Suicide terminology

Historically, suicide terminology has been rife with issues of nomenclature, connotation, and
outcomes,[1][2] and terminology describing suicide has often been defined differently
depending on the purpose of the definition (e.g., medical, legal, administrative). A lack of
agreed-upon nomenclature and operational definitions has complicated understanding. In
2007, attempts were made to reach some consensus.[2][3][4][5] There is also opposition to the
phrase "to commit suicide" as implying negative moral judgment and association with
criminal or sinful activity.

In 2020, research demonstrated that stigmatizing and other verbiage commonly used in
regard to suicide, such as reporting or sharing the method of suicide leads to a 13% increase
in the national suicide rate following highly publicized (celebrity) suicides as well as a 30%
increase in suicides using the same method as the public figure.[6]

Suicide-related ideations

Suicidal ideation is any self-reported thoughts of engaging in suicide-related behavior.[2]

Subtypes of suicide-related ideations depend on the presence or absence of suicidal intent.

To have suicidal intent is to have suicide or deliberate self-killing as one's purpose.[7] Intent
refers to the aim, purpose, or goal of the behavior rather than the behavior itself.[3] The term
connotes a conscious desire or wish to leave or escape from life, and also connotes a
resolve to act. This is contrasted with suicidal motivation, or the driving force behind ideation
or intent, which need not be conscious.

With no suicidal intention

Suicide-related ideation with no suicidal intention is when an individual has thoughts of
engaging in suicide-related behavior but has no intention to do so.[4]

With undetermined degree of suicidal intent

When an individual is unable to clarify whether suicidal intent was present or not, the term
undetermined degree of suicidal intent is used.[4]

With some suicidal intent

Suicide-related ideation with some suicidal intent is when an individual has thoughts of
engaging in suicide-related behavior and possesses suicidal intent.[4]

Suicide-related communications

Suicide-related communications are any interpersonal act of imparting, conveying, or

transmitting thoughts, wishes, desires, or intent for which there is evidence (either explicit or
implicit) that the act of communication is not itself a self-inflicted behavior or self-injurious.[4]
This broad definition includes two subsets.

A suicide threat is any interpersonal action, verbal or nonverbal, without a direct self-injurious
component, that a reasonable person would interpret as communicating or suggesting that
suicidal behavior might occur in the near future.[4]

A suicide plan is a proposed method of carrying out a design that will lead to a potentially
self-injurious outcome; a systematic formulation of a program of action that has the potential
for resulting in self-injury.[4]

With No Suicidal Intent

Suicide Threat, Type I

Suicide Threat, Type I is a suicide threat with no associated suicidal intent. The threat may be
verbal or nonverbal, passive or active.[4]

Suicide Plan, Type I

Suicide Plan, Type I is the expression of a definite plan to end one's life but with no suicidal
intent.[4]
With Undetermined Degree of Suicide Intent

Suicide Threat, Type II

Suicide Threat, Type II is a suicide threat with an undetermined level of suicidal intent. The
threat may be verbal or nonverbal, passive or covert.[4]

Suicide Plan, Type II

Suicide Plan, Type II is a proposed method of achieving a potentially self-injurious outcome

with an undetermined level of intent.[4]

With Some Degree of Suicidal Intent

Suicide Threat, Type III

Suicide Threat, Type III is a suicide threat with some degree of suicidal intent. The threat may
be verbal or nonverbal, passive or covert.[4]

Suicide Plan, Type III

Suicide Plan, Type III is a proposed method of achieving a potentially self-injurious outcome
with some suicidal intent.[4]

Suicide-related behaviors

Suicide related behavior is a self-inflicted, potentially injurious behavior for which there is
evidence (either explicit or implicit) either that: (a) the person wished to use the appearance
of intending to kill themselves in order to attain some other end; or (b) the person intended at
some undetermined or some known degree to kill themselves.[4] Suicide-related behaviors
can result in no injuries, injuries, or death. Suicide-related behaviors comprise self-harm, self-
inflicted unintentional death, undetermined suicide-related behaviors, self-inflicted death with
undetermined intent, suicide attempt, and suicide.

Self-harm is self-inflicted, potentially injurious behavior for which there is evidence (either
implicit or explicit) that the person did not intend to kill himself/herself (i.e., had no intent to
die).[4] Persons engage in self-harm behaviors for its own sake (e.g., to use pain as a
focusing stimulant, or due to a condition like trichotillomania), or when they wish to use the
appearance of intending to kill themselves in order to attain some other end (e.g., to seek
help, to punish themselves or others, to receive attention, or to regulate negative moods).
Self-harm may result in no injuries, injuries, or death.
Suicidal gestures are suicide-related behaviors that are carried out without suicidal intent. It is
considered a controversial term.[8] These behaviors may be labeled as Self Harm, Type I (no
injury) or Self-Harm, Type II (with injury), because the purpose of the behaviors is to alter
one's life circumstances (interpersonal or intrapersonal) in a manner without suicidal intent
but involving self-inflicted behaviors (whether or not it resulted in injuries). If there is an
undetermined degree of suicidal intent, it is labeled as Undetermined Suicide-Related
Behavior, Type I (no injury), or Undetermined Suicide-Related Behavior, Type II (with injury).[4]

With No Suicidal Intent

Self-Harm, Type I

Self-Harm, Type I is self-harm that has not resulted in injury.[4]

Self-Harm, Type II

Self-Harm, Type II is self-harm that has resulted in nonfatal injury.[4]

Self-Inflicted Unintentional Death

Self-Inflicted Unintentional Death, often called accidental suicide, is self-harm that has resulted
in death.[4] It is defined as from self-inflicted injury, poisoning, or suffocation where there is
evidence (either explicit or implicit) that there was no intent to die. This category includes
those injuries or poisonings described as unintended or accidental.

With Undetermined Degree of Suicide Intent

Suicide-related Behavior With Undetermined Degree of Suicide Intent is self-inflicted, potentially

injurious behavior where intent is unknown.[4]

Undetermined Suicide-Related Behavior, Type I

Undetermined Suicide-Related Behavior, Type I is self-injurious behavior that has not resulted
in injuries and for which the person is unable to admit positively to the intent to die or is
reluctant to admit positively to the intent to die due to other psychological states.[4]

Undetermined Suicide-Related Behavior, Type II

Undetermined Suicide-Related Behavior, Type II is self-injurious behavior that has resulted in

injuries and for which the person is unable to admit positively to the intent to die or is
reluctant to admit positively to the intent to die due to other psychological states.[4]
Self-Inflicted Death with Undetermined Intent

Self-Inflicted Death with Undetermined Intent is self-injurious behavior that has resulted in
fatal injury and for which intent is either equivocal or unknown.[4]

With Some Degree of Suicidal Intent

A suicide attempt is defined as a self-inflicted, potentially injurious behavior with a nonfatal

outcome for which there is evidence (either explicit or implicit) of intent to die. A suicide
attempt may result in no injuries, injuries, or death.[4]

Suicide Attempt, Type I

Suicide Attempt, Type I is a suicide attempt with some degree of suicidal intent and no
resultant injuries, regardless of the degree of injury or lethality of method.[4]

Suicide Attempt, Type II

Suicide Attempt, Type II is a suicide attempt with some degree of suicidal intent and resultant
injuries.[4]

Suicide

A suicide is a self-inflicted death with evidence (either explicit or implicit) of intent to die.[4]
The term completed suicide has also been used synonymously, but is generally believed to be
redundant and potentially pejorative, and, as such, is not recommended. Example: "John’s
death was a suicide." "John completed suicide."

Opposition to the term "commit" suicide

According to Fairbairn in his philosophical study of suicide published in 1995, "The most
common way of speaking about suicide is to talk of its being 'committed'."[9] An article
published in 2011 stated that, although "committed suicide" or similar descriptions continued
to be the norm in the English language, the phrase "committed" associates death by suicide,
or more accurately, death by mental illness, with criminal or sinful actions.[10] Research has
pointed out that this phrasing has become so entrenched in English vocabulary that it has
gained "a naturalness which implies a deceptive harmlessness."[10] Per
reportingonsuicide.org,[11]
 Certain phrases and words can further stigmatize suicide, spread
myths, and undermine suicide prevention objectives such as
"committed suicide" or referring to suicide as "successful,"
"unsuccessful" or a "failed attempt." Instead use, "died by suicide" or
"killed him/herself."

While common, Lebacqz & Englehardt argue that referring to suicide as an act "committed" is
hazardous to ethical clarity.[12] Others have also argued in favour of alternative language
regarding suicide, both in the interest of moral and ethical precision,[13][14] as well as
scientific and clinical clarity.[2][4] A United States Navy report urges against the use of the
term "committed suicide" on similar grounds, asserting that "suicide is better understood
when framed objectively within the context of behavioral health."[15]

The lack of clarity in English suicide terminology has been attributed to the connotations of
crime, dishonour, and sin that suicide may carry.[16][17] The German term Selbstmord begehen
is similar, denoting an act of commission.[14] Common language has been described as "
[portraying] suicide as a 'crime' to be 'committed' as is, for example, murder."[12] This is
despite the fact that suicide is largely no longer a crime,[13][18] and that, as noted suicidologist
Samuel Wallace wrote, "all suicide is neither abhorrent nor not; insane or not; selfish or not;
rational or not; justifiable or not."[19]

Canadian suicide prevention activist, P. Bonny Ball, commented that the alleged criminal
implications of suicide are a carryover from the Middle Ages when suicide was considered
"both illegal and sinful by the laws and religions of the time."[20] Sommer-Rotenberg had
similarly argued that "the act of self-killing was considered criminal because it was perceived
as transgressing the moral authority of God and the righteous feelings of humankind."[14]

Since "committing suicide" was akin to committing murder or rape, it has been argued that
they continue to be linked in some languages.[10] However, this common English expression
is not universal: "By contrast the French se suicider and the Italian uccidersi are reflexive.
Likewise in Hebrew: l'hit'abbed, 'to self-destroy,' is something one does to oneself, with no
implication of criminality"[14] and translates in meaning most closesly to "suicided".

Various alternatives have been proposed to alter the language regarding the act of suicide
from a variety of sectors – including government, journalism, community mental health
advocates, and the scientific community. Terms such as "death by suicide" have been
suggested to be more objective.[15] The World Health Organization has agreed that these
terms "are more accurate and less open to misinterpretation."[21]
As it applies to a direct clinical context, the widely cited Beck Classification of Suicidal
Behaviour exclusively uses the terminology of "complete suicide".[22] This classification was
revisited in a number of notable documents (such as the Operational Classification for
Determination of Suicide, the 'Tower of Babel' nomenclature, the WHO/EURO definitions, the
Columbia University suicidality classification, the CDC self-directed violence surveillance
system, and the Denver VA VISN 19 MIRECC self-directed violence classification system).[23]

Advocacy groups have suggested a variety of guidelines for suicide

terminology.[24][25][26][27][28][29] As it concerns media reporting of suicide, a key indicator of
guideline influence on language as it is practiced in that context reports including one by the
Annenberg School for Communication's Public Policy Center at the University of
Pennsylvania suggests that there is "evidence of a change in reporting practices following
the release of the new media guidelines".[30]

References

1. Archives of Suicide Research, 1997, vol. 3, pp. 139–151

2. O'Carroll et al. (1996). Beyond the Tower of Babel: A nomenclature for suicidology. Suicide and Life-
Threatening Behavior, 26(3), 237–252.

3. Silverman MM, Berman AL, Sanddal ND, et al. Rebuilding the Tower of Babel: a revised nomenclature
for the study of suicide and suicidal behaviors. Part 1: background, rationale, and methodology.
Suicide Life Threat Behav 2007; 37:248–63.

4. Silverman MM, Berman AL, Sanddal ND, et al. Rebuilding the Tower of Babel: a revised nomenclature
for the study of suicide and suicidal behaviors. Part 2: suicide-related ideations, communications, and
behaviors. Suicide Life Threat Behav 2007; 37:264–77.

5. Posner K, Oquendo MA, Gould M, et al. Columbia Classification Algorithm of Suicide Assessment (C-
CASA): classification of suicidal events in the FDA's pediatric suicidal
risk analysis of
antidepressants" Am J Psychiatry 2007; 164:1035–43.

6. Thomas Niederkrotenthaler; Marlies Braun; Jane Pirkis; Benedikt Till; Steven Stack; Mark Sinyor;
Ulrich S Tran; Martin Voracek; Qijin Cheng; Florian Arendt; Sebastian Scherr; Paul S F Yip; Matthew J
Spittal (18 March 2020). "Association between suicide reporting in the media and suicide: systematic
review and meta-analysis" (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190013) . BMJ. 368:
m575. doi:10.1136/bmj.m575 (https://doi.org/10.1136%2Fbmj.m575) . PMC 7190013 (https://www.
ncbi.nlm.nih.gov/pmc/articles/PMC7190013) . PMID 32188637 (https://pubmed.ncbi.nlm.nih.gov/3
2188637) .

7. Leenars, A. A. (2004). Psychotherapy with suicidal people. West Sussex, UK: John Wiley & Sons.
 8. Heilbron, Nicole; Compton, Jill S.; Daniel, Stephanie S.; Goldston, David B. (2010-06-01). "The
Problematic Label of Suicide Gesture: Alternatives for Clinical Research and Practice" (https://www.n
cbi.nlm.nih.gov/pmc/articles/PMC2904564) . Professional Psychology: Research and Practice. 41
(3): 221–227. doi:10.1037/a0018712 (https://doi.org/10.1037%2Fa0018712) . ISSN 0735-7028 (htt
ps://www.worldcat.org/issn/0735-7028) . PMC 2904564 (https://www.ncbi.nlm.nih.gov/pmc/article
s/PMC2904564) . PMID 20640243 (https://pubmed.ncbi.nlm.nih.gov/20640243) .

9. Fairbairn, Gavin J (1995). Contemplating Suicide: The Language and Ethics of Self-Harm (https://boo
ks.google.com/books?id=rorke-SCOaYC) . London: Routledge. p. 34. ISBN 978-0415106061.

10. Olson, Robert (2011). "Suicide and Language" (https://www.suicideinfo.ca/wp-content/uploads/201

6/08/IE3.pdf) (PDF). Centre for Suicide Prevention. InfoExchange (3): 4. Retrieved 15 May 2013.

11. "Best Practices and Recommendations for Reporting on Suicide" (https://reportingonsuicide.org/wp-c

ontent/themes/ros2015/assets/images/Recommendations-eng.pdf) (PDF). reportingonsuicide.org.

12. Lebacqz, K. & Englehardt, H.T. (1980). "Suicide and covenant" (https://archive.org/details/suicidephilo
soph00batt/page/672) . In Battin, M.P. & Mayo, D.J. (eds.). Suicide: the philosophical issues. New
York: St. Martin's. p. 672 (https://archive.org/details/suicidephilosoph00batt/page/672) . ISBN 978-
0312775315.

13. Beaton, Susan; Forster, Peter; Maple, Myfanwy (February 2013). "Suicide and Language: Why we
Shouldn't Use the 'C' Word" (http://www.psychology.org.au/Content.aspx?ID=5048) . In Psych. 35
(1): 30–31.

14. Sommer-Rotenberg, D. (11 August 1998). "Suicide and language" (http://www.cmaj.ca/content/159/

3/239.full.pdf+html?sid=a8e8bfae-6950-4f93-92fe-9c612f41229b) . Canadian Medical Association
Journal. 159 (3): 239–40. PMC 1229556 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC122955
6) . PMID 9724978 (https://pubmed.ncbi.nlm.nih.gov/9724978) . Retrieved 15 May 2013.

15. "What's in a word? How we talk about Suicide" (http://www.public.navy.mil/bupers-npc/support/suici

de_prevention/HowToHelp/Documents/What's%20in%20a%20Word%20(Gen).pdf) (PDF). Navy
Suicide Prevention. United States Navy: Navy Personnel Command. Retrieved 16 May 2013.

16. Silverman, M.M. (October 2006). "The Language of Suicidology". Suicide and Life-Threatening
Behavior. 36 (5): 519–532. doi:10.1521/suli.2006.36.5.519 (https://doi.org/10.1521%2Fsuli.2006.36.
5.519) . PMID 17087631 (https://pubmed.ncbi.nlm.nih.gov/17087631) .

17. "Reporting on Suicide: Recommendations for the Media" (https://web.archive.org/web/20130530170

905/http://www.sprc.org/sites/sprc.org/files/library/sreporting.pdf) (PDF). Suicide Prevention
Resource Center. 2001. Archived from the original (http://www.sprc.org/sites/sprc.org/files/library/sr
eporting.pdf) (PDF) on 2013-05-30. Retrieved 16 May 2013.

18. "What's in a word? The Language of Suicide" (http://www.albertahealthservices.ca/MentalHealthWell

ness/hi-mhw-sps-language-of-suicide-1p.pdf) (PDF). Alberta Health Services. 2009. Retrieved
15 May 2013.
19. Wallace, S.E. (1999). "The Moral Imperative to Suicide" (https://archive.org/details/contemporarypers
0000unse_n8s8/page/48) . In Werth, J.L. Jr. (ed.). Contemporary Perspectives on Rational Suicide.
Philadelphia: Taylor & Francis. pp. 48–53 (https://archive.org/details/contemporarypers0000unse_n8
s8/page/48) . ISBN 978-0876309377.

20. Ball, P. Bonny (2005). "The Power of words" (https://web.archive.org/web/20130513011216/http://w

ww.suicideprevention.ca/about-suicide/the-power-of-words/) . Canadian Association of Suicide
Prevention. Archived from the original (http://www.suicideprevention.ca/about-suicide/the-power-of-
words/) on 13 May 2013. Retrieved 16 May 2013.

21. Preventing suicide : a resource for media professionals (https://www.who.int/mental_health/preventi

on/suicide/resource_media.pdf) (PDF). Geneva: World Health Organization. 2008. p. 8. ISBN 978-
92-4-159707-4.

22. Beck, A.T.; Resnik, H.L.P. & Lettieri, D.J, eds. (1974). "Development of suicidal intent scales". The
prediction of suicide. Bowie, MD: Charles Press. p. 41. ISBN 978-0913486139.

23. O'Connor, R.C.; Platt, S. & Gordon, J., eds. (2011). "Challenges to Classifying Suicidal Ideations,
Communications, and Behaviours". International Handbook of Suicide Prevention: Research, Policy &
Practice (https://archive.org/details/internationalhan00ocon) . Oxford: John Wiley & Sons. pp. 18 (ht
tps://archive.org/details/internationalhan00ocon/page/n41) –21. ISBN 978-0470683842.

24. Brenner, L.A.; Silverman, M.M.; Betthauser, L.M.; Breshears, R.E.; Bellon, K.K.; Nagamoto, H.T. (2010).
"Suicide Nomenclature – 2010 Suicide Prevention Conference" (https://www.dcoe.health.mil/Conten
t/navigation/documents/SPC2010/Jan11/1000-1130/Silverman%20Brenner%20Crosby%20A%20Brie
f%20History%20of%20Nomenclature%20and%20Classification%20Systems%20in%20the%20Field%2
0of%20Suicidology.pdf) (PDF). Denver: Department of Defense; Defense Centres of Excellence for
Psychological Health and Traumatic Brain Injury. Retrieved 17 May 2013.

25. Brenner, L.A.; Breshears, R.E.; Betthauser, L.M.; Bellon, K.K.; Holman, E.; Harwood, J.E.; Silverman,
M.M.; Huggins, J.; Nagamoto, H.T. (June 2011). "Implementation of a suicide nomenclature within
two VA healthcare settings". Journal of Clinical Psychology in Medical Settings. 18 (2): 116–28.
doi:10.1007/s10880-011-9240-9 (https://doi.org/10.1007%2Fs10880-011-9240-9) . PMID 21626353
(https://pubmed.ncbi.nlm.nih.gov/21626353) . S2CID 22877623 (https://api.semanticscholar.org/C
orpusID:22877623) .

26. Centre for Suicide Research (September 2012). "Media and Suicidal Behaviour: Guidelines and other
information" (http://cebmh.warne.ox.ac.uk/csr/linksmedia.html) . University of Oxford. Retrieved
18 May 2013.

27. Media Guidelines for the Reporting of Suicide: 2009 Media Guidelines for Ireland (http://www.samarit
ans.org/sites/default/files/kcfinder/files/press/Irish%20Media%20Guidelines%202009.pdf) (PDF).
Samaritans Ireland. 2009.

28. IASP Task Force – Suicide and the Media. "Media Guidelines & Other Resources" (http://www.iasp.inf
o/media_guidelines.php) . International Association for Suicide Prevention. Retrieved 15 May 2013.
29. Suicide Prevention: Guidelines for Public Awareness and Education Activities (https://www.gov.mb.c
a/healthyliving/mh/docs/spg.pdf) (PDF). Government of Manitoba. 2011.

30. "New Guidelines Developed to Promote Responsible Media Coverage of Suicides" (http://pweb1.rwjf.
org/reports/grr/042328.htm) . Robert Wood Johnson Foundation. March 2007. Retrieved 15 May
2013.

Retrieved from
"https://en.wikipedia.org/w/index.php?
title=Suicide_terminology&oldid=1123838622"

Last edited 1 month ago by 2600:8804:A91:3300:3420:5396:2C89:D9BD