When a suicidal thought comes up, tell one person near you first, and hand over those next few dozen minutes

High value
Evidence B
Buys life
Free
Takes minutes
Some willpower

In plain words

Among people who survived a suicide attempt, nearly half said that no more than 10 minutes passed between the thought first appearing and acting on it, so what has to be gotten through is often just those few dozen minutes. Three-quarters had some contact with people around them during that time; they just didn't say anything. Among people admitted to hospital for self-harm, about 2% died by suicide within 1 year and about 7% after 9 or more years; the great majority did not later die by suicide.

Cost: Free. The hard part is speaking up in the moment, and admitting that you shouldn't be alone for the next few hours.
What you get: 82 people who had attempted suicide were interviewed within 3 days of admission: 47.6% (39 people) said that from the first time suicidal thoughts appeared on this occasion to actually acting took no more than 10 minutes. Those whose process lasted longer had clearly higher scores for suicidal intent. Scores on an impulsivity scale had no relationship to how long the process took. 76.8% (63 people) said they had some contact with a partner, family member or friend during this time. The authors concluded that the window for intervention is usually very short and professionals have limited room to step in at this stage, so recognizing the signs and ways to intervene should be spread among ordinary people. A separate systematic review pooled 90 follow-up studies. Among people seen for self-harm, the median share who harmed themselves again without dying within 1 year was 16%. The share who died by suicide within 1 year was 2%. With follow-up of 9 years or more, about 7% died by suicide.
Notes: Why grade B: the Deisenhammer study had only 82 people, came from one hospital, and relied on people's recollection afterward. The Owens paper gives a median of the shares from 90 studies done in different ways, not a single combined figure. The same paper also states clearly that the suicide risk of people who self-harm is still several hundred times that of the general population. So “the great majority did not later die by suicide” describes this group as a whole and can't be taken as a guarantee for any one person; the care they need should still be sought. For moving lethal means farther away, and for 12356, see §1.25. For the first things to do when your mood is low, see §3.18. For the lasting damage after being saved, see §1.33. If you suspect someone close to you has such thoughts, you can ask them directly; see §1.43 (ask people close to you who seem off). For what you can do when someone close to you lets such thoughts show, see §8.15.
Evidence grade: B : Supported by research but without a precise number, or based on small or single studies.
Sources: 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

Mentioned in

Translated from the Chinese original. Original book, section 1, tip 32. This section is about health and medicines. It is general information, not a substitute for a doctor’s diagnosis or prescription. 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