While media attention to homicidal violence perpetrated with a gun has again peaked in the wake of the Charleston, South Carolina murders and a movie theater shooting in Lafayette, Louisiana, pessimism prevails about changing access to guns in this country.

Perhaps looking at another side of gun violence might make a difference. Little attention has been focused on the far greater numbers of gun deaths that result from intentional gunshot wounds – those people with access to a gun who turn it on themselves in what is typically a brief yet lethal moment of suicidality.

In 2013, 21,175 people in the U.S. died at their own hands using guns, more than those who died from homicide. And in the same year, more than 41,000 people died by suicide by all means, making gunshot wounds account for more than 50 percent of all suicide deaths that year. While suicide attempted by poisoning (like overdose) or cutting is not fatal 98 percent of the time, suicide with a gun is fatal 85 percent of the time,



In the decade between 1999 and 2010, the suicide rate for those aged 35 to 64 rose 28 percent; 40 percent for whites and 65 percent for American Indian and Alaska Natives while remaining unchanged for other age groups. Matters are not getting better, especially for those of middle age.

Moreover, suicides among American military personnel remain a serious issue. An estimated 22 veterans died every day in 2009 and 2010, at their own hands, their means principally firearms. In 2012 and 2013, self-inflicted deaths considerably outnumbered combat deaths among active military personnel.

But there are actions we can take to reduce access to deadly means and thereby save lives.When Israeli soldiers were required to leave their weapons on the base when on weekend leave suicide rates (90 percent of which were by firearm) dropped by 40 percent – with no change when soldiers were on base with their weapons. In the U.K., prior to 1960, gas in the home was the leading method of suicide. Gas then was rendered non-toxic and suicide rates fell by nearly one-third, due to the decrease in gas-related deaths. And in Sri Lanka, pesticides that were highly toxic to humans – and the leading cause of suicide there – were banned, and suicide deaths from these agents decreased by 50 percent in 10 years, while suicide by other methods showed no change.



In other words, means matter.

Acute suicidality is also remarkably brief. In a study of people who were hospitalized after attempting suicide, the time reported between the first thought and the action was 10 minutes or less in nearly half of the cases; the time between a decision to act and the attempt itself was less than 10 minutes in greater than 70 percent of cases and near to 90 percent in less than an hour. In a large study of college students, over 50 percent reported the interval between thought and action to be within the same day.

In other words, timing matters.While gun owners in the U.S. are not more likely to be suicidal or have a mental health problem they are far more likely to die from a suicide attempt because they have access to a far more lethal means in the brief time that elapses between idea, decision and action.

Until guns are more effectively regulated in the U.S. (which is the case in many other Western and Eastern countries), we can reduce suicide by firearms by engaging gun owners and their families in reducing access to this highly lethal means of self-destruction.



Gun locks, locked cabinets and storage of guns outside the home are parts of the answer, especially in rural and farm communities where guns are a household tool. Keeping the keys inaccessible can be more achievable than trying to limit gun ownership. Asking people who are suffering from depression, post-traumatic stress disorder, substance use and other mental disorders about gun ownership (in a standardized and non-accusatory manner) may reduce suicidal deaths; when the answer is yes, lives can be saved by reducing access to a weapon in advance of the possible moment when the impulse to die may overcome a person's inherent instinct to survive. Gun safety programs have become an important part of gun clubs, veterans' associations and firearm owners' groups; these organizations can be allies in local and national efforts to reduce self-inflicted gunshot wounds.