Why Don't We Talk About Suicide Prevention When We Talk About Gun Control?

Just two days after the Republican-controlled Senate rejected four measures aimed at regulating access to guns, 60 House Democrats staged a sit-in to demand a vote on gun reform. The House protest, leading Democrats said Wednesday, is a response to renewed calls for change in the wake of a shooting that killed 49 people and injured 53 others at an LGBTQ nightclub in Orlando, Fla. and a congressional stalemate that has persisted for nearly eight years.

The body count that rises by the day, a growing list of the injured, and overwhelming popular support for basic reforms like expanding background checks to all gun sales have not moved Republicans and a handful of anti-reform Democrats on the issue.

Still, the public continues to push for more accountability in gun policy. But even the current conversation about firearms—how mass shootings have killed 1,065 people and injured nearly 4,000 others since 2012, how most of the lives claimed by gun homicides are young black men living in low-income, highly segregated neighborhoods, or how loopholes in existing law allow domestic abusers to purchase weapons to deadly effect—is an incomplete picture of gun violence in the U.S.

Most gun deaths in this country are not homicides, they are suicides. And yet, we rarely mention that fact when discussing the lethal consequences of easy access to firearms.

“People don’t like talking about suicide,” Dr. Cassandra Crifasi, an injury epidemiologist at Johns Hopkins University and a faculty member at the school’s Center for Gun Policy and Research, told me. “It’s a really uncomfortable topic, but the burden of gun violence in the U.S., two-thirds of it, is suicide.”

Six in 10 gun deaths in 2012, according to the most recent year we have data on, were death by suicide. And older white men are more likely to die by suicide than any other demographic group. “But suicidal ideation, the idea that you want to end your life, is not a constant state of being,” Crifasi said. “There is often some event—you lose your job, you have a fight—that triggers the decision.”

Which is where policy comes in as part of a larger conversation about support and prevention, she said: “The idea is that if we could prevent somebody from getting access to the gun in that moment of crisis, then we could help reduce suicide.”

And many of the policies that have been floated as responses to mass shootings—like policies that impose waiting periods while thorough background checks are conducted—are also good policy when it comes to suicide prevention, she added. Studies, including research from Crifasi and Johns Hopkins, have shown that tighter controls on gun purchasing can correspond with a reduction in homicide rates—and suicide rates.

In 1995, Connecticut passed a law that required people looking to buy a gun to first complete hours of safety training and apply for a permit with law enforcement. Missouri, a state that had a similar law on the books for decades, repealed its so-called permit to purchase law in 2007. (“It’s something we’ve advocated for some time,” Kevin Jamison, president of the Missouri Sport Shooting Association, the National Rifle Association affiliate in the state, said at the time. “This makes it easier for people to buy firearms. They don’t have to get permission first.”)

Researchers at Johns Hopkins looked at both states as a case study in what kinds of trends are associated with tighter and looser gun laws.

Connecticut’s gun law, researchers estimated, was associated with a 15% drop in gun-related suicide in the 10 years after it was enacted. (Overall suicide rates declined, too.) Researchers came to this conclusion by comparing gun-related suicide rates in Connecticut to gun-related suicide rates in Rhode Island and North Dakota, two states that are demographically similar to Connecticut but do not have similar gun restrictions in place.

Using the same method—this time comparing Missouri to North Carolina and Nebraska—researchers estimated that the gun-related suicide rate increased by nearly 16% after the repeal of the permitting law. There was no similar increase in other methods of suicide that did not involve guns in Missouri.

The research concluded, basically, that making it harder to buy guns can make it harder for a person to kill themselves with a gun. And the effect can be lasting.

“The vast majority, if you prevent somebody from accessing a particular means they want to use for suicide or if you are able to intervene and save their life, most people who attempt suicide don’t go on to commit a future attempt,” Crifasi added, citing research on repeat attempts.

Bringing suicide into the national conversation about gun violence isn’t to take away from the devastation of gun homicides, or the non-lethal gun violence—the injuries, the use of firearms to threaten, intimidate, and abuse—that occurs on a daily, hourly basis in the U.S. But as we talk about gun violence, to ignore suicide gun deaths is to ignore the danger a person with a gun can pose to themselves.

The National Suicide Prevention Lifeline is a 24-hour, toll-free, confidential suicide prevention hotline available to anyone in suicidal crisis or emotional distress. 1-800-273-TALK (8255)