Published studies generally agree that the transition from suicidal ideation to suicide takes about a year. As always, these studies refer to large samples, so this is a helpful guideline for understanding the overall process. Clinical experience points in the same direction; the people we treat after a suicide attempt describe periods of months, even years, of suicidal thoughts before acting on them. Unfortunately, all too often, the suicide attempt is the first indication or communication to those around them of this internal process. It has been shown that suicide is not a sudden, impulsive act that we can do nothing about.

If we suspect a loved one is thinking about death, we should ask them, even if it's a difficult question. Not doing so is too risky.