Professor Ella Arensman:

I want to complement that information further by bringing in an important evidence base which has been extremely consistent in our research over the past 35 years. We have done several studies on people who survived a highly lethal act of attempted suicide. What seems to be very consistent and particular about the profile is that it features not only mental health conditions but clear comorbidities of severe physical health conditions, including cancer, chronic obstructive pulmonary disease and terminal illnesses, with mental health conditions. As was alluded to already, the risk of repeated self-harm or suicide is very high within the first three to six months following diagnosis. We have managed to interview many of those people through our research over the past 30 years. What has been very consistent in those in-depth interviews, which are sometimes three to four hours in length, is that following the survival of a highly lethal act of attempted suicide where the person has come very close to dying, the majority have reported various motives underlying the act. The majority report a wish to die, but we have not identified people who only reported a wish to die. There are always motives of having a glimmer of hope of some change, some successful intervention or another opening out of the negative cycle. In collaboration with at least six countries, including Australia, we came to defining that concept as ambivalence.

Working then with colleagues in psychiatry and psychology, we also detected there is very limited attention being paid to the complex concept of ambivalence. Our evidence shows it is highly prevalent and I would like people to take that into consideration.