Adolescents are prone to impulse, but adults tend to think about things before acting. Most adults who are suicidal plan their deaths. They think about how they want to do it, where, and when. The degree of planning is a strong indicator of the risk. The more concrete a person’s plan is, the more likely he or she is to implement it. This is why the first step for helpers is to assess the risk and determine if an attempt is imminent.

In terms of how, there are myriad options: a gun, knife, rope, pills, car, poisons, or jump site. Today, people have access to multiple means, so it becomes a matter of choice. Two factors go into the decision: Will death be quick, and will it be painless? Guns are lethal, but they leave a mess. The thought of cutting themselves is abhorrent to some people, while others........

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