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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