By Julia P. Schleimer , Rose M. C. Kagawa and Hannah S. Laqueur

Background: Firearms are the most lethal method of suicide and account for approximately half of all suicide deaths nationwide. We describe associations between firearm purchasing characteristics and firearm suicide. Methods: Data on all legal handgun transactions in California from 1996 to 2015 were obtained from the California Department of Justice Dealer’s Record of Sale database. Handgun purchasers were linked to mortality data to identify those who died between 1996 and 2015. To account for variation in timing and duration of observation time, analyses were stratified by birth cohort. The primary analysis focused on those aged 21–25 in 1996. A secondary analysis tested associations among those aged 50–54 in 1996. Using incidence density sampling, purchasers who died by firearm suicide (cases) were each gender-matched to 5 purchasers (controls) who remained at risk at the case’s time of death. We examined the characteristics of purchasers and transactions, focusing on the transaction closest in time to the case’s death. Data were analyzed with conditional logistic regression. Results: There were 390 firearm suicides among the younger cohort and 512 firearm suicides among the older cohort. Across both cohorts, older age at first purchase and the purchase of a revolver were associated with a greater risk of firearm suicide. For example, among the younger cohort, those who purchased a revolver versus a semiautomatic pistol had 1.78 times the risk of firearm suicide (95% CI 1.32, 2.40) in multivariable models. Other associations varied across cohorts, suggesting cohort or age effects in purchasing patterns. Conclusions: Findings add to the evidence on firearm suicide risk and may help inform prevention strategies and future research.

Injury Epidemiology  2021. 8(68)

By Everytown Research and Policy

Beginning in 2020, the destabilizing impact of the COVID-19 pandemic led to social isolation, economic struggles, and worsening mental health across the country. Though suicide rates across the nation had declined from 2019 to 2020,1 they began to increase in 2021, and veterans were not immune to this trend. More veterans died by suicide in 2021 than in 2020,3 studies show that veterans saw a higher incidence of mental health concerns than before the pandemic. By 2021, 72 percent of veteran suicides involved firearms—the highest proportion in over 20 years. With an average of 18 veterans dying by suicide in the United States each day, 13 of them by firearm, we cannot address veteran suicide without talking about guns. Veterans confront unique challenges during their service and face new ones when they return to civilian life. And these challenges are not always what might be expected. While many assume that suicide in veterans is associated with their time while deployed veterans who served during the wars in Iraq in Afghanistan who were not deployed6 had higher suicide rates than those who were deployed. But one thing is clear: addressing the unique role guns play is an integral part of efforts to end veteran suicide. It is crucial to pursue policies that can protect against veteran suicide, including disrupting a person’s access to a firearm when they are in crisis through secure gun storage, storing a gun outside the home, using Extreme Risk laws; raising awareness about the risks of firearm access; addressing upstream factors that can lead to veteran suicide; and ensuring that we have timely data about the basic aspects of this crisis.

New York: Everytown Research and Policy 2024.

By Jeffrey W. Swanson, April M. Zeoli, Shannon Frattaroli, Marian Betz, Michele Easter, Reena Kapoor, Christopher Knoepke, Michael Norko, Veronica A. Pear, et al..

More than half of suicide deaths in the United States result from self-inflicted firearm injuries. Extreme risk protection order (ERPO) laws in 21 states and the District of Columbia temporarily limit access to firearms for individuals found in a civil court process to pose an imminent risk of harm to themselves or others. Research with large multistate study populations has been lacking to determine effectiveness of these laws. This study assembled records pertaining to 4,583 ERPO respondents in California, Connecticut, Maryland, and Washington. Matched records identified suicide decedents and self-injury method. Researchers applied case fatality rates for each suicide method to estimate nonfatal suicide attempts corresponding to observed deaths. Comparison of counterfactual to observed data patterns yielded estimates of the number of lives saved and number of ERPOs needed to avert one suicide. Estimates varied depending on the assumed probability that a gun owner who attempts suicide will use a gun. Two evidence-based approaches yielded estimates of 17 and 23 ERPOs needed to prevent one suicide. For the subset of 2,850 ERPO respond ents with documented suicide concern, comparable estimates were 13 and 18, respectively. This study’s findings add to growing evidence that ERPOs can be an effective and important suicide prevention tool.

J Am Acad Psychiatry Law 52(3) online, 2024. DOI:10.29158/JAAPL.240056-24

By Ned Levine, Stacy A. Drake, Thomas F. Reynolds, Yijiong Yang, Dwayne A. Wolf, David Persse, Charles E. Wade and John B. Holcomb

Firearm homicide and suicide deaths for 2014 were examined in Harris County, Texas, for spatial variation and socio-economic correlates. Higher firearm homicide rates were found closer to central Houston than firearm suicide rates. Local hot spots were identified for both types but overlapped at only two locations. A Poisson–Gamma–Exposure regression model showed the homicide rate was associated with higher percentages of persons who are Black, aged 15 to 29 years, and living in poverty whereas the suicide rate was associated with a higher percentage of persons of non-Hispanic White ethnicity. Firearm policies that reduce homicides may also reduce suicides.

Homicide Studies Volume 25, Issue 1Feb 2021. Pages 3-105

By Brady Campaign to Prevent Gun Violence

America’s deadliest shootings are those we rarely discuss: Over half of all gun deaths are suicides. On average, 64 people die of gun suicide each day in America — more than firearm murders and unintentional shootings combined. Firearms are by far the most lethal method of suicide. Amid the backdrop of COVID-19 and record-breaking gun sales, unsecured firearms in gun-owning households risk an increase in suicide. This report analyzes the relationship between firearms and suicide to provide tangible solutions for policymakers, community organizers, and more to prevent gun suicide and save lives by focusing on:

• Communities uniquely impacted by firearm suicide, including youth and teens, men, Alaskan Native, American Indian, and Black youth, military-connected and LGBTQ+ communities, and more

• Policy solutions, including extreme risk laws, waiting periods, and child access prevention laws

• Public health solutions, including lethal means safety and awareness of safe storage options, like: trigger locks, lock boxes, gun vaults, safes, off-site storage, and “asking to save lives"

Washington, DC: Brady United Against Gun Violence, 2021.

By V.G. Julie Rajan

Women Suicide Bombers explores why cultural, media and political reports from various geographies present different information about and portraits of the same women suicide bombers. The majority of Western media and sovereign states engaged in wars against groups deploying bombings tend to focus on women bombers' abnormal mental conditions; their physicality-for example, their painted fingernails or their beautiful eyes; their sexualities; and the various ways in which they have been victimized by their backward Third World cultures, especially by "Islam." In contrast, propaganda produced by rebel groups deploying women bombers, cultures supporting those campaigns, and governments of those nations at war with sovereign states and Western nations tend to project women bombers as mythical heroes, in ways that supersedes the martyrdom operations of male bombers.

London: Routledge, 2012. 400p.

Edited by Diego Gambetta

This book attempts to shed light on suicide missions and provide answers to the questions we all ask. Are these the actions of aggressive religious zealots and unbridled, irrational radicals or is there a logic driving those behind them? Are their motivations religious or has Islam provided a language to express essentially political causes? How can the perpetrators remain so lucidly effective in the face of certain death? And do these disparate attacks have something like a common cause? It focuses on four main instances: the Kamikaze, missions carried out by the Tamil Tigers in the civil war in Sri Lanka, the Lebanese and Palestinian groups in the Middle East, and the al-Qaeda 9/11 attack on the World Trade Center and the Pentagon. For more than two years, the authors have pursued an unprejudiced inquiry, investigating organizers and perpetrators alike of this extraordinary social phenomenon. Close comparisons between a whole range of cases raise challenging further questions: If suicide missions are so effective, why are they not more common? If killing is what matters, why not stick to ‘ordinary’ violent means? Or, if dying is what matters, why kill in the process?

Oxford, UK: New York: Oxford University Press, 2005. 452p.

By Talal Asad

Like many people in America and around the world, Talal Asad experienced the events of September 11, 2001, largely through the media and the emotional response of others. For many non-Muslims, "the suicide bomber" quickly became the icon of "an Islamic culture of death"—a conceptual leap that struck Asad as problematic. Is there a "religiously-motivated terrorism?" If so, how does it differ from other cruelties? What makes its motivation "religious"? Where does it stand in relation to other forms of collective violence?

Drawing on his extensive scholarship in the study of secular and religious traditions as well as his understanding of social, political, and anthropological theory and research, Asad questions Western assumptions regarding death and killing. He scrutinizes the idea of a "clash of civilizations," the claim that "Islamic jihadism" is the essence of modern terror, and the arguments put forward by liberals to justify war in our time. He critically engages with a range of explanations of suicide terrorism, exploring many writers' preoccupation with the motives of perpetrators. In conclusion, Asad examines our emotional response to suicide (including suicide terrorism) and the horror it invokes.

On Suicide Bombing is an original and provocative analysis critiquing the work of intellectuals from both the left and the right. Though fighting evil is an old concept, it has found new and disturbing expressions in our contemporary "war on terror." For Asad, it is critical that we remain aware of the forces shaping the discourse surrounding this mode of violence, and by questioning our assumptions about morally good and morally evil ways of killing, he illuminates the fragile contradictions that are a part of our modern subjectivity.

New York: Columbia University Press, 2007. 138p.