The Paradox of Suicidal Impulses

It is a truism that to “fail to prepare is to prepare to fail.” However, suicide seems to defy this rule: more impulsive suicide attempts seem to be more ‘successful.’ As explained in this piece in the NYT:

[T]hose methods that require forethought or exertion on the actor’s part (taking an overdose of pills, say, or cutting your wrists), and thus most strongly suggest premeditation, happen to be the methods with the least chance of “success.” Conversely, those methods that require the least effort or planning (shooting yourself, jumping from a precipice) happen to be the deadliest. The natural inference, then, is that the person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment — at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.

As illogical as this might seem, it is a phenomenon confirmed by research. According to statistics collected by the Injury Control Research Center on nearly 4,000 suicides across the United States, those who had killed themselves with firearms — by far the most lethal common method of suicide — had a markedly lower history of depression, schizophrenia, bipolar disorder, previous suicide attempts or drug or alcohol abuse than those who died by the least lethal methods. On the flip side, those who ranked the highest for at-risk factors tended to choose those methods with low “success” rates.

This is significant because it means that those most likely to end their lives, are those acting on impulse and thus most likely to be prevented from making the attempt by a lack of a readily available method. Thus it is a fallacy to suppose that suicidal individuals blocked from using one means will simply opt for another. Because by the time they do, the impulse has often passed. The suicide rate is actually greatly affected by the easy availability of the means to commit it in particular guns.

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