Gun control, gun ownership, and suicide prevention

The relationship of the extent of gun ownership and the strictness of gun control laws to suicide and homicide rates in the nine major geographic regions of the United States was explored. Gun ownership, rather than the strictness of gun control laws, was found to be the strongest correlate of the rates of suicide and homicide by guns. Regions with a higher extent of gun ownership had higher rates of suicide and homicide by firearms.     

The Association Between Gun Ownership and Statewide Overall Suicide Rates

An extensive body of research has demonstrated an association between gun ownership and suicide that extends beyond the effects of a range of covariates. We aimed to expand on extant research by examining the extent to which gun ownership predicts statewide overall suicide rates beyond the effects of demographic, geographic, religious, psychopathological, and suicide‐related variables. By extending the list of covariates utilized, considering those covariates simultaneously, and using more recent data, we sought to present a more stringent test. Gun ownership predicted statewide overall suicide rates, with the full model accounting for more than 92% of the variance in statewide suicide rates. The correlation between firearm suicide rates and the overall suicide rate was significantly stronger than the correlation between nonfirearm suicide rates and the overall suicide rate. These findings support the notion that access to and familiarity with firearms serves as a robust risk factor for suicide. Therefore, means safety efforts aimed at reducing accessibility and increasing safe storage of firearms would likely have a dramatic impact on statewide overall suicide rates.     

Firearm Storage Practices and Risk Perceptions Among a Nationally Representative Sample of U.S. Veterans With and Without Self‐Harm Risk Factors

Despite the disproportionate use of firearms in Veteran suicides and the well‐established link between firearm access and suicide, little is known about how Veterans store their firearms or what they think about the relationship between firearm access and suicide risk. Using data from 2015 nationally representative online survey (response rate 60.9%), we compare characteristics of Veteran firearm owners with and without self‐harm risk factors with respect to how they store their firearms and their beliefs about suicide risk related to firearms. Overall, one in three U.S. Veteran firearm owners store household firearms loaded and unlocked, one in twenty believe that a firearm increases household suicide risk, and one in four consider their loaded and unlocked firearm to be inaccessible to suicidal household members. Storage practices and risk perceptions are similar among those with and without self‐reported suicide risk factors. Affecting risk perceptions may be a critical aspect of interventions addressing lethal means safety among U.S. Veterans.     

Firearm possession and violent death: A critical review

This article critically reviews the empirical research on the association of firearm possession with suicide and homicide. Both suicide and homicide reflect intentional behavior with the goal of killing oneself or another person. Firearms provide merely a means of reaching this goal. The possession of a firearm can, therefore, not be a primary cause of either suicide or homicide. However, since a defining characteristic of both suicide and homicide is the success of killing, and since guns are more effective means for reaching this goal than poison or other weapons, the rate of firearm possession can be expected to be positively related to overall rates of suicide and homicide. This prediction has been tested with individual-level as well as macro-level studies. Individual-level studies, which typically use case–control designs, allow a better control than macro-level studies of the cultural, demographic, and economic determinants of suicide and homicide. In macro-level studies, the potential impact of gun possession on overall rates is likely to be confounded by the factors that motivate people to commit suicide or homicide. Despite these methodological limitations, the research reviewed in this article supports the assumption that easy access to firearms increases the risk of dying from violent causes. With very few exception, studies found gun ownership positively related to gun-related suicides and homicides. Furthermore, there is evidence that guns do not merely serve as substitutes for other means of killing, but increase the overall rates of suicide and homicide.     

Firearm legislation and statewide suicide rates: The moderating role of household firearm ownership levels

Firearm legislation is associated with statewide suicide rates; however, prior research has often relied upon older data and categorical legislative grades while also failing to consider the nuanced role of firearm ownership. Therefore, the robust literature base on legislation and suicide has not directly examined regarding the extent to which the value of legislation hinges upon the rate of firearm ownership in a given state. The current study examined 2015 US statewide firearm legislation strength scores from Giffords Law Center to Prevent Gun Violence and 2016 statewide suicide rates from the Centers for Disease Control and Prevention. Firearm legislation strength was inversely associated with statewide overall and firearm suicide rates, but not with non‐firearm suicide rates. Firearm ownership rates moderated the association between firearm legislation strength and statewide overall suicide rates. Specifically, firearm legislation strength was inversely associated with statewide overall suicide rates at mean and high levels of firearm ownership. Findings support the potential utility of firearm legislation as part of a national effort to decrease US suicide deaths, particularly in areas with higher firearm ownership rates.     

Firearms Matter: The Moderating Role of Firearm Storage in the Association Between Current Suicidal Ideation and Likelihood of Future Suicide Attempts Among United States Military Personnel

The relationship between firearm ownership and suicide is well documented. This study hypothesized that how soldiers store their firearms would moderate the relationship between suicidal ideation and the self-reported likelihood of engaging in a future suicide attempt, and that this relationship would be explained by fearlessness about death. There were 432 military personnel (91.3% men, 74.2% White, M_age = 27.60) who endorsed current ownership of a private firearm and who were recruited from a military base in the southeastern United States (94.5% National Guard). Firearm storage moderated the relationship between suicidal ideation and the self-reported likelihood of engaging in a future suicide attempt, but this relationship was not explained by fearlessness about death. Individuals who reported keeping their firearms loaded and stored in an unsecure location exhibited higher mean levels of fearlessness about death. Findings highlight the need for research examining contributors to suicide risk in the context of firearm storage, and provide support for suicide prevention efforts involving restricting means.     

“Hey,let me hold your guns for a while”: A qualitative study of messaging for firearm suicide prevention

A recommended component of suicide prevention is encouraging at‐risk individuals to voluntarily and temporarily reduce access to firearms and other lethal methods. Yet delivering counseling on the topic can be difficult, given the political sensitivity of firearm discussions. To support such counseling, we sought to identify recommended framing and content of messages about reducing firearm access for suicide prevention. Through qualitative interviews with firearm owners and enthusiasts, we identified key points for use in framing (identity as a gun owner, trust, voluntary and temporary storage, and context and motivation) and specific content (preference for “firearm” over “gun,” and legal issues such as background checks for transfers). These findings build on prior work and should enhance efforts to develop and deliver effective, acceptable counseling and—ultimately—prevent firearm suicide.     

Modifying Children's Responses to Unsecured Firearms and Modifying the Keeping and Storage of Firearms in Families of Elementary School Children: A Possible Role for Child Behavior Therapy

ABSTRACT

This paper reviews the literature on young children (children under 13) at-risk of firearms injuries, and outlines potential strategies for reducing the disproportionate rate of firearms accidents among low-income children. The available evidence suggests that this problem stems from risky gun storage practices common in low-income homes keeping guns for protection, and these practices, in turn, are a response to high rates of crime victimization and fears of crime. The role that child behavior therapy could assume to reduce the risk of firearm injury to young children and other persons due to these unsafe storage practices is the primary focus of this paper.     

A Suicide Prevention Campaign for Firearm Dealers in New Hampshire

A spate of suicides involving a just‐purchased firearm led a statewide coalition of firearm dealers, firearm rights advocates, and suicide prevention professionals to discuss the role of gun shops in preventing suicide. The group developed and mailed materials for (1) firearm retailers on avoiding sales to suicidal customers and (2) their customers on suicide and firearm safety. All storefront retailers were identified (n = 65), visited unannounced 6 months after receiving materials, and asked to complete a survey. Nearly half (48%) had at least one campaign product on display. Belief that reducing a suicidal person's access to firearms might save a life was associated with displaying materials (69% vs. 41%, p = .06). Public health and gun groups can successfully collaborate on suicide prevention activities.     

Changes in suicide methods in Quebec between 1987 and 2000: the possible impact of bill C-17 requiring safe storage of firearms

This study presents the changes in the overall and firearm suicide rates for Québec (Canada) before and after Bill C-17, which was implemented to secure safe storage of firearms. It covers 20,009 suicide cases reported to the coroner's office. Interrupted time series analysis is used to compare suicide rates in the two periods. Firearm suicide rates have dropped among males and females, but the downward trends were not significant when compared to those prior to the law. Hanging suicide rates have risen considerably among men and women, but those upward trends did not increase significantly when compared with those preceding the law. The decline in suicide rates involving firearms has not resulted in a parallel decline in overall suicide rates. The analyses suggest that Bill C-17 neither improved the downward trend in firearm suicide, which had already begun before the enactment of the law, nor reduced the upward trend of the overall suicide rate. Correlation analyses between firearm suicide, hanging suicide, and the overall suicide rate suggest that firearm suicide is replaced by hanging suicide among males.     

Firearms and Their Role in Homicide and Suicide*

ABSTRACT: Various arguments against firearms from the standpoint of their role in homicide and suicide are discussed. It is contended by some that murderers are law-abiding citizens who get into trouble because of the availability of firearms. A study in Detroit indicated that both murderers and suicidal persons are prone to misuse the firearm as they would misuse any potential instrument of destruction, independent of gun control measures. If the Second Amendment to the Constitution is to be used by those favoring the right to bear arms, the argument must involve an incorporation of an inherent responsibility toward the use of the firearm; that people wanting to use them should be able to accept reasonable rules and personality qualification as a factor in having the right to obtain them. More effective education and screening of the overly aggressive person or the self-destructive individual are suggested, in terms of school mental health programs, screening at the police precinct level, gun permit application level, and through effective suicide prevention and crisis centers.     

Rate, relative risk, and method of suicide by students at 4-year colleges and universities in the United States, 2004-2005 through 2008-2009

A total of 622 suicides were reported among students attending 645 distinct campuses from 2004-2005 through 2008-2009. Adjusting for gender in the population at risk of 14.9 million student-years and for the source of these data, the student suicide rate of 7.0 was significantly and substantially lower than for a matched national sample. Suicide rates by firearm were significantly and substantially lower for both female and male students. Hanging was significantly and substantially lower for male students, less prominently so for female students. It is principally the ninefold decrease in the availability of firearms on campuses (vs. homes) and secondarily other features of the campus environment that are the bases for lower student suicide rates.     

Gun availability and use of guns for suicide, homicide, and murder in Canada

A reliability check of Lester's (2000b) 1970-1995 time series that examined associations between the availability of firearms and their use for homicide and suicide in Canada. For the period 1974 to 1999, the relative availability of firearms as measured by the rate of accidental death from firearms and the average of the percentages of suicides + homicides using firearms was positively associated with the rate of homicide by firearms but not negatively associated with the rate of homicide by all other methods, and positively associated with the rate of suicide by firearms and negatively associated with the rate of suicide by all other methods. Correlations for the homicide versus murder rates, homicide rate using guns versus murder rate using guns, and homicide rate by all other methods versus murder rate by all other methods were very similar. There was a decrease over time of total suicide and homicide rates and firearm suicide and homicide rates, and with a slight indication of substitution of other methods for suicide.     

Suicide and Firearm Prevalence: Are Youth Disproportionately Affected?

The effect of firearm availability on suicide may differ among age groups. We used regression analysis to examine the relationship between suicide rates and household firearm ownership for four age groups in the nine census regions from 1979 to 1994, adjusting for regional divorce rates, education, unemployment, and urbanicity. Results showed that firearm ownership levels are correlated with suicide rates among 15- to 24-year-olds and 65- to 84-year-olds, but not among 25-to 64-year-olds. The findings suggest that if the relationship is causal, a 10% fall in regional firearm ownership levels would lead to a 3.0% decrease in suicide rates.     

Health Problems and Male Firearm Suicide

Drawing on constructs of masculinity as it relates to both gun ownership and men's health, we use a rich data set, the New Jersey Violent Death Reporting System as well as hospital discharge data, to analyze 3,413 completed male suicides between the years of 2003 and 2009. We test the hypotheses that the use of firearms is more common when physical health problems are cited as suicide circumstances, and that suicide decedents who use firearms have poorer physical health than those who used other methods. Results show that firearms are disproportionately used in male suicides when physical health is listed as a circumstance. Additionally, among suicide decedents with a hospitalization during the 3 years prior to death, those who used firearms were in poorer health than those who used other methods. These findings have implications for prevention efforts, because restricting access to lethal means is an important aspect of suicide prevention.     

The Evolving Position of the American Psychiatric Association on Firearm Policy (1993–2014)

Before the Supreme Court's 2008 decision in District of Columbia v. Heller, the American Psychiatric Association's position on gun policy reflected the strong gun control perspective championed by the nation's public health establishment. After Heller declared that an individual's right to bear arms is constitutionally protected, the APA refocused its attention on the specific aspects of firearm policy that implicate the interests and rights of persons with mental illness. Psychiatrists are mindful of the need to curtail firearm access by persons with mental disorders that elevate the risk of suicide or violence to others, but they are also opposed to stigmatization, discrimination, and unfair treatment of individuals based on mental illness. Although civil commitment is an acceptable basis for prohibiting access to firearms, other adjudications of conduct indicative of elevated risk should also be included. Every state should provide a fair and reasonable process for restoring firearm rights after a suitable waiting period based on individualized assessment of whether the person remains at an elevated risk. However, restricting firearm rights of persons solely on the basis of a diagnosis of a mental disorder or voluntary treatment, whether in-patient or outpatient, discourages treatment and would be counterproductive. Copyright © 2015 John Wiley & Sons, Ltd. (original adopted by the American Psychiatric Association 2014).     

The Growing Use of Firearms by Suicidal Older Women, 1979–1992: A Research Note

Suicide among older women (65 +) has received very little attention despite increasing numbers of suicides in this population. An examination of national mortality data from the National Center for Health Statistics for the years 1979 through 1992 shows an increasing trend in rates of suicide among older women and a declining trend among women under 65. Over the 14-year period, firearms replaced poisoning as the most prevalent method of suicide by women 65 and over. The results seem consistent with the assertion that the availability, familiarity, and cultural acceptability of firearms may play a role in the choice of suicide method among older women. Although violent death and the use of firearms are generally associated with males in our society, the trends reported here indicate that greater attention to firearm suicides among older women is warranted.     

Suicidal behavior and firearm access: results from the second injury control and risk survey

The association between home firearms and the likelihood and nature of suicidal thoughts and plans was examined using the Second Injury Control and Risk Survey, a 2001-2003 representative telephone survey of U.S. households. Of 9,483 respondents, 7.4% reported past-year suicidal thoughts, 21.3% with a plan. Similar proportions of those with and without a home firearm reported suicidal thoughts, plans, and attempts. Among respondents with suicidal plans, the odds of reporting a plan involving a firearm were over seven times greater among those with firearms at home, compared with those without firearms at home. The results suggest people with home firearms may not be more likely to be suicidal, but when suicidal they may be more likely to plan suicide by firearm.     

Youth suicide: insights from 5 years of Arizona Child Fatality Review Team data

Data on 153 youth suicides in Arizona (1994-1999) were used to explore demographic, behavioral, and experiential factors that distinguish between firearm suicide and suicide by other means. In bivariate analyses, White youths were more likely than non-White youths to use a firearm to commit suicide as were youths who had not experienced a life crisis or expressed suicidal thoughts in the past, relationships that hold in multivariate analyses at the p < 0.2 level. Targeted suicide prevention activities should supplement interventions focused on restricting access to highly lethal means of suicide such as firearms.     

Firearm violence and the effects of gun control legislation

Two gun control laws designed to reduce different types of violent crimes were evaluated. In 1981, East St. Louis, IL, imposed stricter penalties for individuals who carry firearms outside their homes for protection (individuals could keep firearms in their homes). This law had only a temporary impact in reducing firearm use in assaults and robberies. In Evanston, IL, a slightly different approach was taken with legislation that banned handguns in the entire city (i.e., individuals could not keep handguns within their homes). A temporary reduction in firearm assaults occurred a few months before the gun law took effect. The implications of these findings are discussed.