Special Report | By Noah Leavitt | Fall 2018

Harvard Chan researchers and Utah gun-rights advocates are forging a rare partnership in the quest to prevent firearm suicides

On a hot Saturday afternoon in July 2017, a man and a woman met up at the Gun Vault, in South Jordan, Utah, about 15 minutes south of Salt Lake City. Alongside a four-lane highway, the squat, two-story tan building sits beside an express oil-change shop, its parking lot ringed by neatly manicured grass and trees. The structure is anonymous and nondescript but for the red letters emblazoned in front: “Indoor Range.”

The man was Clark Aposhian, 53, chair of the Utah Shooting Sports Council—the state’s top gun lobby—and head of a company called Fair Warning Training, which teaches firearm safety. Nearly 6 feet tall, broad-shouldered, with thick forearms and hands that engulf small weaponry, he wore a black T-shirt with a skull on the right chest, khaki shorts, sneakers, and a San Francisco 49ers baseball cap. The attire was unusually casual; Aposhian typically carries a concealed handgun under camouflage cargo pants and military boots.

The woman was Morissa Sobelson, 31, a doctor of public health candidate at the Harvard T.H. Chan School of Public Health who will be graduating next spring. Slender, red-haired, with a lightly freckled face, Sobelson grew up in New Hampshire, the famously firearm-friendly “Live Free or Die” state—but she had never before fired a gun. True to form, she Googled “what to wear to the shooting range” the night before and learned that it’s best to cover up to prevent hot brass casings from scorching bare shoulders or flying down one’s shirt. She arrived attired in a gray T-shirt, yoga pants, sneakers, and a Boston Red Sox cap. When Aposhian greeted her, he removed the Red Sox cap and handed her a Utah Shooting Sports Council cap, which is decorated with an outline of the Beehive State flanked by a rifle and a submachine gun.

Aposhian went to his SUV and hauled out a number of heavy black cases. They reminded Sobelson of the heavy black case she used to lug around in high school, outfitted not with munitions but with the ungainly baritone saxophone that she played in the marching band.

For Sobelson’s amusement, Aposhian had chosen 11 weapons from his personal collection to fire. There was a classic Smith & Wesson .38 Special revolver; a compact Glock 19 9-millimeter pistol, suitable for concealed carry; a sleek and powerful .50 caliber Desert Eagle semi-automatic pistol, the largest legal caliber for a handgun in the U.S.; two AK-47s—a pistol and an assault rifle; an AR-15 rifle with a holographic sight; and a fully automatic machine gun, the Heckler & Koch HK53. When Sobelson emailed the list to a friend in the Marines, he wrote back: “That is the most impressive mobile arsenal I’ve ever heard of.”

For a newcomer, the indoor range at the Gun Vault can be intimidating: 20 stalls stretched out like bowling lanes across a dark room. Fired rounds continuously echo off the concrete walls. One feels the vibration in one’s bones, like the bass at a live concert.

After an hour of shooting, Aposhian beamed with praise at his pupil. “She did not shy away at all,” he said. Recalling the session, Sobelson said: “The part I remember most vividly was how much I jumped. I physically jumped an inch off the ground every single time for the first several minutes.” But Aposhian had stayed close by, a steady figure coaching her about how to safely fire each unfamiliar weapon. Looking back, Sobelson also allowed that, “There was a fun, exhilarating aspect to it, which I would come to appreciate.”

Outwardly, Aposhian and Sobelson are a complete mismatch. He is a tactical firearms instructor and fierce defender of gun rights. She is a public health professional and progressive liberal.

They have joined forces because Utah has a serious and singular gun problem. From their opposite vantages, they are collaborating on a Harvard Chan research project to address that problem. To succeed, this improbable pair, along with their colleagues, will have to find common ground—however narrow—on one of America’s most divisive social issues.

Guns and swimming pools

Eighty-five percent of gun deaths in Utah are suicides, according to the U.S. Centers for Disease Control and Prevention (CDC). For every accidental firearm death in the state, there are 70 firearm suicides. Utah has the fifth-highest suicide rate in the U.S., and half of the state’s suicide deaths are by gun.

These statistics are generally in line with national data. Of the approximately 30,000 Americans killed each year by guns, two-thirds take their own lives. But more than other places, Utah is seeing sharp upward trends. From 1999 to 2015, the firearm suicide rate among men in the state increased from 16 to 21.5 per 100,000; during the same period, the rate for women doubled, from 1.5 to 3.0 per 100,000. Of particular concern is a spike in youth suicides. In 2016, suicide was the leading cause of death for Utahns ages 10 to 17, with 7.9 suicide deaths per 100,000 in that age group; more than half of the deaths involved a firearm.

A 2017 survey from the Salt Lake Tribune and the Hinckley Institute of Politics found that 42 percent of Utahns own a firearm—a figure significantly higher than the national average (according to the Pew Research Center, about a third of Americans own guns). And data from the Utah Behavioral Risk Factor Surveillance System show that 48 percent of Utah households own firearms—including 70 percent of rural households. As a 2008 study from the Harvard Injury Control Research Center showed, firearm access confers outsized risk for suicide. Suicide rates in states with the highest rates of gun ownership are 3.7 times higher for men and 7.9 times higher for women than in states that have the lowest gun ownership—even though rates of nonfirearm suicides are about the same. A 2018 CDC study found that while firearms were the most common method of suicide overall in the United States—accounting for 48.5 percent of deaths—people without a known mental health condition were nearly twice as likely to die by firearm suicide than by other methods.

For researchers like Sobelson, the public health challenge in reducing gun suicide in Utah is that firearms are ubiquitous. “Owning a gun is like having a swimming pool in Florida,” she says. “It’s part of your recreational culture. It’s what you had growing up. It’s what you do on the weekends. It’s a leisure-time activity in your family and in your household.”

Utah’s casual acceptance of firearms also translates into some of the most permissive gun laws in America. There is no waiting period for purchase. There are no restrictions on the size of gun magazines or on the type or the number of firearms one can buy. One can carry a fully loaded firearm in a car. Nearly a quarter of a million Utahns hold concealed-carry permits, which allows them to bear loaded weapons either openly or hidden. And anyone can openly carry a gun with a loaded magazine, as long as the firing chamber is empty.

Despite this abundance of weaponry, Utah does not have a high rate of violence or crime. In 2016, there were just 2.5 homicides per 100,000 people, the 10th-lowest rate in America. Yet while Utah doesn’t have a homicide problem, it has a disproportionately high suicide rate: seven times higher than the rate of homicides. According to the 2017 Salt Lake Tribune–Hinckley Institute of Politics survey, nearly 40 percent of Utahns personally know someone who has attempted, or has died by, suicide.

Sobelson believes firearms are the key to addressing suicides in Utah. “If we want to move the dial on suicide, this can’t just be a discussion about mental health, although that’s important,” she explains. “This has to be a real discussion about how people store and handle guns.” In essence, Sobelson is pointing to public health’s tried-and-true and quietly strategic approach of changing not people but the environment.

One of the classic public health success stories involves the campaign in the mid-20th century to reduce motor vehicle deaths in the U.S. Based on copious research data on virtually every aspect of driving, the multipronged campaign dramatically recast the experience of taking the wheel: safer car and truck design, improved roads and signage, stricter traffic safety laws, enforcement of seat belt use, and public education leading to new social norms that stigmatized drunken driving.

In Utah, researchers hope to collect similarly revealing data about guns and the context of gun use. In particular, they will investigate an approach known as “means restriction.” Think of the 1980s’ “Friends Don’t Let Friends Drive Drunk” campaign, but with firearms. Decades of research on guns and suicide have proven not only that gun access by itself is a formidable risk factor, but also that the impulse to kill oneself is typically fleeting—and that if the lethal impulse is deflected in the moment, it usually doesn’t return.

Put another way, guns are an immediate—and overwhelmingly lethal—response to what is often a passing crisis (nationwide, about 85 percent of suicide attempts with a firearm end in death). With those facts, the public health question becomes clear: How can we reduce gun access during those critical moments when a suicidal person decides to take his or her own life?

Read more: Myths of Suicide

Toxic Perfectionism A 20-minute climb to the top of Ensign Peak, behind Utah’s State Capitol, rewards one with a spectacular view. Salt Lake City stretches out below, with the Great Salt Lake to the right and the snowcapped Wasatch Range to the left. The city is laid out on a massive grid based on the Plat of Zion, a document created by Joseph Smith, the founder of the Church of Jesus Christ of Latter-day Saints (LDS). The grid was designed in part so that Mormon residents would always know how far they were from Salt Lake City’s spiritual center: the Salt Lake Temple. But that fixed measure of spiritual attainment can also be a measure of failure. “In Utah, there’s a toxic perfectionism,” says Abigail Norton, whose younger brother died by gun suicide in 2015. Norton is open about her own struggles with mental illness—she has bipolar disorder—and the pain of grappling with her brother’s suicide inspired her to pursue a master of public health degree at Brigham Young University, in Provo. “There’s a strong Latter-day Saint culture, where you’re expected to be the very best that you can be,” Norton says. “Sometimes, that cultivates the perception that we need to be perfect. And it draws people into a dark place where they feel like nothing they do is right or good enough.” The weight of almost impossibly high standards is pervasive in a state where roughly 60 percent of the population is Mormon, adds Taryn Hiatt, who directs Utah’s chapter of the American Foundation for Suicide Prevention. When Hiatt was 26, her father died by suicide following a long battle with depression and addiction. “He saw himself as unworthy of God’s love,” she says. The Mormon Church is trying to change this dangerously perfectionist narrative. It is offering resources to support people with mental health problems and empowering faith leaders, teachers, family, and friends to recognize when someone is struggling. In October 2010, Elder Jeffrey R. Holland, one of the Church’s leaders, spoke openly about his struggle with depression. His words sent the message that mental illness is a condition, not a character defect. In her research on suicide prevention, Harvard Chan’s Morissa Sobelson sees the LDS engagement in a positive light. “Mormons are highly organized and very much into collective engagement,” she says. “When given a direction, they will usually follow. And the church’s strong value of self-reliance and community support can contribute to solutions.”

“Live Free or Die”

One winter when Sobelson was cross-country skiing on Mount Katherine, in New Hampshire’s White Mountains, she met a snowshoer on the peak. Dressed in camouflage clothes, he was carrying a holstered pistol, drinking a beer, and smoking a cigarette. Sobelson was wearing Lululemon and a backpack. As Sobelson tells it, “We had a nice conversation about wilderness preservation and responsible forestry management.”

For Sobelson, it’s hard not to draw parallels between her home state and Utah. Both places disdain government interference—Utah in its gun culture, New Hampshire in its rejection of mandatory seat belts and motorcycle helmets and income taxes. And in both locales, that bristling independence often coexists with strong social cohesion.

“In places where people have more of a ‘live free or die’ attitude, you often find the kindest, most engaged people,” Sobelson says. “There’s nothing inherent about gun ownership that precludes a strong sense of community, human connection, and just an enjoyment of the day to day.” In New Hampshire, she adds, “Many of the same people who have a rights mentality, whether it’s regarding their finances or their seat belts, are also socially progressive. Even today, when I talk to friends that I grew up with, they may be very pro-gun, but they’re also very pro-choice and very in favor of same-sex marriage. Growing up in New Hampshire, I learned not to make assumptions about people’s values. I also learned that people are complex beings with whom we have to ask questions and build relationships. You err on the side of being open and not putting people into boxes.”

In Concord, the Granite State’s capital, social justice and advocacy were vital in Sobelson’s family. Her parents are both health care providers—her mother, a therapist, and her father, a family doctor. They imbued in her the importance of disagreeing respectfully. “Discussion and debate were encouraged,” says Sobelson, adding that she and her parents felt it was important “to engage with others on an intellectual level—not to just write off a disagreement as a personality difference.” As a part of the state’s small but tight-knit Jewish community, they embodied the spirit of the Hebrew phrase tikkun olam: “repairing the broken world.”

Sobelson describes herself as an intense person who likes the company of other intense people. She was naturally drawn to Aposhian and his passion not only for firearms but also for data. “He had the stats down on suicide way better than I did,” Sobelson says. Aposhian was also an honest guide into the world of guns. “I knew nothing about firearms. I didn’t know the parts of the weapon. I didn’t know the different types of locks. I didn’t understand the culture very well,” Sobelson admits. “So I asked as many silly questions as I could. He was willing to walk me through in a way that didn’t assume I would subscribe to his politics or his beliefs.”

One of the silly questions she asked: “Why do people own guns?” Aposhian explained that there are several types of gun owners. A small percentage love big, military-style automatic weapons and collect them in vast numbers. Many others are recreational hunters and sport shooters and are likely to own several rifles or shotguns. The third category includes people who own guns for self-defense and are more likely to keep handguns.

For all three groups, “the idea of temporarily giving up one’s guns, even during a difficult stretch, is hard,” Sobelson says. “You learn ways of structuring the conversation so that you don’t hit on the words ‘control’ and ‘remove.’”

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An affinity for firearms

In making the case for gun rights, Clark Aposhian rarely invokes the iconic 27 words of the U.S. Constitution’s Second Amendment: “A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed.” As Aposhian says, “I don’t rely on the Second Amendment, because it only means what the current Supreme Court justices say it means. I rely on logical thinking.”

Aposhian fired his first gun at the age of 10 in his childhood home of San Francisco. “We had three guns. One was a little .22 bolt-action rifle that Dad got when he was a kid in Utah. Another was a classic Model 94 Winchester 30-30 lever action that Dad had hunted with when he was a kid. Later, he acquired a self-loading .308 deer rifle, wood stock and everything. “I found that I had an affinity towards firearms. I like them. I seem to do well with them, to handle them well, and shoot them well.”

In his teens, Aposhian became interested in gun-rights advocacy when working to defeat a gun-control proposition in California. As a young adult in the state, he also undertook Peace Officer Standards and Training.

Although Aposhian didn’t move to Utah until his early 20s, his roots in the state date back to the early 20th century, when Mormon missionaries smuggled his father’s family and others out of Armenia during the final years of the Armenian Genocide. The values of the Church of Jesus Christ of Latter-day Saints—and Utahns in general—affirmed Aposhian’s belief in the importance of gun rights, because they resonated with his belief in self-reliance.

A data devotee, Aposhian also enjoys the legal minutiae of defending gun rights. “I understand laws. I understand the legislative process. They don’t bore me to tears, like they do some folks.” He tries not to draw too many hard lines in gun-related legislation. His evaluation criteria for proposed gun laws are simple: Will the law address an actual problem? Is implementing it realistic? And is it feasible to enforce?

Aposhian was initially hesitant to pair up with the Harvard Chan team. “As a gun-rights person, I’m always a little skittish about reports that come from Harvard or anywhere back East,” he concedes. But he was shocked by the finding that nearly nine-tenths of gun deaths in Utah are by suicide. At first, he didn’t trust the numbers. “I went and I verified them. Then I verified them again. Then I gave the data points to my board and said, ‘Verify these numbers.’”

The numbers checked out. “That’s when my board had an epiphany,” he says.

The Conversation Sergeant Josh Hansen is used to getting late-night phone calls from fellow veterans who are contemplating suicide. He’s the co-founder, along with Laura Cantin, of Continue Mission, a nonprofit organization that provides a support network for those who have served in combat. Continue Mission stages group activities—such as biking, hiking, and running—to help veterans manage post-traumatic stress disorder and other conditions. Preventing suicide is personal for Hansen, who served two tours in Iraq as an IED hunter—someone who locates and disables roadside bombs. He was wounded in action in March 2007, and six members of his battalion were killed. Later, four others in his battalion died by suicide—some using firearms—upon returning home. Harvard Injury Control Research Center data show that veterans in Utah are more likely than other Utahns to die by suicide and to use a firearm in the death. https://cdn1.sph.harvard.edu/wp-content/uploads/sites/54/2018/09/Josh-Hansen_-A-Ten-Minute-Window_Title-and-Caption.mp4 At one point, Hansen himself was close to taking his own life. He had gained weight, was out of a job, and was heavily medicated. The turning point came at the funeral for one of his fellow veterans. “Seeing his pregnant wife and his child and how sad and hurt all of us were, I thought, ‘Wow, I can’t do this to my family,’” he says. Today, when veterans call him to say they are thinking of harming themselves, he knows how to respond. It may involve simply driving over and sitting with them until the crisis passes. Or it can involve an all-night trip to the emergency room. Whenever he receives a call, Hansen specifically asks about firearms. “I’ll talk to veterans and their spouses, and say, ‘Hey, I know you’re struggling right now. If you need me to take your firearms and hold them for you, I’m here to do that,’” says Hansen. In his own life, he follows similar precautions during a crisis. “I have ammo in one locked cabinet and my firearms in a different locked cabinet, with a different key. I also have gun locks. If I’m having struggles, I’ll give the keys to my wife and tell her to hide them. Because I guarantee that by the time it would have taken me to get into those cabinets, my mood will have changed.” Such conversations require trust, Hansen says. Many veterans may not feel comfortable talking about suicide to a therapist, let alone handing over their firearms to a police officer. But they will listen to him or to a family member. Clark Aposhian, chair of the Utah Shooting Sports Council, agrees that the solution in such volatile moments is not law enforcement but a sympathetic offer of support. “I put myself out there to say, ‘Hey, if you’re in a bad way at 2 in the morning, give me a call. I’ll baby-sit your guns.’”

Aposhian can recite gun advocates’ common rejoinder to the numbers: “If they don’t use a gun to kill themselves, they’re going to find something else.” He calls it “a defense mechanism: You don’t want to blame the gun.” To neutralize that reflex, he says, “We tell them, ‘Hey, the great thing about guns is, they’re effective. That’s why we like them. They’re accurate, they’re consistent, they’re reliable. The terrible thing about guns is that they are so effective. They’re devastatingly effective. If people try to kill themselves with a gun, there isn’t a second chance.’”

Beneath that hard logic, however, is a softer emotional truth. “We don’t like to talk about suicide,” Aposhian says. “I mean, it’s our family, it’s our friends, it’s our neighbors, it’s our co-workers, most of whom are seemingly fine. They have a gun. And unfortunately, every once in a while—honestly, quite often—they’ll use that firearm to harm themselves.” He adds: “Obituaries may not mention how someone died. I’m not suggesting we change the cultural norm. But if we were to do that, it would be glaringly obvious how many of our family members and friends are in turmoil. I’ve felt the grief, and the pain, and the anguish. You start to internalize it—we all know someone who you can put into that place. Wouldn’t you do anything to try and stop it?”

Read more: Why Utah?

Aposhian and his colleagues in the Utah Shooting Sports Council viewed the chance to partner with Harvard Chan as a civic duty to prevent harm but also as a pragmatic act of self-preservation. “If we didn’t become a part of this program, there would be legislation and it would very likely involve restrictions. The gun-control side would start out saying, ‘Let’s ban assault weapons, let’s increase waiting periods, let’s have magazine capacity restrictions.’ But if we became part of the effort, we could help steer that legislation. I told my board, ‘This train is coming down the track. We can stand still and get run over, or we can hop on and help steer it.’”

Getting to Trust

Clark Aposhian remembers the first time he sat across from Cathy Barber—director of the Means Matter Campaign at the Harvard Chan School, and an innovative national leader in the public health effort to reduce gun suicide. It was at a meeting of Utah’s Suicide Prevention Coalition in 2016. “We stared across the table at each other,” he says. “Rather glaringly.”

He also remembers the moment Barber won his trust. The group was working on a pamphlet focused on suicide prevention and gun safety. Oftentimes, Aposhian says, pamphlets produced by nongun groups urge people to keep weapons out of the home or to store them unloaded under lock and key, with the ammunition locked away separately. That kind of messaging is misguided, Aposhian says, because many gun owners never lock up firearms—instead, preferring to teach their children how to handle loaded guns responsibly—and others are concerned that locking a gun would impede access in an emergency. “Anything you say after that is going to fall on deaf ears,” he says.

When Aposhian discussed that point with Barber and the group, he expected backlash. Instead, they incorporated his suggestions into the pamphlet. “At that point, we could trust these folks. And Cathy has never mitigated that trust,” says Aposhian. “I know she’s not a fan of firearms. That’s fine. Somehow we work well together. Gun-rights folks, we rely on data. And she’s a big-data-type person on suicide. She does not bring a lot of emotion into it.” (In response to this characterization, Barber says: “It’s hard not to bring emotion to the work when you’re talking about suicide. What I try not to bring is an emotional ideology that divides people.”)

Barber returns Aposhian’s praise. “Clark is a font of creative ideas,” she says. “One time, I was at a meeting of the suicide prevention group in Utah. Clark said, ‘I have an idea for a PSA [public service announcement].’ My heart kind of sank, because everybody wants to do PSAs, and they’re always doom and gloom, and they don’t have any impact on suicide. But Clark’s idea was that a guy is at a shooting range and he turns to the camera and says: ‘Last year, I was at my worst, struggling with a depression. And a couple of buddies of mine stopped by the house and said they’d like to hold on to my guns for me because they were worried about me. I think those guys saved my life.’

“I thought: That’s perfect. It’s an example of resilience, because the guy is back at the shooting range, he’s recovered. For people who are struggling, it represents hope that things are going to get better. It’s also this peer model—a bro way of showing how to help somebody. And it takes place in a pro-gun atmosphere.”

Barber’s long path to such nuanced negotiations, and to Utah, began with research on domestic violence, working in a battered women’s shelter. She arrived at Harvard Chan in 1999, assigned to develop a surveillance system that would capture data on gun injuries. “Although I started with an interest in interpersonal violence, the suicide stories were overwhelming, both because of their numbers—which were greater than homicide—and because within so many of the stories were little seeds of how these tragedies might have been prevented.”

Barber’s public health philosophy pivots on the idea of mutual respect. “When people with different political perspectives begin talking to one another, you see the moral integrity of other points of view. It makes you a little bilingual in how you hear things in the future,” she says. She doesn’t always agree with Aposhian, but she tries to see where he’s coming from, because it makes her more aware of how preconceived notions regarding gun owners may taint her interactions with them. “People don’t do well when they’re approached as part of the problem. But too often, that’s how public health deals with the gun injury issue,” she says. “If you don’t trust the messenger, you don’t trust the message. And people who really hate guns, or on some level cannot find it in themselves to respect gun owners, are not the right messengers.”

Her journey to the gun suicide issue began in the early 2000s. There was growing data on the trend, yet suicide-prevention groups weren’t talking about guns, and pro-gun groups weren’t talking about suicide. These mutual blind spots meant no one was taking on the issue. “Suicide wasn’t on the gun advocates’ radar—they hadn’t looked at the data,” Barber says. “And the suicide-prevention groups showed a stunning lack of imagination—they assumed that talking about guns meant talking about gun control, and that was controversial, so they dropped the topic.”

Barber concluded that reducing suicide would require full-hearted engagement from both sides. She also knew a top-down public health intervention wouldn’t work. She needed to enlist the firearms community as part of the solution.

In 2009, a local tragedy far from Utah led to a template for action. In the span of a week, three people in New Hampshire bought guns from the same gun shop and took their own lives within hours of each purchase. That catalyzed the New Hampshire Gun Shop Project, which develops information for firearm retailers, instructors, and range owners on ways they can prevent such deaths—an unusual collaborative model that has been replicated in at least 20 states. At the heart of the project is grassroots education. Barber and others pushed the idea of an “11th commandment of firearm safety”: to be alert to signs of suicidal behavior in friends and family, and help keep guns away during these fragile periods.

“If you look at people like firearm instructors or gun-rights advocates, these are groups that have a real sense of responsibility around firearms, a deep-rooted ethic around safety and protecting the family. All those values dovetail with the values around suicide prevention. So why not capitalize on those shared values?” Barber says. Once she breaks down the statistics around suicide and firearms to gun-rights advocates, they are usually eager to collaborate. “It’s like you’re pushing on an open door,” Barber says. “It’s not a big sales pitch.”

“You could be next”

One day this spring, State Represent-ative Steve Eliason stood in the Utah Capitol’s rotunda—a glistening, marble-clad neoclassical hall, filled with paintings and statues depicting Utah history. Boyish-looking but dressed in a blue pin-striped suit, he exuded energy, walking and talking rapidly, often shifting between topics and destinations. He wound up at the skylit House chamber, where he had passed 16 bills in Utah’s whirlwind 45-day session this year. Several of those bills pointedly addressed gun suicide.

When Eliason joined the legislature in 2011, firearm deaths were far from his mind. A Republican from Sandy, a city of 87,000 about a half-hour south of Salt Lake City, he entered politics partly because party leaders were looking for someone to fill a spot on the ballot. Eliason is a certified public accountant (CPA) by trade and a lifelong Utahn. Like many of his fellow citizens, he is also a gun owner, and he speaks proudly about the handgun he built as a child. When he was elected, his agenda centered on humanitarian issues, such as support for homelessness services.

In 2012, shortly into Eliason’s first term, three of his son’s middle school classmates died by suicide. “I went to a back-to-school night and met one of those parents. And he tearfully pleaded with me to do something about it,” Eliason says. “Later, I had a boy in my Scout troop whose father was in prison. The boy said, ‘Steve, there’s a lot of kids dying in my school, and nobody’s talking about it.’ I looked at him and thought, ‘You could be next.’”

Eventually, Eliason says, “I had so many colleagues come forward who said, ‘I lost a loved one.’ ‘I lost a family member.’ ‘I lost a friend.’ ‘Let me know how I can help you.’ I realized, this isn’t a bipartisan issue. This is nonpartisan.”

The deaths inspired his first piece of legislation, which mandated statewide parental seminars on suicide prevention, child depression, and bullying. Later, Eliason helped secure state funding for the Harvard Chan research project on gun suicide in Utah. And he has been the sponsor or co-sponsor of nearly two dozen bills aimed at stemming Utah’s rising tide of suicides, from distributing free trigger locks to having gun salespeople routinely bring up the topic of suicide before selling a weapon.

Read more: Making Gun Access Difficult at Vulnerable Times

In 2014, the National Rifle Association (NRA) issued an “action alert” for an Eliason bill that called for using money from concealed-weapon permit fees to distribute gun locks to health care providers, mental health professionals, school districts, and public health organizations. Such alerts are typically the kiss of death for a gun-related piece of legislation—but Aposhian and the Utah Shooting Sports Council bucked the NRA, and eventually the association announced a “neutral” stance on the bill. In general, Eliason has steered clear of restrictive legislation that might draw opposition from Aposhian and the Utah Shooting Sports Council. But in 2017, he helped pass HB390, modeled after the successful New Hampshire Gun Shop Project.

Like Aposhian, Eliason was spurred to take action not only by hearing about personal tragedies but also by data—in this case, showing that many youths obtain firearms from parents or siblings. “My background is as a CPA, so I’m used to looking at the micro level of detail,” he says.

Eliason met Cathy Barber in 2014. “I literally just started doing internet research and came across Harvard’s Means Matter program. I cold-called Cathy one day and said, ‘I’m working on this. Do you have any suggestions?’ She was a breath of fresh air—very politically astute in terms of the lay of the landscape.”

On that call, Barber verbally drew two circles in a classic Venn diagram. “She said, ‘One of these circles is the strong Second Amendment community’—which I put myself in. ‘The other circle is the opposite side of the spectrum—do we want to be like Australia and get rid of all firearms? The two circles overlap in a little oval, where both sides agree. That’s the culture of safety. And I highly advise you to operate in that oval if you want to be effective.’”

While Utah is a conservative state, its politics often draw on bipartisan cooperation (there are only 17 Democrats in the 104-seat legislature). According to Eliason, individual values often trump party ideology.

Eliason says he’s guided by an approach called linear programming, an algebraic term that involves identifying limiting parameters and then designing solutions that maximize outcomes. “Instead of saying the answer is to take away everyone’s guns—which is a nonstarter—how about we focus on the culture of safety?” He calls it “the art of the doable.”

Agreeing to disagree

One afternoon in March, Aposhian and Sobelson were chatting amiably in the Gun Vault’s viewing area. The conversation turned to the AR-15, the semi-automatic rifle that had been used in a recent series of mass shootings, including the 2017 massacre on the Las Vegas Strip, which killed 58 and injured 851, and this past February’s shooting at Marjory Stoneman Douglas High School in Parkland, Florida, which left 17 dead.

When Sobelson brought up the weapon, Aposhian didn’t waver. He acknowledged the AR-15’s lethality but downplayed the public danger, pointing out that there are millions of AR-15s in the U.S. yet only a handful of mass shootings each year. “The threat by the AR-15 is disproportionately small, compared to the amount of attention focused on them,” he said.

As Aposhian spoke, Sobelson listened attentively and didn’t interrupt. Neither Aposhian nor Sobelson backed down from their positions, but they also weren’t afraid to challenge each other. Sobelson asked Aposhian what could be done to ensure that people live safely around these powerful weapons. Aposhian mentioned research showing that mass killers are a tiny subset within the already-small subset of gun owners with mental health problems. The conversation illustrated just how narrow and shifting the common ground is between them but also why they’ve found success: They never make things personal.

Aposhian and Sobelson disagree on lots of issues. Sobelson and others in Utah have floated the idea of taxing ammunition to support suicide prevention, in the same way that alcohol is taxed to support drunken-driving prevention. Aposhian vehemently opposes the idea of taxing bullets, partly because it is a tax and partly because it is not a proven remedy.

In March 2018, Harvard Chan’s Morissa Sobelson (left) and Kim Myers, Utah’s suicide prevention coordinator, joined Clark Aposhian on the weekly show “Gun Radio Utah” to discuss their work to prevent firearm suicides. Listen to that conversation at the end of this article.

In June, Sobelson testified in the Utah House in support of a so-called red-flag law, which would allow a law enforcement officer or judge to temporarily remove guns from the home of someone deemed a danger to himself or herself or to others. The Utah Shooting Sports Council opposes the bill. But evidence from Indiana and Connecticut shows that such laws reduce the incidence of suicide. “Shortly after I gave my testimony, one of the members of the committee spoke up,” Sobelson says. “He said his own father had died by suicide, and that if he had known to take away his father’s guns, he could have saved his father’s life. He was choking up.”

Sobelson says her work in Utah has challenged her assumptions about gun owners. She summarizes the liberal stereotype of gun-rights advocates: “All they care about are guns, guns, guns and uber-masculinity and risk taking. They are either apathetic or actually feel drawn to violence.” But this picture “is the opposite of what I’ve seen,” she adds. “People who are into guns tend to also be into values of supporting their families and their communities and feeling that the world is an extra-complex place to be raising a family.” Moreover, many gun owners whom she meets distance themselves from the hard-line, no-compromise stance of the National Rifle Association. “The great majority of gun owners that I’ve talked to are completely in favor of safety and sensible gun laws.”

Sobelson recalls a conversation with a pro-gun health care provider in Utah. “He said, ‘Back East, you people like your craft beer—which, in high quantities in the wrong context, can be a very dangerous product. But are we trying to take that away from you?’” She found his argument “persuasive,” adding, “I think firearms can be owned and handled responsibly. That’s one of my beliefs going into this.”

Sobelson also believes that the Harvard Chan study could provide valuable political cover to conservative lawmakers who may put themselves at risk by appearing to promote a reduction in firearm access. “The fact that this study came out of legislation passed by a Republican legislature is critical. We’re seeing people asking questions that may not traditionally align with their political interests.”

Indeed, the public health approach is a natural fit for such across-the-aisle deals, because the goal is not to assign blame. “It’s trying to prevent harm,” says Harvard Injury Control Research Center Director David Hemenway. “It’s not a debate about liberal versus conservative. The focus is on saving lives.”

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The path forward

Morissa Sobelson is under no illusions that her work will defuse the gun debate or single-handedly prevent gun deaths. Her hope is that it will slightly shift the conversation—away from entrenched political positions. The focus on means restriction, safe storage, and temporary removal of firearms during periods of personal crisis changes the tenor of the discussion, from a winner-take-all political fight to one where compromise is pragmatic. In her heart, she nurtures the broader hope that the way Harvard Chan researchers communicate across philosophical borders about firearms can be used to talk about other highly charged problems, such as climate change. “At a time nationally and globally where there’s so much divisiveness and so much darkness, these small areas of progress are incredibly invigorating.”

In a July 2018 op-ed in the Deseret News, Utah’s largest conservative newspaper, Sobelson and Aposhian shared a byline and an ideal: “We must listen, ask questions, and put learning new perspectives ahead of winning the arguments. We must enter spaces that are unfamiliar, whether that’s a shooting range or a health care coalition meeting, with a willingness to learn and to move outside our comfort zones. … Political polarity and emotional vitriol cannot be excuses for inaction.”

Steve Eliason agrees. “What I would say to other lawmakers who may be thinking about working in this area is: If you listen to your constituents and hear some of the personal stories of loss, and also stories of people who’ve overcome depression and despair, you will realize that this is very important to voters. It’s not difficult at all to find common ground. At the end of the day, whether you are very liberal or very conservative, you can agree that one of the proper roles of government is to preserve the lives of its citizens. If we put a fraction of the dollars that we spend on defense towards suicide prevention, how many more lives could be saved?”

Comrades in arms

Sobelson’s fiancé, Jamie Henn, works on climate change for the nonprofit group 350.org. Despite the fact that the couple is “constantly staring into the abyss,” as Sobelson puts it, they remain optimistic and hopeful—although Sobelson says, “We’re not so optimistic that we’re ever going to get invited to another cocktail party again in our lives.”

While they may not be invited to more cocktail parties, they were invited to Clark Aposhian’s wedding in June. There, the couple shared food and drinks and conversation with fierce gun-rights advocates, including a Utah legislator who had helped pass a law that allows teenagers to obtain concealed-carry permits. The lawmaker lamented the lack of civility in today’s political discourse, and Sobelson genuinely sympathized.

The high point of the reception was the unveiling of two singular confections. The groom cake featured a black-and-gray frosted sculpture of the Browning M1911 semi-automatic pistol, Utah’s official state firearm, with frosting bullets strewn around it. The bride cake was topped with a plastic bride and groom, each in formal wear, each brandishing a pistol in the “weapons ready” position. Afterward, Aposhian and his newly betrothed, Kasey Aposhian (who instructs schoolteachers in classes on concealed-carry firearms), drove off in a two-ton military transport truck, with a sign saying “Just Married” hanging off the back. Sobelson was as giddy as the rest of the guests.

A few weeks after the nuptials, Aposhian was in Mexico on his honeymoon and Sobelson was preparing her testimony before the Utah House in support of the red-flag law. She texted Aposhian, her comrade in arms, “Sad you will still be away so we won’t get to face off.”

Then she typed an emoji: .

Noah Leavitt is assistant director of communications and content strategy at the Harvard T.H. Chan School of Public Health.

Photography and video by Craig LaPlante, senior manager, creative digital media at the Harvard T.H. Chan School of Public Health.

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