i often wondered that too. I'm not sure because I really think that sometimes the state of mind that occurs with some people during a time of contemplating self harm or suicide its not really a choice or have to do it type of thing.

I don't wanna be flamed for this comment but when I was self harming and had suicidal thoughts, i don't think my state of mind was thinking about choosing, nor was it compelled to have to do harm either.

My state of mind was so frantic to stop the pain and thoughts. That when I self harmed i just wasn't thinking clearly but rather a compulsion to get rid of pain. So similar to 'have to do' but without the cognitive effort to reach a decision. Hope this makes sense.

Good topic