Despite an alarming uptick in homicides in some urban areas in the last few years, violent death rates are significantly lower than they were in the 1990s. There is one notable exception to this trend. Suicide rates for men and women have steadily increased for the past 15 years.
The statistics are bleak. Suicide is the tenth leading cause of death in the U.S. From ages 10 to 34, it is the second leading cause. Last year, at least 40,000 people in the U.S. died by suicide. From 1999 to 2014, the suicide rate for men and women jumped 24 percent.
There’s a long-standing stigma associated with suicide, and it gets far less media attention than other kinds of gun violence, such as mass shootings or domestic violence killings. Many religions view suicide as a sin; some consider it worse than homicide.
The role of guns in suicides is also often overlooked. Gun advocates have been slow to acknowledge the extra risks posed to suicidal people who have easy access to a gun. Yet those hazards are clear.
A firearm is used in a small minority of all attempts, but because guns are incredibly lethal, they are responsible for more than half of all suicide deaths. The Trace has prepared this statistical guide to illuminate the links between guns and suicides and identify some solutions that could save lives.
Suicides comprise two-thirds of all gun deaths. The typical victim of a gun homicide is a young, black male. The typical suicide victim is a middle-aged white man. Roughly 80 percent of suicide victims are men, and 83 percent are white.
Young people are also at an elevated risk of gun suicide. Among those aged 10 to 19, there were 2,259 suicides in 2014. Nearly half of those deaths — 41 percent — involved firearms, according to data from the CDC. The only more common cause of death for young people is accidental injuries, a category that includes traffic accidents and drownings.
One explanation for why men die so disproportionately by suicide is that men are less likely than women to seek help when they need it. Another is that men are more likely to use a gun. Women attempt suicide three times more often, but typically opt for pills or poisons, which are substantially less lethal, on average.
Guns are a devastatingly effective means of ending one’s own life. Firearms suicide accounted for six percent of attempts, and 54 percent of fatalities in one study that examined hospital data from eight states. For comparison, drug or poison overdosing accounted for 71 percent of attempts but only 12 percent of fatalities.
Suicides attempted with a firearm are lethal 82.5 percent of the time.
One of the biggest myths about suicide prevention is the notion that people who don’t succeed at killing themselves will simply find another means until they succeed, says Dr. Matthew Miller, the co-director of the Harvard Injury Control Research Center.
“You’ve got people saying, ‘Oh, if he didn’t shoot himself, he would have jumped off a tall building or found another way to kill himself.’ It’s not illogical, it’s just wrong — wrong in the face of facts that strongly say otherwise,” he says.
According to Catherine Barber, a suicide expert and Miller’s Harvard colleague, extensive research on this topic shows that between 5 and 11 percent of people who attempt suicides will go on to kill themselves — but the majority will not.
That’s because suicide is often an impulsive decision. One study found that a quarter of people took less than five minutes between deciding to kill themselves and attempting suicide.
A sweeping study published in July in the American Journal of Public Health, found that for every 10 percentage point increase in a state’s gun ownership rate, there was an associated increase of 3.3 deaths per 100,000 among firearm-owning men, and a .5 increase among women.
Dr. Michael Siegel, a professor of Community Health Sciences at Boston University School of Public Health, and his colleague, Emily Rothman, examined 33 years of data from all 50 states to reach their conclusions. The variation between states was tremendous: For men, average gun suicide rates were as low 4.2 per 100,000 in Massachusetts, and as high as 26.1 in Wyoming, a six-fold difference. The study controlled for other factors that could be used to explain a state’s suicide rates, such as unemployment or alcohol abuse.
Over the 33-year study period, Wyoming averaged both the highest gun ownership rate and the highest gun suicide rate in the country.
Wyoming is part of a cluster of Western states including Nevada, Colorado, Idaho, and Alaska that have had higher-than-average suicide rates so consistently that some researchers refer to this region as the Suicide Belt. The nine states with the lowest gun ownership — including California, Rhode Island, and New Jersey — have the lowest rates.
Studies that focus specifically on the presence of guns in a home also show a correlation with higher suicide rates. One explanation: Suicide is often an impulsive act, with the person in distress opting for what seems like the easiest obtainable means. Guns are more lethal than any other instrument; if kept close at hand a firearm is the method most likely to be used.
Two studies of youth access by the National Institutes for Health are instructive. One found that at least 82 percent of teens who committed suicide with a gun had used a weapon belonging to someone in their home. Another, using data from a 22-year period, determined that a 10 percent drop in the percentage of households owning guns was associated with an 8.3 percent decline in overall suicide rates for young people.
Military suicide rates are increasing at an alarming pace. Before the Iraq and Afghanistan wars, the suicide rate for veterans on active duty was about 25 percent lower than that of the general population. For reasons researchers have struggled to identify conclusively, the number of military suicides doubled between 2001 and 2012. In 2012, suicides overtook combat and transportation accidents as the leading cause of death for members of the military.
A report from the Department of Defense examining over 55 million veteran records estimated that between 18 and 22 veterans kill themselves every day. Veterans are even more likely than the general population to use a gun. Firearms accounted for 68 percent of suicides.
One intervention that can have a profound effect on saving lives is blocking access to guns from suicidal individuals in a time of crisis, by removing them, storing them out of reach, or convincing gun owners to voluntarily surrender their weapons.
Michael Anestis, who runs the Suicide and Emotion Dysregulation Lab at the University of Southern Mississippi, says blocking access to firearms is an effective prevention technique that is often overlooked. “Suicide is really hard, and if you make it harder, logistically, it’s much less likely to happen,” he says.
Anestis has shown that laws requiring gun owners to store their firearms with a locking device are associated with 68 percent fewer gun suicides per capita than states without them.
Many public health efforts, including several spearheaded by Harvard’s Means Matter Campaign, are focused on convincing suicidal people to store their guns away from home, or surrender control of their weapons to a trusted friend when they or a family member is in crisis.
California is one of at least six states — including Connecticut, Illinois, Indiana, Massachusetts and Texas — that allows law enforcement to petition for the removal of guns from a person who is a danger to themselves, according to Lindsay Nichols, a senior attorney at the Law Center to Prevent Gun Violence. (California’s law is unique in that it allows immediate family members to petition a judge for such an intervention.)
In Connecticut, where such a law has been in effect since 1998, police seized more than 2,000 guns between 1999 and 2009. A concern about suicide was the most common reason for seeking a warrant, cited in 46 percent of the cases.
Some people buy guns for the explicit purpose of committing suicide. An examination by the New England Journal of Medicine found that in the first week after purchase, the firearm suicide rate among California handgun purchasers was 57 times higher than the statewide rate.
To address this phenomenon, a program called the Gun Shop Project is asking gun store owners and firing ranges to distribute materials about suicide prevention to their clients. One goal is to help gun dealers spot potentially suicidal customers. Another is to reframe the idea of keeping guns away from suicidal people as a firearms safety tenet by making the practice as basic as keeping a gun unloaded when it’s not in use.
While it’s too early to proclaim the program a success, Barber, who helped develop the program, says that early results are promising. In New Hampshire, 48 percent of gun stores opted to display the suicide prevention materials, and the program has been copied in other states. Most importantly, some gun store owners have credited the program with saving lives.
In August, the National Shooting Sports Foundation, the gun industry’s trade group, partnered with the American Foundation for Suicide Prevention on a similar initiative. The program will distribute materials to shooting range operators and gun safety instructors across the country, with the goal of preventing nearly 10,000 suicides by 2025.
Many health professionals shy away from speaking to their patients about firearms — because they don’t know how to broach the topic, or because they’ve been discouraged from doing so. In Florida, for example, doctors have been banned from asking their patients about guns.
One study found that just half of patients who had visited an emergency room for suicidal thoughts or attempts had been asked if they had access to guns, according to their charts.
A report published earlier this year in the Annals of Internal Medicine urged doctors to discuss gun ownership with patients, including those who are considered more at-risk for suicide, such as middle-aged and older white men. Another survey published in the same journal found that 66 percent of Americans thought it was appropriate for doctors to talk to patients about gun ownership; 62 percent of gun owners thought the topic was appropriate if children were in the home.
States that impose a delay between the moments when someone buys a gun and when they can bring it home had 51 percent fewer gun suicides per capita compared to those without waiting periods, according to a study by Anestis, the University of Southern Mississippi researcher.
Federal law doesn’t require gun dealers to impose waiting periods, so states are left to pass their own requirements, which typically range from 3 to 14 days. Hawaii, which has one of the lowest suicide rates in the country, has a 14-day waiting period. South Dakota had a two-day waiting period before its law was repealed in 2009. The next year, the state saw a 7.6 percent uptick in its suicide rate.
And in the first four years after the law changed, the state saw an 8.9 percent increase in suicide rates.
The National Suicide Prevention Hotline is 1-800-273-8255. It is available 24 hours a day.