Which of these statements about suicide is accurate?

Question

a. The majority of persons who attempt suicide have given overt or covert indications of their intentions to others.
b. A background in health care has a protective effect, leading to a lower rate of suicide among physicians and nurses than in the general public.
c. Most persons with previous suicide attempts survived because they did not truly intend to die; they are at lower risk than those making their first attempt.
d. Use of a low-lethality means or likelihood of being discovered in time to prevent death are merely suicide gestures, not genuine attempts.

Answer 1

A
Most persons who later attempt suicide have given some indication of being at risk, of having ideation or intent related to suicide. The suicide rate among physicians and nurses is higher than in the general population; their special knowledge of pharmacology and physiology can make attempts more likely to be lethal. Most people who complete suicide have made at least one previous attempt, and a history of prior attempts is one of the strongest predictors of future risk. Some attempts may appear unlikely to have succeeded from the outset, because the means was one of low lethality (e.g., choking oneself with socks wrapped around the neck) or because circumstances would have led to their being rescued before harm resulted (e.g., an attempt initiated in front of witnesses). Many tend to interpret such unlikely-to-succeed attempts as meaning that the person "wasn't really serious about suicide," that it was a (so-called) suicide gesture. In fact, often a depressed or psychotic person simply is too cognitively impaired to plan well to succeed at suicide. Further, identifying a serious attempt as "a gesture" (not serious) can increase the risk of suicide if it is perceived as a challenge or if the person feels they or their attempt are being ridiculed or not taken seriously. The person may respond by intensifying efforts and may succeed in a subsequent attempt.