Thanks for this. I run a suicide prevention charity which responds to suicidality using indigenous and sociological rather than medical approaches. The only thing I disagree with in your article is the statement that we can’t know why some with suicidal thoughts end their lives and why some don’t. My child killed himself 15 days after being prescribed Prozac. Both my government and Mylan Pharmacueticals conducted causality assessments and found the drug to be the probable cause of his suicide. In some cases, the reason people end their lives is because of the pharmacological treatment they are given. The Joiner model also explains some suicides as being a product of social isolation, a sense of being a burden and the ability to overcome the survival instinct through either the use of drugs or desensitisation to pain and suffering. My charity’s work suggests that along with these factors, those who die are distinguished by their lack of self efficacy. They do not believe they have the power to change the circumstances causing their suffering. In our experience, no matter how bad the situation, if people believe they are capable of changing their circumstances through their own efforts, they will survive.