The women were identified from the Prison Service database of self-harm incidents as having received oxygen/resuscitation or treatment at an outside hospital. They had all been contacted by suicide prevention coordinators at each prison to discuss participation in this study. Interviews were semistructured and focused on the women's own accounts of the "near miss" incident, including intentions and motivations, factors leading up to the incident, experiences of care and support, and suggestions for prevention. Fourteen of the 15 women stated they had intended to kill themselves. Several of the women had planned the suicide attempt some days before the incident. Among the reasons for attempting suicide were chronic mental health problems and histories of abuse. Some precipitating factors were bullying and missed medication. Eleven of the women reported previous self-harm and/or suicide attempts, both outside and inside prison, often from an early age. A significant finding was the direct association made by at least six women between their suicidal behavior and previous sexual abuse, assault, or rape. One-third of the women linked their suicide attempt to bereavement, even though the significant death may have occurred some years ago. The authors recommend that prison staff receive training in the life events and precipitating factors that underlie suicide attempts and that information on such factors be routinely collected on inmates, followed by a professional assessment of suicide risk. Staff training should include warning signs for suicide and ways in which staff can provide support and activities proven to impede suicidal thoughts and plans. 13 references