The method also involves a lot of time and planning, Dr. Lavonas added.
"There are a lot of steps needed to research it, gather the materials, and set it up. These hours spent preparing indicate someone with very serious suicidality. Unfortunately, this nonimpulsive component means that it will be very difficult for the mental health community to impact."
Time is actually one of the most tragic issues about these acts, he said. "All of that time spent in preparation could have been spent in trying to get help."
Neither Dr. Lavonas nor Dr. Pepe had any financial declarations.