The author, as well as some researchers, feels that that is due to a dichotomy in suicidal behavior, much as there is in homicide. He discusses a premeditation vs. passion division amongst deaths by suicide. The premeditated suicides are most easily impacted by programs, medications, and therapy. The passion or impulsive suicides not so much. His discussion resonates with my experience.
The impulsive suicides are best impacted by creating “barriers to suicide or means restriction”. This was well documented (and then ignored) in the 60s and 70s in Great Britain. Death by suicide dropped by a third with the change from coal-gas to natural gas stoves during those decades. In the 50s “sticking one’s head in the oven” accounted for half of all British suicides. "Many of those were impulsive acts using a means with little time for second thoughts". “Remove it, and the process slowed down; it allowed time for the dark passion to pass".
We need to modify how we address death by suicide, how we think about death by suicide. They are not homogenous (neither the individuals nor the methods) and likely require multiple, varied interventions. Youth particularly fall into the more impulsive category, making brief, timely interventions critical. This recognition of differences can lead to more successful intervention.
But never lose sight of the underlying condition:
"They had wanted their inner pain to stop; they wanted some measure of relief; and this was the only answer they could find. They were in spiritual agony, and they sought a physical solution."