which the samurai takes a sword and slices into his abdomen, causing a fatal injury. The cut is usually performed diagonally from the top corner of the samurai's writing hand, and has long been considered an honorable form of death (even when done to punish dishonor). Though obviously such a wound would be fatal, seppuku was not always technically suicide, as the samurai's assistant (the kaishaku) would stand by to cut short any suffering by quickly administering decapitation—sometimes as soon as the first tiny incision into the abdomen was made.

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