Human beings engage in a wide range of self-injurious thoughts and behaviors. These range from risk taking (e.g., skydiving), through suicide ideation, instrumental suicide-related behavior (e.g., suicide threats) to suicidal acts (attempted and completed). Suicide involves self-chosen behavior intended to bring about one's death in the shortest term. Each year, at least half a million people worldwide end their own lives. Difficulties in identifying unequivocal evidence of intent underpin the generally accepted view that official statistics underestimate the true suicide rate by an unknown amount. The presence of a note or letter often provides the clearest evidence of intent, but less than 30% of those who die by their own hand leave such a communication. Differing legal and ascertainment procedures account for some of the ...

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