Methods used in attempts may indicate the degree of risk An increasing number of nations are developing national strategies to try to prevent some of the estimated million suicides that occur annually throughout the world. Detection of people at risk is a key component of such programmes. Although attempted suicide (or self harm) is an important risk factor,1 the risk of suicide after attempted suicide seems to differ between countries. In the United Kingdom, the risk of suicide in the first year after self harm, although 60-100 times greater than in the general population,2 3 4 is much lower than that reported from other countries.4 In the linked cohort study (doi:10.1136/bmj.c3222), Runeson and colleagues assess the effect of the method of the attempted suicide on the risk of subsequent completed suicide.5 Using data from Swedish national case registers, the authors found that one in 10 people (12%) admitted to hospital after attempted suicide between 1973 and 1982 died by suicide during long term follow-up (to the end of 2003), 4.2% within the first year. These figures are three to four times greater than …