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).

. 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.

Brent D, Perper J, Moritz G, et. al. Psychiatric risk factors for adolescent suicide: a case-control study. Journal of the American Academy of Child and Adolescent Psychiatry. 1993;32(3):521-529.

Cavanagh J, Carson A, Sharpe M, and Lawrie S. Psychological autopsy studies of suicide: a systematic review. Psychological Medicine. 2003;33:395-405.

Owens D, Horrocks J, and House A. Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry. 2002;181:193-199.

O’Donnell I, Arthur A, Farmer R. A follow-up study of attempted railway suicides. Social Science and Medicine, 1994; 38:437-42.

Shaffer D, Gould M, Fisher P, et. al. Psychiatric diagnosis inchild and adolescent suicide. Archives of General Psychiatry. 1996;53(4):339-348.

Suominen K, Isometsä E, Suokas J, et al. Completed suicide after a suicide attempt: a 37-year follow-up study. Am J Psychiatry. 2004; 161:563-564.

Other studies (Longterm Survival among Nonfatal Suicide Attempters)