When It Is Darkest by Rory O' Connor

Author:Rory O' Connor [O’Connor, Rory]
Language: eng
Format: epub
ISBN: 9781473583467
Publisher: Ebury Publishing
Published: 2021-05-06T00:00:00+00:00

Past Suicidal Behaviour

The eighth and final volitional factor is arguably the most important because we know that if someone crosses the precipice from thoughts to acts of suicide once, they are more likely to do so again. Put simply and as I’ve said elsewhere, past suicidal behaviour is one of the best predictors of future suicidal behaviour.70 Despite the latter statement being scientifically accurate, however, I need to add two caveats:

1. You may remember that, earlier in this book, I said that our ability to predict suicide is no better than chance, no more accurate than the toss of a coin.71 This is true. Nonetheless, it still doesn’t prevent a past history of suicide attempts or self-harm being one of the single best predictors of suicide. Statistically speaking, if you engage in suicidal behaviour once, then you are more likely to do so again. And it doesn’t seem to make a difference whether the past self-injurious behaviour was suicidal in intent (suicide attempt) or not (non-suicidal self-harm).72 Take all acts of self-injurious behaviour seriously.

2. Statistical risk isn’t the same as clinical risk. Do you remember the section on the difference between absolute versus relative risk from earlier (page 154)? Relative risk can sound really scary even when the absolute risk is relatively low. It is important to hold on to the fact that the vast majority of people who engage in suicidal behaviour will never attempt suicide or self-harm again, nor will they end their life by suicide. So, the absolute risk of suicide is low. In our clinical studies, between 20 and 30 per cent of people who are admitted to hospital following a suicide attempt are treated again for another suicide attempt within 12 months and very much fewer than 1 per cent will die by suicide.73

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