In the past, roulette has been found to be an extremely effective method of suicide
The odds are one in 1,000 that you will survive a Russian roulette roll (which is the figure derived from research published in 1995)
More interesting (and depressing) is how Russian roulette has been used as a means of suicide in Russia.
Russian Roulette Suicide Statistics. By Daphne T. Roper. National Institute of Mental Health. http://www.nimh.nih.gov/publications/news/russian_rookie_suicide_survey.pdf.
Here’s the first table with the number of deaths each year of Russian roulette-related suicides. I’m not going to link to the full version of the numbers but you can see from the first column, how many more than 100 people die from suicide each year in Russia compared to the amount the U.S. saw in 2012 of suicide by gunfire.
In Russia, there’s a gun homicide risk of 14 times higher than it is in the United States and a gun suicide risk of 9 times higher
That said, there’s another interesting study on the impact of Russian roulette that comes from the U.S., where researchers from the University of Minnesota looked at the issue with a different methodology. Here is the findings of the most recent study in the journal Injury Prevention:
Researchers conducted a multisite study using two methods, a self-report survey and a survey with a blood sample, in which individuals played Russian roulette every week for the duration of their lives. More than 1,000 participants were identified and followed up. More than 500 of those killed themselves, one-third of the participants killed themselves after one week of playing this game. The others did not. Researchers found that for players, roulette was associated with an overall risk of death of 14.3 per million. However, these participants were not selected at random, and the results were robust to adjustment for age, gender, and smoking. There was an increase in overall suicide risk among older players, and among both sexes. Interestingly, when participants were divided into those who had not played Russian roulette and those who had, people who played Russian roulette as teenagers or older tended to have twice the risk of death compared to those who had not. “Our results demonstrate that playing Russian roulette may have a high risk of suicidal behavior among older individuals,” the study concluded. This is the first study