Nearly all patients who express suicidal thoughts to their GP or psychiatrist will not go on to suicide — yet most people who do die by suicide deny suicidal ideation, a landmark Australian study shows.

The findings, published in BJPsych Open, raise questions about the long-held view that a patient’s risk of suicide can be accurately predicted by clinicians asking about them about suicidal thoughts.

A meta-analysis of 71 studies, covering a total of 4.7 million participants, shows suicidal ideation as a standalone test correctly predicts suicide in only 2% of patients, and that about 60% of people who take their own lives deny having suicidal thoughts when asked by their doctor.

About 80% of people who take their own lives have not expressed any suicidal ideation, the analysis found.