Some evidence that vast majority of people who failed to kill themselves through suicide really didn't want to die

Apparently only 12 percent of those who unsuccessfully try to commit suicide end up killing themselves through suicide.  Is it possible that it is so low because they got help or treatment or because the reason that they really didn't intend to kill themselves to begin with?  I don't see any obvious measure of treatment here, but what is clear is that those who tried to kill themselves through the most "effective" means but who failed were apparently most likely to try again (this next time successfully).  That seems consistent with the choice of suicide being endogenous with whether people wanted to be successful to begin with.  A synopsis is available here:

.

Method of attempted suicide as predictor of subsequent successful suicide: national long term cohort study.

Runeson B, Tidemalm D, Dahlin M, Lichtenstein P, Långström N.
Source
Department of Clinical Neuroscience, Karolinska Institutet, Division of Psychiatry, St Göran, SE-112 81 Stockholm, Sweden. bo.runeson@ki.se

Abstract

OBJECTIVE:

To study the association between method of attempted suicide and risk of subsequent successful suicide.

DESIGN:

Cohort study with follow-up for 21-31 years.

SETTING:

Swedish national register linkage study.

PARTICIPANTS:

48,649 individuals admitted to hospital in 1973-82 after attempted suicide.

MAIN OUTCOME MEASURE:

Completed suicide, 1973-2003. Multiple Cox regression modelling was conducted for each method at the index (first) attempt, with poisoning as the reference category. Relative risks were expressed as hazard ratios with 95% confidence intervals.

RESULTS:

5740 individuals (12%) committed suicide during follow-up. The risk of successful suicide varied substantially according to the method used at the index attempt. Individuals who had attempted suicide by hanging, strangulation, or suffocation had the worst prognosis. In this group, 258 (54%) men and 125 (57%) women later successfully committed suicide (hazard ratio 6.2, 95% confidence interval 5.5 to 6.9, after adjustment for age, sex, education, immigrant status, and co-occurring psychiatric morbidity), and 333 (87%) did so with a year after the index attempt. For other methods (gassing, jumping from a height, using a firearm or explosive, or drowning), risks were significantly lower than for hanging but still raised at 1.8 to 4.0. Cutting, other methods, and late effect of suicide attempt or other self inflicted harm conferred risks at levels similar to that for the reference category of poisoning (used by 84%). Most of those who successfully committed suicide used the same method as they did at the index attempt-for example, >90% for hanging in men and women.

CONCLUSION:

The method used at an unsuccessful suicide attempt predicts later completed suicide, after adjustment for sociodemographic confounding and psychiatric disorder. Intensified aftercare is warranted after suicide attempts involving hanging, drowning, firearms or explosives, jumping from a height, or gassing.