The offices of the Injury Control Research Center are on the third floor of the Harvard School of Public Health building in Boston. The center, directed by David Hemenway, consists of an internationally renowned team of public-health officials, social scientists and statisticians, and over the past decade they have been in the vanguard of a movement that looks at suicide prevention in a new and very different way: call it the Band-Aid approach.

“One of the differences between us and those in mental health,” Hemenway explained, “is that we focus on the ‘how’ of suicide. What are the methods used? Is there a way to mitigate them? And that’s where examples like the British coal-gas story are very instructive, because they show that if you can somehow remove or complicate a method, you have the potential of saving a tremendous number of lives.”

Animating their efforts is one of the most peculiar  in fact, downright perverse  aspects to the premeditation-versus-passion dichotomy in suicide. Put simply, those methods that require forethought or exertion on the actor’s part (taking an overdose of pills, say, or cutting your wrists), and thus most strongly suggest premeditation, happen to be the methods with the least chance of “success.” Conversely, those methods that require the least effort or planning (shooting yourself, jumping from a precipice) happen to be the deadliest. The natural inference, then, is that the person who best fits the classic definition of “being suicidal” might actually be safer than one acting in the heat of the moment  at least 40 times safer in the case of someone opting for an overdose of pills over shooting himself.

As illogical as this might seem, it is a phenomenon confirmed by research. According to statistics collected by the Injury Control Research Center on nearly 4,000 suicides across the United States, those who had killed themselves with firearms  by far the most lethal common method of suicide  had a markedly lower history of depression, schizophrenia, bipolar disorder, previous suicide attempts or drug or alcohol abuse than those who died by the least lethal methods. On the flip side, those who ranked the highest for at-risk factors tended to choose those methods with low “success” rates.

“We’re always going to have suicide,” Hemenway said, “and there’s probably not that much to be done for the ones who are determined, who succeed on their 4th or 5th or 25th try. The ones we have a good chance of saving are those who, right now, succeed on their first attempt because of the lethal methods they’ve chosen.”

Inevitably, this approach means focusing on the most common method of suicide in the United States: firearms. Even though guns account for less than 1 percent of all American suicide attempts, their extreme fatality rate  anywhere from 85 percent and 92 percent, depending on how the statistics are compiled  means that they account for 54 percent of all completions. In 2005, the last year for which statistics are available, that translated into about 17,000 deaths. Public-health officials like Hemenway can point to a mountain of research going back 40 years that shows that the incidence of firearm suicide runs in close parallel with the prevalence of firearms in a community. In a 2007 study that grouped the 15 states with the highest rate of gun ownership alongside the six states with the lowest (each group had a population of about 40 million), Hemenway and his associates found that when it came to all nonfirearm methods, the two populations committed suicide in nearly equal numbers. The more than three-times-greater prevalence of firearms in the “high gun” states, however, translated into a more than three-times-greater incidence of firearm suicides, which in turn translated into an annual suicide rate nearly double that of the “low gun” states. In the same vein, their 2004 study of seven Northeastern states found that the 3.5 times greater rate of gun suicides in Vermont than in New Jersey exactly matched the difference in gun ownership between the two states (42 percent of all households in Vermont opposed to 12 percent in New Jersey). From these and other such studies, the Injury Control Research Center has extrapolated that a 10 percent reduction in firearm ownership in the United States would translate into a 2.5 percent reduction in the overall suicide rate, or about 800 fewer deaths a year.

Beyond sheer lethality, however, what makes gun suicide attempts so resistant to traditional psychological suicide-prevention protocols is the high degree of impulsivity that often accompanies them. In a 1985 study of 30 people who had survived self-inflicted gunshot wounds, more than half reported having had suicidal thoughts for less than 24 hours, and none of the 30 had written suicide notes. This tendency toward impulsivity is especially common among young people  and not only with gun suicides. In a 2001 University of Houston study of 153 survivors of nearly lethal attempts between the ages of 13 and 34, only 13 percent reported having contemplated their act for eight hours or longer. To the contrary, 70 percent set the interval between deciding to kill themselves and acting at less than an hour, including an astonishing 24 percent who pegged the interval at less than five minutes.