Research

Firearms and suicide: What we know, what we can do, and steps forward

netECR

By Allison E. Bond.

What do we know about firearms and suicide?

In the United States (US), firearms are the most commonly used and most lethal method for suicide1.Additionally, suicides account for two-thirds of all gun deaths in the US1. The presence of firearms in the home is associated with a 3-5x increase in the risk of suicide for everyone in that home. We can’t talk about gun violence without talking about suicide, and we can’t talk about suicide without taking about gun violence. Gun violence can be a tense issue and can be difficult to study due to logistical and political barriers as well as a host of other reasons. Despite this, research in this field has provided us with important findings that have furthered our understanding of suicide and have the potential to help us prevent suicides by firearm. 

Research has found that there are demographic and logistical differences between those who die by suicide with a firearm and those who die by suicide with other methods. Those who die by suicide with a firearm are more likely to be male, younger, own a firearm, and store their firearms unsafely2,3,4. Understanding who chooses to use firearms in their suicide death can help us increase the effectiveness of suicide prevention and intervention efforts, such as means safety.

What can we do to prevent suicide deaths by firearms?

Means safety is arguably one of the most effective ways to decrease risk for suicide. Means safety refers to making methods for suicide less lethal or less available (e.g., locking cabinets containing pills), and has been used to decrease suicide risk for decades. In the United Kingdom, many people were dying by suicide using domestic gas. When the carbon monoxide content of the gas was diminished, suicide rates by domestic gas decreased while suicide rates by other methods remained stable, resulting in a dramatic and sustained decrease in the overall suicide rate5. Similarly, research has found that reducing the size of medication pack sizes is associated with a decrease in suicide by overdose6. This suggest that when we reduce the availability of a highly used method for suicide, suicide rates decrease.

Additionally, means safety has been found to be effective in reducing suicide by pesticides. In multiple countries throughout the world, pesticides are a commonly used methods for suicide. Sri Lanka, for example, saw a 50% decrease in suicide rates when it banned pesticide that contained lethal chemicals7. This finding highlights that when a method is made less lethal, less suicide deaths occur.

When it comes to firearms, similar promising results have been found. The Israeli Defense Force instituted a policy that did not allow service members to take their firearms with them on leave. This policy change was associated with a 40% reduction in firearm suicide rates among young service members8. The number speaks for itself, reducing access to firearms when they are not mission critical was associated with less suicide deaths.

The US has a different relationship with firearms than many other countries throughout the world. Given this unique relationship, some may wonder if firearm means safety decreases suicide rates in the US; research suggests it does. In the US unsafe storage of a firearm has been found to increase risk for suicide9, while safe storage of a firearm may protect against suicide attempts10. Firearm safe storage, which puts time and distance between an individual in a suicidal crisis and firearms, can reduce risk for suicide attempts. Means safety efforts focused on firearm safety should be implemented across the US, especially with those found to be more likely to use a firearm in their suicide attempt.

Who should discuss firearm safety for suicide prevention?

Almost everyone. Asking about firearm storage and engaging in conversations about firearm safety needs to become common. We have made difficult topics a part of everyday conversations in the past, so there is every reason to believe we can accomplish that with firearms. An example is drunk driving, campaigns like “friends don’t let friends drive drunk,” organizations like Moms Against Drunk Driving, and education in schools have all made conversations about drunk driving part of everyday life. They may still be uncomfortable conversations, but they are conversations that people feel equipped to have with their loved ones.

We need the same for firearms safety for suicide prevention. Even though these conversations will be difficult, we need everyone to feel equipped to discuss firearm safety with their friends and family. Many firearm owners deem family members as credible sources to discuss firearm safety for suicide prevention, which highlights how important such voices can be11. Other credible sources include law enforcement officers, military members, and military veterans11. Therefore, it is important that we ensure these, and other credible professions are provided the education, resources, and support they need to be able to engage in discussions about firearm safety for suicide prevention with members of the community.

How can move forward on a tense issue?

Find common ground

It is no surprise that firearms are a tense topic, and conversations about firearm legislation can be met with hostility. If we put our political beliefs aside and focus on finding a common ground, it may be easier to discover than expected. Suicide effects everyone, every race, gender, sexual orientation, and occupation. Suicide prevention can be the common ground for discussing firearm safety. Focusing conversations, survey questions, and other communications around suicide prevention can reduce the tension and help us move forward together.

Don’t be the expert

Scientists need to leverage the voices, preferences, and experiences of the firearm owning community in order to better understand ways to increase compliance with safe storage suggestions. Engaging the community of interest and allowing them to share their expertise will also help foster relationships and increase buy-in. One example of successfully leveraging the expertise of firearm owners comes from the Suicide and Emotion Dysregulation Laboratory. The lab created a survey asking firearm owners about the importance of safe storage, what it means to them, and different storage options. In just a few weeks, the survey received over 400 responses from firearm owners. These responses were used to create infographics with information about storage options for new firearm owners. In addition to providing the field with important information, engaging the community of interest helps brides the gap between science and the community.

Spread research findings

It’s common practice for researchers to present findings at scientific conferences and publish in peer review journals. Although this is an essential part of spreading scientific knowledge, it cannot be the only part. Most community members do not attend scientific conferences or have access to scientific journals. Therefore, most of the population does not know what research on firearms and suicide has found. Researchers need to find creative ways to disseminate findings to those outside the walls of academia. The Science Simplified Network has created visual abstracts that summarize research findings. These abstracts have been disseminated through Twitter (@sci_simplified) and Instagram (@Science.Simplified) with the hopes of reaching community members and starting conversations about topics such as firearm safety for suicide prevention.

Our knowledge of firearms and suicide has greatly increased in the last few decades; however, we still have a long way to go. If we work together, we can advance the field, learn from each other, and determine ways to reduce the rate of firearm suicide deaths.

References

  1. Centers for Disease Control and Prevention. (2020). Web based injury statistics query and reporting system (WISQARS). National Center for Injury Prevention and Control, Atlanta, GA. Retrieved August 20, 2021, from https://www.cdc.gov/injury/wisqars/index.html
  2. Bond, A. E., & Anestis, M. D. (2021). Firearm type and number: examining differences among firearm owning suicide decedents. Archives of suicide research, 1-8.
  3. Bond, A. E., Bandel, S. L., Wagler, K., Daruwala, S. E., & Anestis, M. D. (2021). Differentiating suicide decedents who died by firearm verse hanging. International review of psychiatry, 1-7.
  4. Anestis, M. D., Khazem, L. R., & Anestis, J. C. (2017). Differentiating suicide decedents who died using firearms from those who died using other methods. Psychiatry research, 252, 23-28.
  5. Kreitman, N. (1976). The coal gas story. United Kingdom suicide rates, 1960-71. Journal of Epidemiology & Community Health, 30(2), 86-93.
  6. Hawton, K., Bergen, H., Simkin, S., Dodd, S., Pocock, P., Bernal, W., … & Kapur, N. (2013). Long term effect of reduced pack sizes of paracetamol on poisoning deaths and liver transplant activity in England and Wales: interrupted time series analyses. Bmj, 346.
  7. Knipe, Duleeka W., Shu-Sen Chang, Andrew Dawson, Michael Eddleston, Flemming Konradsen, Chris Metcalfe, and David Gunnell. “Suicide prevention through means restriction: impact of the 2008-2011 pesticide restrictions on suicide in Sri Lanka.” PloS one 12, no. 3 (2017): e0172893.
  8. Lubin, G., Werbeloff, N., Halperin, D., Shmushkevitch, M., Weiser, M., & Knobler, H. Y. (2010). Decrease in suicide rates after a change of policy reducing access to firearms in adolescents: a naturalistic epidemiological study. Suicide and Life-threatening behavior, 40(5), 421-424.
  9. Dempsey, C. L., Benedek, D. M., Zuromski, K. L., Riggs-Donovan, C., Ng, T. H. H., Nock, M. K., … & Ursano, R. J. (2019). Association of firearm ownership, use, accessibility, and storage practices with suicide risk among US Army soldiers. JAMA network open, 2(6), e195383-e195383.
  10. Grossman, D. C., Mueller, B. A., Riedy, C., Dowd, M. D., Villaveces, A., Prodzinski, J., … & Harruff, R. (2005). Gun storage practices and risk of youth suicide and unintentional firearm injuries. Jama, 293(6), 707-714.
  11. Anestis, M. D., Bond, A. E., Bryan, A. O., & Bryan, C. J. (2021). An examination of preferred messengers on firearm safety for suicide prevention. Preventive medicine, 145, 106452.

Allison E. Bond (@AllieBond12) is a clinical psychology PhD student in the New Jersey Gun Violence Research Center at Rutgers University. Email: ab2242@scarletmail.rutgers.edu.

Published by netECR

Website of the International Network of Early Career Researchers in Suicide and Self-harm.