It is an all too common occurrence here in the United States: mass shootings occur, and the same sequence of events occur. First, there are outpourings of frustration, then grief, and then comes the political commentary. The course is tragically predictable, and even the ensuing debates feel tired. Columbine, Sandy Hook, The Pulse Nightclub, and mostly recently Stoneman Douglas High School; hidden behind these tragedies is the issue of Firearm suicide. According to a 2018 Journal of American Medical Association report, the United States has the 2nd highest gun death rate in the world; why is that the case? It is clear, we need more data to help us to understand.
Reviewing the available data on gun-related deaths yields important information. For example, approximately 2/3 of gun related deaths are suicides. The Centers For Disease Control and Prevention (2018) found that from 2012-2016, approximately 22,000 gun deaths occurred each year (93 deaths each day), with approximately 66% percent (58 deaths per day) caused by suicide. Through the “Means Matter” research program, the Harvard T.H. Chan School of Public Health (2018) further examined the staggering evidence about suicide. The data they present tell an important tale:
- 52% of US suicides are due to firearms, and 85% of firearm suicide attempts are fatal
- In firearm suicides among youth ages 17 and under, occurring over a 2 period in 4 states and 2 counties, 82% used a firearm belonging to a family member, usually a parent
Importantly, this research illustrates that the common thought, “they will just find another way to kill themselves,” is a misconception. Means Matter research also demonstrates that concepts such h as bridge nets can reduce suicide rates. Giving someone a moment of pause can have life saving potential. Locking guns in safes and using safety locks could give a suicidal individual a moment of pause. Also having an open and honest conversation about gun access reduces risk.
As professionals we have the opportunity to give suicidal individuals a moment of pause and reflection. We have a chance to intervene and educate people about lethal means. To reduce firearm suicide, this education can take place on all fronts – with parents, with gun owners, even with gun retailers. This discussion shouldn’t be about “taking sides” – it should be about providing potentially life saving education.
In light of this data on the characteristics of firearm suicide, stakeholders have thought about ways to engage with the gun-owning community as a critical part of a prevention strategy. For example, the American Foundation For Suicide Prevention and the National Shooting Sports Foundation (2018) have partnered to produce a series of educational materials. The focus of these materials is to educate gun shops and gun range owners about suicide with firearms, and prevention mechanisms.
Another example is Counseling on Access To Lethal Means (CALM), which assists licensed professionals on introducing this topic in a variety of settings. With the emphasis on shared decision-making, CALM may be a framework to reduce risk while in crisis, without taking away someone’s guns. It is important to note that these are programs are just beginning to take shape and research is still required.
The debate about firearm suicide can be nuanced and complex. Gun rights activists often confuse means restriction as in infringement on their 2nd Amendment rights. The solution to firearm suicide comes from a reliance on facts and a shared understanding of the public health problem. Through research, conversation, and program development we can reduce the daily toll guns take. We can move from having a debate about 2nd amendment rights to co-creating solutions with gun rights activists and measure their impact.
Where we Need More Research
- How can we measure the effectiveness of educational programs that bring together gun owners and suicide prevention specialists?
- What impact can healthcare systems have by adopting counseling on lethal means (CALM)?
- Centers for Disease Control and Prevention. National Centers for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System (WISQARS) (2018). Searched 2012-2016 data found at: https://wisqars-viz.cdc.gov/
- The Global Burden of Disease 2016 Injury Collaborators (2018). Global Mortality From Firearms, 1990-2016. JAMA.2018;320(8):792–814. doi:10.1001/jama.2018.10060 on September 13, 2018 found at: https://jamanetwork.com/journals/jama/fullarticle/2698492
- Harvard T.H. Chan School of Public Health (2018) “Means Matter” on September 13, 2018 found at: https://www.hsph.harvard.edu/means-matter/means-matter/
- National Shooting Sports Foundation (2018) “Suicide Prevention Program for Retailers and Gun Ranges” on September 13, 2018 found at: https://www.nssf.org/safety/suicide-prevention/
- Suicide Prevention Resource Center (2018) “Counseling on Access and Lethal Means” on September 13, 2018 found at: https://training.sprc.org/enrol/index.php?id=3