Mikey, a 13-year-old boy from upstate New York, was friendly and engaged. One day in January, he shot and killed himself with one of his father’s guns. Mikey’s suicide came as a shock. “He may have gotten angry for some reason. At that age you’re not thinking how final a gun is.” –Alexandria Bodden, Mikey’s older sister and gun violence prevention advocate

Claiming the lives of 23,000 Americans every year, including 1,100 children and teens, firearm suicide is a significant public health crisis in the US. Nearly two-thirds of all gun deaths in the US are suicides, resulting in an average of 63 deaths a day. And the problem is getting worse: Over the past decade, the US firearm suicide rate has increased by 19 percent. This trend has been of particular concern for children and teens, whose firearm suicide rate has increased by 65 percent over the past 10 years; and for veterans, who have a firearm suicide rate 1.5 times higher than non-veteran adults.

2/3 Nearly 2/3 of all gun deaths in the US are suicides. “National Center for Injury Prevention and Control, Web-based Injury Statistics Query and Reporting System (WISQARS) Fatal Injury Reports”. CDC. (2019). https://bit.ly/3itntGu 1/2 Firearm suicide makes up half of all suicides CDC, NCIPC. “Web-based Injury Statistics Query and Reporting System (WISQARS)”. (2012-2016). www.cdc.gov/injury/wisqar

In 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. Addressing firearm suicide is an essential element of any strategy to reduce gun violence in this country. Given the unique lethality of firearms as a means of suicide, policies and practices that limit or disrupt access to firearms have been shown to save lives.

Key Findings

Americans should be aware of the prevalence of firearm suicide, how having access to a gun increases the risk of suicide, and steps they can take to mitigate risk. Research shows that having access to a firearm triples one’s risk of death by suicide. This elevated risk applies not only to the gun owner, but to everyone in the household. People who live in US states with high rates of household gun ownership are also almost four times more likely to die by gun suicide than those in states where fewer households have guns. This relationship remains strong even when controlling for other factors associated with suicide, like poverty, unemployment, serious mental illness, and substance abuse.

Access to a gun robs a person in crisis from a second chance at life.

There is a popular misconception that suicide is inevitable, that suicidal ideation is a permanent condition. But most people who attempt suicide do not die—unless they use a gun. Across all suicide attempts not involving a firearm, 4 percent will result in death. But for gun suicide, those statistics are flipped: Approximately 90 percent of gun suicide attempts end in death. And the vast majority of all those who survive a suicide attempt do not go on to die by suicide. This suggests that a reduction in suicide attempts by firearm would result in an overall decline in the suicide rate.

Firearm suicides follow sharply divergent demographic patterns.

Men, white Americans, and those living in rural areas are disproportionately affected. Men represent 86 percent of firearm suicide victims; they are six times more likely than women to die by firearm suicide. For men, firearm suicide rates largely increase with age, and are especially high for males 65 and older. For women, firearm suicide rates are highest in the 40-to-60 age range.

86% Men represent 86% of firearm suicide victims CDC, NCIPC. Web-based Injury Statistics Query and Reporting System (WISQARS). (2012-2016). www.cdc.gov/injury/wisqar

White Americans represent 86 percent of all firearm suicide victims, and have the highest rate of firearm suicide by race. American Indians/Alaska Natives also have a disproportionately high rate of firearm suicide, with the second-highest rate of firearm suicide among the country’s five major racial and ethnic groups.

Americans living in rural areas experience far higher rates of firearm suicide than those living in urban areas. The average firearm suicide rate increases as counties become more rural, and the rate of firearm suicide in the most rural counties is 2.5 times higher than in the most urban.

Recommendations

Firearm suicide is preventable. Policies and practices that focus on disrupting access to firearms can reduce firearm suicides. Lawmakers and the public should:

Build public awareness about the suicide risk posed by firearm access.

Most gun-owning Americans think their firearms make them safer. The reality is that access to a firearm increases the risk of suicide for all people in the household. In the absence of public health campaigns led by the federal government, trusted experts like law enforcement, gun dealers, and medical professionals have all launched campaigns that help inform Americans about the risks of firearms in the home and how to mitigate those risks. For example, through a program called the Gun Shop Project, dozens of gun shops nationwide have begun displaying and distributing materials with information about the risks of firearm access—particularly as it pertains to suicide.

Physicians and other medical professionals are also crucial sources of information about the risk of firearm access. By asking their patients about firearm access and counseling about firearm suicide risk, medical professionals may help prevent these deaths. Counseling on Access to Lethal Means, or CALM, is one example of a program that 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.”

Limit the easy and immediate acquisition of firearms.

Policies and practices that disrupt the easy and immediate acquisition of firearms have been shown to save lives. States with permit-to-purchase (PTP) laws, which require an individual to obtain a permit in addition to a background check when buying a handgun, see reductions in firearm suicide. Connecticut’s enactment of PTP and comprehensive point-of-sale background check laws were associated with a 15 percent decline in the firearm suicide rate over the following decade. By contrast, when Missouri repealed its PTP law, the state experienced a 16 percent increase in the firearm suicide rate over the following five years.

80% Over 80% of child firearm suicides involved a gun belonging to a family member Johnson R. M., Barber C., Azrael D., Clark D. E., & Hemenway D.”Who are the owners of firearms used in adolescent suicides?”. Suicide & Life-Threatening Behavior. (2010). https://doi.org/10.1521/suli.2010.40.6.609

A mandatory waiting period may also help prevent firearm suicides. A waiting-period law requires a certain number of days to elapse between the purchase of a firearm and when the purchaser can actually take possession of that firearm. Policies that create this buffer are associated with reduced rates of firearm suicide.

Encourage the secure storage of firearms in the home to prevent access by children and other unauthorized users.

Secure firearm storage can help mitigate the risks of firearm suicide, especially for children. Approximately 4.6 million American children live in households with at least one loaded, unlocked firearm. When American children die by firearm suicide, over 80 percent use a gun belonging to a family member. One study found that households that locked both firearms and ammunition were associated with a 78 percent lower risk of self-inflicted firearm injuries and an 85 percent lower risk of unintentional firearm injuries among children, compared to those that locked neither. And researchers estimate that if half of households that store at least one unlocked gun moved to lock all of their guns, 251 youth fatalities from firearm suicide and unintentional shootings could be prevented in a single year. These lives saved would make up one-third of all preventable youth deaths from firearm suicide and unintentional shootings that year.

Many cities and states have laws that require or encourage secure storage. Six states and the District of Columbia have passed laws mandating that owners securely store their firearms. And 14 states have passed Child Access Prevention (CAP) laws, which impose criminal penalties when a person fails to securely store a firearm and a child gains unauthorized access to it. States with laws mandating secure storage or with CAP laws saw an 8 percent decrease in overall suicide rates and an 11 percent decrease in firearm suicide rates among adolescents aged 14 to 17.

Create mechanisms to temporarily remove firearms from individuals in moments of crisis.

To protect individuals in crisis, several states have passed Extreme Risk laws as a way to temporarily remove firearm access. Extreme Risk laws give family members and law enforcement a way to intervene before warning signs escalate into tragedies. These laws permit immediate family members and law enforcement to petition a court for an order to temporarily remove guns from dangerous situations. If a court finds that a person poses a serious risk of injuring themselves or others with a firearm, that person is temporarily prohibited from purchasing and possessing guns, and any guns they already own are held by law enforcement or another authorized party while the order is in effect. At the time of publication, 17 states and DC have Extreme Risk laws in place.

If you or someone you know is in crisis, please call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255), or text HOME to 741741 to reach the Crisis Text Line for free from anywhere in the US.

For more information on secure storage of firearms and how you can help others improve their storage practices, visit besmartforkids.org.