The rate of firearm suicides in a community reflects the percentage of households with firearms.
Multiple Studies show that the risk of suicide in a home is correlated to the presence of a firearm in the home. The best-known study that compared firearm ownership and suicide rates looked at two groups of states. A high gun ownership group of 15 states with 39 million inhabitants had 47% of households with firearms. A low gun ownership group of 6 states with 40 million inhabitants had 15% of households with firearms.
The high gun ownership states had suicide rates averaging 13 per 100,000 and the low ownership states 7 per 100,000. Non firearm suicide rates were almost identical, 4 per 100,000 and 5 per 100,000. The firearm suicide rate was 8 per 100,000 in the high ownership states and 2 per 100,000 in the low ownership states. The difference in suicide rates could be accounted for by more households having firearms in the high ownership states. 1
Homes where suicides occur are more likely than other similar homes to have firearms.
Looking at homes where suicides occur and comparing them in terms of gun ownership with other similar homes without a suicide history is another way to look for a relationship of gun ownership and suicide. Several such studies have been done, and one study analyzed a group of these studies. The authors analyzed together 14 studies that met their criteria for lack of bias, suitable controls and outcome measures. The analysis found suicides were 3.24 times more likely and homicides twice as likely for people living in homes with firearms.2
How a firearm is stored can decrease the suicide risk of the weapon for family members:
A study looked at how guns are stored in the home and the risk of accidental injury or suicide to people under age 20. The study compared two groups of households. The first was 81 homes where firearm suicide attempt (95% fatal) and 25 homes where an unintentional firearm injury (52% fatal) had occurred to someone less than 20 years old. The second was 480 control homes where a gun was owned and someone under age 20 was living but no injury occurred. In homes where injuries had not occurred, guns were 24% more likely to be stored unloaded, 25% more likely to be stored locked, and 24% more likely to have ammunition stored separately from the firearm. Safe storage can limit the risk to the owner, protecting others in the family. 3
Firearm ownership is not more likely in families with a history of depression or suicidal thoughts:
A study compared the frequency of any history of major depression or serious suicidal thoughts reported by families, the frequency of handgun ownership by families, and the frequency of firearm and non-firearm suicides in seven census regions in the United States.
Across all regions, household handgun ownership rates correlated with overall suicide rates: more highly with firearm suicide rates than non-firearm rates. The frequency of handgun ownership was negatively correlated with non-firearm suicide rates among the regions.
The percentage of households reporting a history of major depression or a history of suicidal thoughts did not correlate with the frequency of handgun ownership. The frequency of suicidal thoughts did correlate with suicide rates, but the frequency of depression histories did not.
These findings indicate that people with a history of depression or suicidal thoughts are not more likely to own firearms. The study also found that the presence of firearms was related to suicide risk, particularly for firearm suicide. 4
Features of firearm suicides that account for the risk firearms represent
Several features of firearms make their presence risky when someone has an urge to commit suicide
The impulse to commit suicide is often not long lasting. Many attempts occur within minutes and most within 24 hours of making a decision to do so.5 Having a firearm available makes it very easy to move from urge to act. Once initiated there is no turning back. It is very likely to succeed, 85% of attempts are fatal. 6 There will be no suffering if the attempt is successful.
Hanging or drowning are lethal about half the time. Both take more time to complete and will likely involve suffering. Carbon monoxide poisoning requires persistence and leaves a chance for rescue. Overdoses and cutting, the most common attempts, are much less likely to be lethal.6 An exception would be deliberate narcotic overdose, though these can be reversed if the victim is found in time.
Many suicide attempts are in response to crisis in people without long histories of mental illness and most survivors do not end up dying of suicide. Survivors often report that the attempt has resolved the feeling of crisis and they doubt they will try again. In one long term follow-up of 1422 survivors, only 2.3% died by suicide during 3 to 25 years of follow-up.7
Firearms lead to the death of people less ill than those desperate enough to use other methods. A study of 1397 suicides in Finland found that firearm victims compared to those using other means were less likely to have had psychiatric treatment or hospitalization, to have “coped psychosocially relatively well,” and that their suicides were also “associated with recent life events and alcohol in the blood”. They were more likely to have a partner as well.8
Implications for Indiana
Indiana’s percentage of suicide by firearms (57%) is below the firearm to non-firearm suicide ratio seen in the highest gun ownership states (66%), but well above the 32% seen in the lowest gun ownership states in the study reviewed above. In that study, non-firearm suicides were 7% higher where fewer households had firearms. Based on these observations, if Indiana was in the lowest category of firearm ownership among the states, Indiana might have seen about 475 non-firearm suicides and 224 firearm suicides for a total of 699 in 2018, a saving of 300 lives.
- Miller and Hemenway, Rates of Firearm Ownership and Suicide: A Three-year Study, NEJM, 359:10, 989-991,2008
- . Anglemyer, Horvath, and Rutherford, The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among Household Members, Annals of Internal Medicine, 160:101-110, 2014
- Grosssman et al, Gun Storage Practices and Risk of Youth Suicide and Unintentional Injuries, Journal of the American Medical Association, 293:6, 707-711, 2005
- Hemenway, D, Miller, M Association of rates of household handgun ownership, lifetime major depression, and serious suicidal thoughts with rates of suicide across US census regions. Injury Prevention 2002;8:313–316
- https://www.hsph.harvard.edu/means-matter/means-matter/duration/
- Spicer, R.S. and Miller, T.R. Suicide acts in 8 states: incidence and case fatality rates by demographics and method. American Journal of Public Health. 90(12): 1885-1981, 2000
- J. Michael Bostwick, M.D., Chaitanya Pabbati, M.D., Jennifer R. Geske, M.S., and Alastair J. McKean, M.D., Suicide Attempt as a Risk Factor for Completed Suicide: Even More Lethal Than We Knew. Am J Psychiatry. 2016 Nov 1; 173(11): 1094–1100.
- Pirkola et al, Do Means Matter, Differences in Characteristics of Finnish Suicide Completers Using Different Methods, Journal of Nervous and Mental Disorders, 191(11), 745-750 , 2003