In my experience in nursing, like you say some are cries for help, some are proper attempts to end a painful (in thier opinion) life. I've specialed many suicide watch patients when I was a nurse. I will add this, what they say can and does stay with you, but, I've seen the flip side, when a patient has recovered and thanks you for helping them. I know EMT's don't see this side as its the wards, but just imagine the person getting better and being grateful for the help they got at a dark time in thier lives