Suicide: The Irreversible Option
If, in a morbid moment, you wonder who would be most likely to make an attempt on your life, look in the mirror. Your prospects of committing suicide are 70 percent greater than your chances of being murdered.
Every 17 minutes, on average, an American takes his or her own life and 25 others attempt to do so. With a toll of more than 30,000 lives a year in this country, suicide ranks eleventh among causes of death. Five million living Americans have survived suicide attempts – a number that grows by 765,000 each year  .
The rate of suicide has trended slightly downward over the past decade, from a high of 12.4 per 100,000 population in 1990 to 10.8 per 100,000 in 2001 – the last year for which complete statistics have been compiled.
Making that trend less encouraging than it might seem is the widely held belief that suicide is significantly underreported by the medico legal community – somewhere in the 10 to 50 percent range, by one authoritative estimate.  A number of factors are cited for this probable undercounting, including variations in state legal standards for a ruling of suicide, forms of suicide that mimic accidents or natural death, fatal patterns of risky behavior arising from suicidal impulses, and community and family pressure to avoid suicide rulings. Some experts believe that up to 15% of auto fatalities are actually suicides by vehicle. 
 Unless otherwise noted statistics in this monograph are from U.S.A Suicide: 2001 Official Final Data, in Vital Statistics of the United States, Mortality, 2001, National Center for Health Statistics, U.S. Department of Health and Human Services, Washington, D.C., 2003
 Rosenberg, et. al., Operational Criteria for Determining Suicide, Morbidity and Mortality Weekly Report, 37 (50), 773-774, 779-780, Washington, D.C.,1988
 Fine, Carla, No Time to Say Goodbye, Doubleday, 1997, cited by Jackson, Jeffrey, SOS, a Handbook for Survivors of Suicide, American Association of Suicidology, 2003, available from http://www.suicidology.org,, accessed 6/2/04