Abstract: Most studies aimed at understanding suicidal behavior have focused on quantifying the associations between putative risk factors and suicidal behavior in comparative studies of cases and controls. The current study, in comparison, exclusively focused on cases—89 Army soldiers presenting for hospital care following a suicide attempt—and attempted to reveal the antecedents of, reasons for, and consequences of suicide attempts. This mixed-methods study using qualitative interviews and self-report surveys/interviews revealed that in most cases, the most recent onset of suicidal thoughts began shortly before the suicide attempt and were not disclosed to others, limiting opportunities for intervention via traditional approaches. The primary reason given for attempting suicide was to escape from psychologically aversive conditions after concluding that no other effective strategies or options were available. Participants reported both negative (e.g., self-view, guilt) and positive (e.g., learning new skills, receiving support) consequences of their suicide attempt—and described things they believe would have prevented them from making the attempt. These findings provide new insights into the motivational and contextual factors for suicidal behavior and highlight several novel directions for prevention and intervention efforts.