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Suicides often an impulse
Some suicide "completers" make repeated threats and carefully plan or time their actions. Others act in the heat of the moment, giving no warning.
Perversely, according to statistics collected by the Injury Control Research Center, those who act impulsively usually choose more lethal means and are significantly more likely to succeed on their first attempt.
Firearms are used in less than 1 percent of American suicide attempts, but 54 percent of those are suicide completions.
Most of those who kill themselves with firearms are impulsive. Statistically, they are far less likely to leave notes or to have risk factors including histories of depression, mental illness, previous attempts or substance abuse.
Of almost 200 people who survived attempted suicide by a firearm, 70 percent said they shot themselves less than an hour after making the decision, and more than 10 percent said less than five minutes.
Describing their experience later, most can't imagine why they did such a thing.
What if they'd had no gun? Could the availability of the means spur the act?
The British coal gas experience suggests it could.
The British used to cook and heat their homes with coal gas-fired stoves. Unburned coal-derived gas releases carbon monoxide, and those who impulsively decided to die could simply turn on the valve and stick their heads in the oven.
Prior to replacing coal gas, such suicides accounted for almost half of Britain's total.
When the phase-out was complete, the national suicide rate dropped by nearly a third and stayed there.
Two bridges span Rock Creek in northwest Washington, D.C. - the Ellington and the Taft. Both have identical 125-foot drops. Prior to 1985, both had concrete railings. The railing on the Taft was chest-high to an average man; the one on the Ellington was only waist-high.
Twice as many people jumped from the Ellington.
After an impenetrable suicide barrier was erected, jumping from the Ellington was eliminated. Jumping suicides in D.C. fell by exactly the percentage for which jumping from the Ellington had accounted.
Richard Seiden of the University of California-Berkeley, known for pioneering studies of suicide, tells of a young man apprehended on the eastern promenade of the Golden Gate Bridge after passers-by noticed disturbing behavior. He wanted to jump from the western promenade, but he was afraid to run across six lanes of traffic.
In Seiden's paper, Where Are They Now, he reported that less than 10 percent of those prevented from jumping from the Golden Gate subsequently killed themselves.
Seiden believes the obvious: People who attempt suicide aren't thinking clearly. Many fixate on Plan A, but have no Plan B. Confronted by an obstacle, most don't look for other means.
The impulsively suicidal can be stopped - by luck or intervention or anything that slows them down.
Those who carry out the impulse are most likely to create problems for the coroner.
Families are in anguish - and in denial. "It couldn't be suicide," they say. "He wasn't depressed or mentally ill. She never spoke of suicide. She left no note."
That's just the type of person most likely to succeed.
husercj@co.laplata.co.us
Dr. Carol J. Huser, a forensic pathologist, has served as La Plata County coroner since
January 2003.
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