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DeBastiani, Summer and De Santis, Joseph P 2018. Suicide Lethality: A Concept Analysis. Issues in Mental Health Nursing, Vol. 39, Issue. 2, p. 117.
Kunde, Lisa Kõlves, Kairi Kelly, Brian Reddy, Prasuna and de Leo, Diego 2018. “The Masks We Wear”: A Qualitative Study of Suicide in Australian Farmers. The Journal of Rural Health,
Park, C. Hyung Keun Yoo, Seong Ho Lee, Jaewon Cho, Sung Joon Shin, Min-Sup Kim, Eun Young Kim, Se Hyun Ham, Keunsoo and Ahn, Yong Min 2017. Impact of acute alcohol consumption on lethality of suicide methods. Comprehensive Psychiatry, Vol. 75, p. 27.
Mackenzie, J.C. Cartwright, T. and Borrill, J. 2017. Exploring suicidal behaviours by probation clients—a qualitative near-lethal study. Journal of Public Health, p. 1.
Der, Edmund M Dakwah, Irene A Derkyi-Kwarteng, Leonard and Badu, Akosa A 2016. Hanging as a method of suicide in Ghana: A 10 year autopsy study. Pathology Discovery, Vol. 4, Issue. 1, p. 2.
Deisenhammer, Eberhard A. Behrndt, Elisa-Marie Kemmler, Georg Haring, Christian and Miller, Carl 2016. A comparison of suicides in psychiatric in-patients, after discharge and in not recently hospitalized individuals. Comprehensive Psychiatry, Vol. 69, p. 100.
Arensman, Ella Bennardi, Marco Larkin, Celine Wall, Amanda McAuliffe, Carmel McCarthy, Jacklyn Williamson, Eileen Perry, Ivan J. and Vollmer-Conna, Ute 2016. Suicide among Young People and Adults in Ireland: Method Characteristics, Toxicological Analysis and Substance Abuse Histories Compared. PLOS ONE, Vol. 11, Issue. 11, p. e0166881.
Park, Subin Lee, Hochang Benjamin Lee, Su Yeon Lee, Go Eun Ahn, Myung Hee Yi, Ki Kyoung and Hong, Jin Pyo 2016. Trends in Suicide Methods and Rates among Older Adults in South Korea: A Comparison with Japan. Psychiatry Investigation, Vol. 13, Issue. 2, p. 184.
Kim, Ha Yun and Nam, Eun Woo 2016. Factors related to suicidal ideation by gender among adolescents in Peru : Focused on baseline survey for adolescents in poor urban area of Peru. Korean Journal of Health Education and Promotion, Vol. 33, Issue. 1, p. 71.
Kanamüller, Juha Riipinen, Pirkko Riala, Kaisa Paloneva, Eero and Hakko, Helinä 2016. Hanging suicides in northern Finland: A descriptive epidemiological study. Death Studies, Vol. 40, Issue. 4, p. 205.
Orellana, Jesem D. Balieiro, Antônio A. Fonseca, Fernanda R. Basta, Paulo C. and Souza, Maximiliano L. Ponte de 2016. Spatial-temporal trends and risk of suicide in Central Brazil: an ecological study contrasting indigenous and non-indigenous populations. Revista Brasileira de Psiquiatria, Vol. 38, Issue. 3, p. 222.
Kim, Jinyoung Kim, Minseob Kim, Yoo-ra Choi, Kyoung Ho and Lee, Kyoung-Uk 2015. High Prevalence of Psychotropics Overdose among Suicide Attempters in Korea. Clinical Psychopharmacology and Neuroscience, Vol. 13, Issue. 3, p. 302.
Hassamal, Sameer Keyser-Marcus, Lori Crouse Breden, Ericka Hobron, Kathrin Bhattachan, Atit and Pandurangi, Ananda 2015. A Brief Analysis of Suicide Methods and Trends in Virginia from 2003 to 2012. BioMed Research International, Vol. 2015, p. 1.
Bhosle, S.H. Zanjad, N.P. Dake, M.D. and Godbole, H.V. 2015. Deaths due to hanging among adolescents – A 10-year retrospective study. Journal of Forensic and Legal Medicine, Vol. 29, p. 30.
Oh, Sang Lee, Kyoung Kim, Soo Park, Kyu Kim, Young and Kim, Han 2014. Factors associated with choice of high lethality methods in suicide attempters: a cross-sectional study. International Journal of Mental Health Systems, Vol. 8, Issue. 1, p. 43.
Park, Subin Ahn, Myung Lee, Ahrong and Hong, Jin 2014. Associations between changes in the pattern of suicide methods and rates in Korea, the US, and Finland. International Journal of Mental Health Systems, Vol. 8, Issue. 1, p. 22.
Lee, Chun-Yi Wu, Ya-Wen Chen, Chih-Ken and Wang, Liang-Jen 2014. The Rate of Fatality and Demographic Characteristics Associated With Various Suicide Methods. Crisis, Vol. 35, Issue. 4, p. 245.
Thomas, Kyla H. Beech, Ed and Gunnell, David 2013. Changes in commonly used methods of suicide in England and Wales from 1901–1907 to 2001–2007. Journal of Affective Disorders, Vol. 144, Issue. 3, p. 235.
Hanging is the most frequently used method of suicide in the UK and has high case fatality (>70%).
To explore factors influencing the decision to use hanging.
Semi-structured qualitative interviews with 12 men and 10 women who had survived a near-fatal suicide attempt. Eight respondents had attempted hanging. Data were analysed thematically and with constant comparison.
Hanging was adopted or contemplated for two main reasons: the anticipated nature of a death from hanging; and accessibility. Those favouring hanging anticipated a certain, rapid and painless death with little awareness of dying and believed it was a ‘clean’ method that would not damage the body or leave harrowing images for others. Materials for hanging were easily accessed and respondents considered it ‘simple’ to perform without the need for planning or technical knowledge. Hanging was thus seen as the ‘quickest’ and ‘easiest’ method with few barriers to completion and sometimes adopted despite not being a first choice. Respondents who rejected hanging recognised it could be slow, painful and ‘messy’, and thought technical knowledge was needed for implementation.
Prevention strategies should focus on countering perceptions of hanging as a clean, painless and rapid method that is easily implemented. However, care is needed in the delivery of such messages as some individuals could gain information that might facilitate fatal implementation. Detailed research needs to focus on developing and evaluating interventions that can manage this tension.
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DeBastiani, Summer and De Santis, Joseph P 2018. Suicide Lethality: A Concept Analysis. Issues in Mental Health Nursing, Vol. 39, Issue. 2, p. 117.
Kunde, Lisa Kõlves, Kairi Kelly, Brian Reddy, Prasuna and de Leo, Diego 2018. “The Masks We Wear”: A Qualitative Study of Suicide in Australian Farmers. The Journal of Rural Health,
Park, C. Hyung Keun Yoo, Seong Ho Lee, Jaewon Cho, Sung Joon Shin, Min-Sup Kim, Eun Young Kim, Se Hyun Ham, Keunsoo and Ahn, Yong Min 2017. Impact of acute alcohol consumption on lethality of suicide methods. Comprehensive Psychiatry, Vol. 75, p. 27.
Mackenzie, J.C. Cartwright, T. and Borrill, J. 2017. Exploring suicidal behaviours by probation clients—a qualitative near-lethal study. Journal of Public Health, p. 1.
Der, Edmund M Dakwah, Irene A Derkyi-Kwarteng, Leonard and Badu, Akosa A 2016. Hanging as a method of suicide in Ghana: A 10 year autopsy study. Pathology Discovery, Vol. 4, Issue. 1, p. 2.
Deisenhammer, Eberhard A. Behrndt, Elisa-Marie Kemmler, Georg Haring, Christian and Miller, Carl 2016. A comparison of suicides in psychiatric in-patients, after discharge and in not recently hospitalized individuals. Comprehensive Psychiatry, Vol. 69, p. 100.
Arensman, Ella Bennardi, Marco Larkin, Celine Wall, Amanda McAuliffe, Carmel McCarthy, Jacklyn Williamson, Eileen Perry, Ivan J. and Vollmer-Conna, Ute 2016. Suicide among Young People and Adults in Ireland: Method Characteristics, Toxicological Analysis and Substance Abuse Histories Compared. PLOS ONE, Vol. 11, Issue. 11, p. e0166881.
Park, Subin Lee, Hochang Benjamin Lee, Su Yeon Lee, Go Eun Ahn, Myung Hee Yi, Ki Kyoung and Hong, Jin Pyo 2016. Trends in Suicide Methods and Rates among Older Adults in South Korea: A Comparison with Japan. Psychiatry Investigation, Vol. 13, Issue. 2, p. 184.
Kim, Ha Yun and Nam, Eun Woo 2016. Factors related to suicidal ideation by gender among adolescents in Peru : Focused on baseline survey for adolescents in poor urban area of Peru. Korean Journal of Health Education and Promotion, Vol. 33, Issue. 1, p. 71.
Kanamüller, Juha Riipinen, Pirkko Riala, Kaisa Paloneva, Eero and Hakko, Helinä 2016. Hanging suicides in northern Finland: A descriptive epidemiological study. Death Studies, Vol. 40, Issue. 4, p. 205.
Orellana, Jesem D. Balieiro, Antônio A. Fonseca, Fernanda R. Basta, Paulo C. and Souza, Maximiliano L. Ponte de 2016. Spatial-temporal trends and risk of suicide in Central Brazil: an ecological study contrasting indigenous and non-indigenous populations. Revista Brasileira de Psiquiatria, Vol. 38, Issue. 3, p. 222.
Kim, Jinyoung Kim, Minseob Kim, Yoo-ra Choi, Kyoung Ho and Lee, Kyoung-Uk 2015. High Prevalence of Psychotropics Overdose among Suicide Attempters in Korea. Clinical Psychopharmacology and Neuroscience, Vol. 13, Issue. 3, p. 302.
Hassamal, Sameer Keyser-Marcus, Lori Crouse Breden, Ericka Hobron, Kathrin Bhattachan, Atit and Pandurangi, Ananda 2015. A Brief Analysis of Suicide Methods and Trends in Virginia from 2003 to 2012. BioMed Research International, Vol. 2015, p. 1.
Bhosle, S.H. Zanjad, N.P. Dake, M.D. and Godbole, H.V. 2015. Deaths due to hanging among adolescents – A 10-year retrospective study. Journal of Forensic and Legal Medicine, Vol. 29, p. 30.
Oh, Sang Lee, Kyoung Kim, Soo Park, Kyu Kim, Young and Kim, Han 2014. Factors associated with choice of high lethality methods in suicide attempters: a cross-sectional study. International Journal of Mental Health Systems, Vol. 8, Issue. 1, p. 43.
Park, Subin Ahn, Myung Lee, Ahrong and Hong, Jin 2014. Associations between changes in the pattern of suicide methods and rates in Korea, the US, and Finland. International Journal of Mental Health Systems, Vol. 8, Issue. 1, p. 22.
Lee, Chun-Yi Wu, Ya-Wen Chen, Chih-Ken and Wang, Liang-Jen 2014. The Rate of Fatality and Demographic Characteristics Associated With Various Suicide Methods. Crisis, Vol. 35, Issue. 4, p. 245.
Thomas, Kyla H. Beech, Ed and Gunnell, David 2013. Changes in commonly used methods of suicide in England and Wales from 1901–1907 to 2001–2007. Journal of Affective Disorders, Vol. 144, Issue. 3, p. 235.
Manjeet S. Bhatia, Professor & Head, Department of Psychiatry
26 January 2011
Lucy Biddle et al have excellently reviewed the important factors influencing the decision to use hanging as a method of suicide in U.K. There are some observations as related to hanging in India. The authors have mentioned that hanging has a high case fatality rate of 70%. It wouldhave been more informative if rest 30% have been analysed because in our study in India, hanging has a high case fatality rate of about 99%.In our analysis, hanging is viewed as a rapid,easily accessible, having high fatality and require no technical knowledge.Most of the patients have no knowledge whether it is painful or not. Those who reject hanging are ambivalent about committing suicide and also that if they use other methods e.g. poisoning, they might be saved. None of the patients view it as a slow or 'messy' as reported by authors. In conclusions, authors are not correct in mentioning that prevention strategies should focus on perceptions of hanging as a clean, painless and rapid method. Rather, prevention must focus on strategies to treat underlying cause and prevent suicide rather than substituting a method of suicide with another. ... More
Conflict of interest: None Declared
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