Treat the first ten years after becoming disabled as a high-risk period for suicide, and don't write it off as something “cheer up” will fix

High value
Evidence A
Buys life
Free
Takes minutes
Some willpower

In plain words

In the first few years after a disability, it is common for the person or their family to fall apart emotionally; it is not a matter of willpower. A long-term follow-up at two spinal cord injury centers in the U.K. found that the suicide rate in this group was 5 times that of the general population. More than 90% of the suicides happened in the first ten years after the injury. For people whose injury was itself a suicide attempt, the risk is higher still.

Cost: Free. Make one phone call, or book one appointment.
What you get: The study followed 2304 patients with traumatic spinal cord injury who were newly admitted from 1991 to 2010, survived the first year after injury, and had a neurological deficit at discharge, with follow-up through the end of 2014. Of these, 63 (2.7%) had an injury that was itself a suicide attempt. By the end of follow-up 533 had died, 4.2% of them by suicide, and 91% of the suicides came in the first ten years after injury. The age-standardized suicide death rate was 62.5 per 100,000 people (10万) per year (95% CI 36.4–88.6, a range of plausible values), 5 times the suicide rate of the general population of England and Wales in 2014 (12.2 per 100,000). For those injured through a suicide attempt, compared with other causes of injury, the odds ratio for death was 4.32 (P<0.001) and for suicide 9.46 (P<0.001).
Notes: This study looked only at spinal cord injury, so applying it to other causes of disability such as blindness, amputation or burns is extending it beyond what it covers. What it does show is the time window: the risk does not end at discharge, and it needs watching for ten years. To have someone talk with you, call 12356 (China's national mental-health hotline); see §29.11 (12356). Don't stockpile sleeping pills or pesticides at home; see §1.25 (suicidal thoughts). If grief and low mood are still stuck after half a year, book a psychiatry or clinical psychology appointment; see §29.8 (grief that lasts past half a year).
Evidence grade: A : Specific numbers from meta-analyses, large cohorts or randomized trials; for law and policy, the statute or official text.
Sources: Savic G, DeVivo MJ, Frankel HL, Jamous MA, Soni BM, Charlifue S (2018). Suicide and traumatic spinal cord injury - a cohort study. Spinal Cord, 56(1):2-6. https://doi.org/10.1038/sc.2017.98

Translated from the Chinese original. Original book, section 33, tip 2. Content may be out of date and rules differ by place. When you actually deal with an agency, a doctor or a court, follow what local officials, doctors and lawyers tell you. Disclaimer