Thursday, September 12, 2019

Gun Violence Suicide -- Men, Gendered Behavior, and Available Guns




When we speak of gun violence, few think of the horrible toll of suicide by firearm. Though most people who attempt suicide are struggling with mental illness, suicide attempts are usually impulsive responses to acute crises. Those who reach for guns in these times of trouble seldom survive. These lethal weapons are responsible for over 50% of suicide deaths. Our country’s suicide problem is also a gun violence problem.

Most people who attempt suicide without a gun survive in both the short and long term – 90% of survivors do not die by suicide. For example, attempts using cuts or poisoning are only fatal 6 to 7 percent of the time. Also, a literature review of 90 studies (2002) showed that nine out of ten people who attempt suicide and survive will not go on to die by suicide at a later date.

But those who reach for a gun rarely have a second chance. A study by Dr. J. Michael Bostiwck, a psychiatrist at the Mayo Clinic, showed that the odds of successfully committing suicide are 140 times greater when a gun is used than for any other method.

Of course, mental illness increases the risk for suicide. Some ignore the instrument of destruction as being any part of the problem by saying the firearm, an inanimate object, “doesn't pull the trigger.” However, if a gun is readily available, a temporary crisis often becomes a permanent loss. Consider these frightening recent statistics:

* Nearly two-thirds of all gun deaths in the US are suicides, resulting in an average of 61 deaths a day.

* The problem is getting worse: Over the past decade, the US firearm suicide rate has increased by 19 percent.

* Suicides by firearms claim the lives of over 22,000 Americans every year, including over 1,000 children and teens

* The trend has been of particular concern for children and teens, whose firearm suicide rate has increased by 82 percent over the past 10 years; and for veterans, who have a firearm suicide rate 1.5 times higher than non-veteran adults
    (Centers for Disease Control and Prevention. National Center for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports. A yearly average was developed using five years of most recent available data: 2013 to 2017. Children and teens defined as aged 0 to 19.)
The U.S. suicide rate by firearms is 10 times that of other high-income countries. A recent poll, 16 percent of respondents – or roughly 40 million American adults – reported that someone they care for attempted or died by suicide with a gun.

    (Survey USA Market Research Study. Data collected from December 7, 2018 to December 11, 2018. https://bit.ly/2ExxpyZ.)
States with higher rates of gun ownership have higher suicide rates than states with low gun ownership, whereas non–firearm suicide rates are comparable, indicating that firearm access drives overall suicide rates.

(“Reducing Suicides By Firearms.” Policy Number: 20184. American Public Health Association. November 13, 2018.)

There is evidence that gun control can reduce suicide rates. A buyback program that wound up taking a fifth of Australia’s guns off the street wound up reducing firearm suicides by 74 percent without affecting non-firearm suicides.

(Andrew Leigh and Christine Neill. “Do Gun Buybacks Save Lives? Evidence from Panel Data.” American Law and Economics Review, Vol. 12, No. 2. Fall 2010.)

When the Israeli Defense Forces stopped letting soldiers bring their guns home over the weekend, suicides fell 40 percent, primarily due to a drop in firearm suicides committed on weekends.

(Gad Lubin, MD, Nomi Werbeloff, PhD, Demian Halperin, MD, Mordechai Shmushkevitch, MD, Mark Weiser, MD, and Haim Y. Knobler, MD. “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). November 2010)

A study in California found that the rate of suicide among new gun owners in the first week after buying a gun was 57 times higher than the state’s population as a whole. Policies and practices that disrupt the easy and immediate acquisition of firearms may save lives. This begins at the point of sale, with strong background check and permitting laws.

(Wintemute GJ, Parham CA, Beaumont JJ, Wright MA, Drake C.
Mortality among recent purchasers of handguns.”
The New England Journal of Medicine. 1999.)

By state or region…for every age, for both genders, where there are more guns, there are more total suicides.”

Dr. David Hemenway, National Academy of Sciences

Firearm suicides are less common in U.S. states that check if potential gun purchasers are mentally ill or criminal fugitives. By strengthening our existing background checks system, we can keep more deadly weapons from falling into the wrong hands, preventing shootings before they happen and saving lives.

In homes with firearms, 86 percent of the suicides used the firearms. In the homes without firearms, only 6 percent of the suicides used a firearm.”
    Dr. David Hemenway, National Academy of Sciences
We must understand that keeping guns out of the hands of individuals with a high risk of committing violence – convicted felons, domestic abusers, and those experiencing a mental health crisis – is crucial to preventing deadly shootings.

Yet …

In November 2018, the NRA issued a tweet advising physicians to stay away from the issue of guns: "Someone should tell self-important anti-gun doctors to stay in their lane."
The NRA pushes for laws that restrict how federal money can be spent to study gun violence, which makes it difficult for lawmakers to figure out how to reduce gun deaths.

Of particular concern, the gun lobby has successfully backed legislation specifically aimed at restricting doctors’ ability to discuss firearms with their patients. In 2011, Florida passed a law to prohibit doctors from discussing firearms with their patients, and Montana and Missouri followed with their own laws that interfere with the doctor-patient relationship. While the Florida prohibition has since been struck down, the clear intent of these laws is to discourage doctor counseling on gun safety.

By asking their patients about firearm access and counseling about firearm suicide risk, medical professionals may help prevent these deaths.

Elaine Frank, with the Harvard Injury Control Research Center and the New Hampshire Firearm Safety Coalition, leads a program called Counseling on Access to Lethal Means, or C.A.L.M. This program trains medical professionals on how to explain the differing lethality of various suicide methods, and to “help clients at risk for suicide and their families reduce access to lethal means, particularly firearms.”

America's gun problem is much bigger than mass shootings. Women are more likely to attempt suicide, nearly twice as likely according to some research. But men are two to four times more likely to carry it out … and, men who employ firearms are overwhelmingly successful in their attempts.

The Center for Disease Control’s recent analysis of factors contributing to the increase in suicide rates in the U.S., released June 7, 2018, reads like a list of disproportionately masculine traits:

Mental health problems (often untreated or undiagnosed);

Alcohol or drug use (higher for men than women and often a solace for failed manhood);

Social or personal problems (for which men are not supposed to seek help); and

Access to firearms (again, mostly men).

Promundo, with support from Axe, carried out a survey of 1,500 young men aged 18–30. Which young men were more likely to think about suicide? Those who believed in a version of manhood associated with being tough, not talking about their problems, and bottling up their emotions were twice as likely to have considered suicide.

Perhaps, the association between manhood and gun ownership is a problem in itself. After all, the suicide crisis is not occurring primarily because modern males are being deprived of their traditional masculine roles. In fact, women still struggle mightily with being “breadwinners” and attaining executive positions. Rather the anxiety of males seems to be linked with toughness, stoicism, and yes with toxic masculinity – aggression and violence with the expectation that using these behaviors is the correct way of being a man.

It appears that when people who partake of the gun culture experience
a stress or a loss of significance. They turn to guns as a tool to restore
their sense of mattering and importance.”

Psychologist Arie Kruglanski who surveyed gun owners both before and immediately after the 2016 Orlando nightclub shooting






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