Recent statistical investigations show that nonfatal suicide attempts outnumber fatal ones seven or eight times. However, there is a higher percentage of fatalities among those people who have made a previous attempt. In addition to the usual wishes expressed in suicide, the author emphasizes the 'appeal for help', and suggests that the ambiguity of most suicidal acts is expressed as, 'I want to kill myself and should like to kill others with myself; I want to be dead, but if I should not die do something about me'. He points out that in most societies there is a powerful reaction to help someone who has made a suicide attempt and that when this does not happen, it indicates a highly abnormal situation. He suggests that even though the universality of this plea is not yet proven, it appears reasonable that 'a predictable effect of an action, even if it is only an alternative effect, is likely to play a part in its motivation'.