Background Although suicide is one of the leading causes of death worldwide, there is a need for studies to identify variables that can differentiate patients with suicide ideation at risk of transitioning to an attempt. Method In this study, we assessed suicide ideation and attempts, non‐suicidal self‐injury (NSSI), hopelessness, borderline symptoms and meaning in life in a sample of 348 patients with different diagnoses of mental disorders. We divided the sample into four subgroups: patients without suicide ideation or suicide attempts; patients with current suicide ideation; patients with lifetime suicide attempts and patients with a suicide attempt in the previous year. Results The group with suicide attempts in the previous year showed higher levels of hopelessness, borderline symptoms and NSSI, and lower levels of meaning in life than the other groups. Limitations Groups were composed of unequal numbers of patients, and in some of them, the sample size was small. The sample was composed mainly of women with eating disorders. The study design was retrospective, and so the results must be considered in terms of correlates. Conclusions Our results suggest that hopelessness, borderline symptoms—including NSSI—and meaning in life play a key role in suicide attempts. Thus, psychotherapeutic interventions should focus on managing NSSI, searching for meaning and managing emptiness, loss of control and feelings such as self‐contempt in patients with suicide ideation. Copyright © 2016 John Wiley & Sons, Ltd. Key Practitioner Message Recent suicide attempters show higher levels of hopelessness, borderline symptoms and NSSI than lifetime attempters and suicide ideators. Clinicians should focus attention on assessing hopelessness, borderline symptoms and NSSI in those with suicide ideation. Lower levels of meaning in life are related to recent suicide attempts. Levels of hopelessness differentiate between recent and lifetime suicide attempters.