If you or someone you know may be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing or texting “988.”
Paul Nestadt, a psychiatrist treating suicidal patients, co-authoring research papers on suicide, and teaching graduate courses on the subject, admits, “I can’t tell you which of my patients is likely to die by suicide in the next six months.”
Studies show predictions of who will be suicidal are only slightly better than a coin toss, with no improvement in 50 years.
Nestadt focuses on interventions that don’t rely on identifying at-risk individuals, primarily making it harder for people to carry out suicide.
A Focus on Means, Not Predictions
“Instead of asking every doctor to figure out which patient will die by suicide and locking that patient up, it might be that we need to make sure there aren’t loaded guns available,” Nestadt said.
Research indicates limiting access to lethal means is among the most effective approaches to save lives. This includes barriers on buildings and bridges or restricting the number of pills purchasable at once.
Over 28,000 people died by gun suicide last year, accounting for more than half of all suicide deaths in the U.S., according to federal data. Gun suicides have reached record highs for five consecutive years.
Many victims are middle-aged white men and veterans, but gun suicides have also increased among women and some Black and Latino men.
Creating barriers for one method typically doesn’t lead people to choose another. Suicide risk can escalate quickly, and any delay — such as unlocking a safe to access a gun — provides time to reconsider or seek help.
The Role of Policy and Personal Stories
One policy gaining traction is the extreme risk protection order, or red flag law. Adopted in 22 states and the District of Columbia, these laws allow judges to temporarily remove guns from individuals deemed dangerous to themselves or others.
Research suggests these laws effectively prevent suicide but require identifying at-risk individuals. For instance, Dorothy Paugh’s father, who lost his job in 1965, bought a handgun and later died by suicide. Paugh believes a red flag law could have saved him.
Related Post: AI health tools lack real patient testing
Decades later, Paugh advocated for Maryland’s red flag law, which she believes is saving lives. Studies show that for every 10 to 20 guns removed under these laws, one suicide is prevented.
However, Paugh’s son, Peter, fatally shot himself in 2012 without showing warning signs. “I did not know that my son was suicidal. I didn’t have a clue,” she said. Even with a red flag law, she wouldn’t have thought to use it.
Those most vulnerable to firearm suicide are often not identified as such by family or clinicians. Studies show gun users were less likely to seek mental health care, and most veterans who die by gun suicide never express their thoughts beforehand.
This approach could include requiring permits and background checks for gun purchases, as well as waiting periods. Connecticut’s permit-to-purchase law was linked to a 15% decrease in gun suicide rates, while Missouri’s repeal of such a law was associated with a 16% increase.
Approximately three dozen states mandate gun owners to secure their firearms in homes with children, reducing youth suicides. This is critical as gun suicide rates have risen 245% among Black youths and 98% among Latino youths since 2014.
Laws requiring permits and safe storage also reduce homicides and other gun injuries. Exposure to gun violence increases trauma and suicide risk, creating a “double whammy,” according to Michael Anestis, executive director of the New Jersey Gun Violence Research Center.
Gun owners and trade associations generally oppose universal measures, favoring education campaigns instead. The National Shooting Sports Foundation has partnered with the American Foundation for Suicide Prevention to create materials for gun shops.
The National Rifle Association argues that gun-focused policies ignore deeper issues like mental illness. “Suicide is a serious issue that deserves serious solutions focused on the underlying causes, not on political efforts to restrict the rights of law-abiding Americans,” said NRA spokesperson Justin Davis.
Some initiatives bring together gun store owners, public health experts, and libraries to provide free locks, identify temporary gun storage, and educate on avoiding sales to suicidal individuals.
These efforts give Paugh hope. “It’s not a cure-all,” she said of policies to decrease gun access. “But it does save lives.” Having lost both a parent and a child, she knows how valuable that can be. “If you’re that one person or that person’s family, it’s all the difference in the world,” she said.
Political and Industry Resistance to Gun Control Measures
In the United States, discussions about gun control, even in the context of suicide prevention, often face strong political and industry opposition. Gun owners and the firearm industry argue that policies such as background checks, waiting periods, and red flag laws infringe on their Second Amendment rights. This resistance makes it challenging to implement broad measures aimed at reducing firearm suicides. Policymakers, aware of the polarizing nature of the topic, often view these discussions as politically risky, further complicating efforts to pass legislation.
