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.