Case Fatality Rates by Suicide Method, 8 U.S. States, 1989-1997

The bar graph below shows “case fatality” (the percent of people who die in a suicide attempt) for several methods of suicide. It is based on a study that used emergency department data and death certificate data from 8 U.S. states. Firearms have the highest case fatality, and drug/overdose ingestion and cutting have the lowest.

(Spicer, R.S. and Miller, T.R. Suicide acts in 8 states: incidence and case fatality rates by demographics and method. American Journal of Public Health. 2000:90(12);1885.)

What Governs Lethality?

A number of factors are theorized to influence the lethality of a given method. The first is inherent deadliness. For example, car exhaust with a high CO level will be more deadly than car exhaust with a low CO level. The second is ease of use. A method that requires technical knowledge is less accessible than one that does not. The third is accessibility. Given the brief duration of some suicidal crises, a lethal dose of pills in the nightstand poses a greater danger than a prescription that must be hoarded over months to accumulate a lethal dose. Similarly, a gun in the closet poses a greater risk than a very high bridge five miles away, even if both methods have equal lethality if used. The fourth is ability to abort mid-attempt. More people start an attempt and abort it than carry it through; therefore, methods that can be interrupted without harm mid-attempt — such as overdose, cutting, CO poisoning, and hanging/suffocation — offer a window of opportunity for rescue or change of heart that guns and jumps do not. The fifth factor is acceptability to the attempter. Although fire, for example, is universally accessible, it is rarely used in the U.S. for suicide.

1Source for chart: Spicer, R.S. and Miller, T.R. Suicide acts in 8 states: incidence and case fatality rates by demographics and method. American Journal of Public Health. 2000:90(12);1885.