Tell someone nearby when suicidal thoughts arise; do not face the next few minutes alone

Cost: No monetary cost. The difficult part is speaking up and acknowledging that you should not be alone for the next few hours.

In plain language: In the small interview study described below, nearly half of people who survived a suicide attempt reported ten minutes or less between first considering that attempt and acting. Around three quarters had contact with someone close during that period. The source emphasizes reaching out during a potentially short crisis window. Follow-up statistics for people treated after self-harm describe groups, not a guarantee about an individual.

Findings reported by the source: Researchers interviewed 82 people within three days of admission after a suicide attempt. Of these, 47.6% (39 people) reported ten minutes or less from the first thought of that particular attempt to acting. Longer processes were associated with higher suicide-intent scores, while impulsivity-scale scores were not related to duration. Some 76.8% (63 people) reported contact with a partner, family member or friend during the period. The authors emphasized the short intervention window and the value of teaching ordinary people to recognize warning signs and intervene. A separate review of 90 follow-up studies reported median proportions of 16% for nonfatal repetition of self-harm at one year, 2% for suicide at one year and around 7% after follow-up of nine years or longer.

Source author's evidence grade: B; not site verification or professional approval.

Notes: The interview study involved only 82 people from one hospital and relied on retrospective recall. The review reported medians across heterogeneous studies, not a single pooled estimate. It also described suicide risk after self-harm as hundreds of times that of the general population. The fact that most people in a group did not later die by suicide is not reassurance about a particular person and does not remove the need for care. For distancing lethal means and China's 12356 support line, the source refers to this chapter's entry 25; for initial steps during low mood, chapter 3, entry 18; for consequences after survival, this chapter's entry 33. It refers to entry 43 on asking someone directly about suicidal thoughts and chapter 8, entry 15 on supporting someone who expresses them.

Original source bibliography (titles retained as supplied): Deisenhammer EA, Ing CM, Strauss R, Kemmler G, Hinterhuber H, Weiss EM (2009). The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt? Journal of Clinical Psychiatry, 70(1), 19-24. https://doi.org/10.4088/JCP.07m03904；Owens D, Horrocks J, House A (2002). Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry, 181, 193-199. https://doi.org/10.1192/bjp.181.3.193