What is the best predictor of a suicide attempt?

The best predictor of a suicide attempt is a previous suicide attempt. This is supported by extensive research indicating that individuals who have previously attempted suicide are at a significantly higher risk of attempting again in the future. This trend is attributed to various factors, including underlying mental health issues that may persist and lead individuals to attempt suicide multiple times. Historical behavior often serves as a strong indicator of future actions, as those with a previous attempt may continue to experience the same emotional distress, hopelessness, or other circumstances that contributed to their initial attempt.

While current mental health status, substance abuse history, and family history of suicide are important variables to consider, they do not have the same level of predictive power in assessing risk as a prior attempt does. Current mental health status can fluctuate and may not always capture the individual's long-term risk. Similarly, substance abuse and family history play significant roles in risk assessment but are seen as contributing factors rather than determinative predictors. The history of a previous suicide attempt remains the most direct and critical warning sign in this context.