How to Reduce Rate of Firearm Suicide in the United States?

Methods include targeted legislation, smart gun technology, and public education

NEW YORK, NY, July 22, 2016 – A new study finds that legislation reducing access to firearms has lowered firearm suicide rates in other countries.  This finding is based on evidence from around the world on the relationship between firearm ownership rates and firearm suicide rates.

To reduce firearm suicide rates in the United States, where similar legislation does not appear feasible, the authors recommend the swift implementation of targeted legislation to reduce firearm access to individuals at risk for suicide, smart gun technology, public education on firearm suicide, and research to evaluate the effectiveness of prevention methods.

Half of suicide deaths involve a firearm.  In 2014, of the more than 33,500 firearm deaths in the United States, over 21,000 were the result of suicide.  About 38 percent of U.S. households own at least one gun, making firearms widely available to those at risk of suicidal and homicidal behaviors.

Researchers from Columbia University Medical Center (CUMC) and New York State Psychiatric Institute (NYSPI) reviewed case-control, ecological, and time-series studies based on data from the United States and other countries. They extrapolated from more definitive gun control measures implemented elsewhere in considering what might be possible and effective in the United States, given the social context and constitutional limitations on firearm legislation.

Studies in the U.S. showed, at both ecological and individual levels, that greater firearm availability is associated with greater risk of firearm suicide. Globally, four studies in other developed countries found that per capita gun ownership correlates with firearm suicide rates at the national level.

Over the three-year period from 2000–2002, the 15 U.S. states with the highest household firearm ownership (47 percent) had almost twice as many suicides (N=14,809) as the six states with the lowest firearm ownership (15 percent) (N=8,052). This difference in overall suicides is largely accounted for by the difference in firearm suicides (9,749 compared with 2,606). Non-firearm suicides (5,060 compared with 5,446) and the total populations of the two sets of states were comparable.

Successful gun control efforts in Switzerland, Australia, Canada, and New Zealand have proven impossible to duplicate in the United States. Because of the Second Amendment to the U.S. Constitution, variations in state laws and regulations, and the opposition of gun rights advocates, such efforts have generally resulted in either inaction or passage of passing limited gun control or safety laws in a few states.

While states vary greatly in the stringency of their firearm laws, recent studies are encouraging about the benefits of targeted and multifaceted firearm restrictions, including permit to purchase, waiting periods, safe storage, gun violence restraining orders, background checks, and registration guidelines, all of which are associated with lower firearm suicide rates and lower overall suicide rates.

Smart gun technology, such as fingerprint recognition, limits use of a gun to the owner and permitted users. Mandating that new guns use the new technology and instituting trade-in programs to replace old guns with safer ones can prevent a household’s firearms from being used for suicide by family members or others with access to the firearm.

Safe storage methods, keeping guns unloaded, methods of identifying individuals at risk of suicide, and changing the belief that a suicide is “inevitable” are among the public health messages that may help reduce firearm suicide rates.  Social marketing initiatives to change public perceptions—similar to the successful campaigns to prevent driving while impaired, encourage seat belt use, and promote smoking cessation—may also prove valuable in reducing firearm suicide rates.

“These findings illustrate the influence that social policy can have on medical conditions, in this case suicide,” noted Jeffrey Lieberman, MD, chair of the department of psychiatry at CUMC and director of NYSPI.

All methods to reduce firearm suicide rates require not only implementation, but also monitoring and systematic evaluation of their effectiveness. “Ultimately,” said J. John Mann, MD, the Paul Janssen Professor of Translational Neuroscience (in Psychiatry and in Radiology) at CUMC, director of the Molecular Imaging and Neuropathy division at NYSPI, and senior author, “such program evaluation and lifting of the ban on federal funding of research on firearm violence will help improve efforts to reduce firearm suicide mortality.”

“Prevention of Firearm Suicide in the United States: What Works and What Is Possible,” was published in the American Journal of Psychiatry on July 22, 2016. The authors are J. John Mann and Christina A. Michel.

Dr. Mann receives royalties from the Research Foundation for Mental Hygiene for commercial use of the Columbia Suicide Severity Rating Scale. Ms. Michel reports no financial relationships with commercial interests.

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New York State Psychiatric Institute and Columbia University Department of Psychiatry  (NYSPI/Columbia Psychiatry)

New York State Psychiatric Institute (founded in 1896) and the Columbia University Department of Psychiatry have been closely affiliated since 1925. Their co-location in a New York State facility on the New York-Presbyterian/Columbia University Medical Center campus provides the setting for a rich and productive collaborative relationship among scientists and physicians in a variety of disciplines. NYSPI/Columbia Psychiatry is ranked among the best departments and psychiatric research facilities in the nation and has contributed greatly to the understanding of and current treatment for psychiatric disorders.  The Department and Institute are home to distinguished clinicians and researchers noted for their clinical and research advances in the diagnosis and treatment of depression, suicide, schizophrenia, bipolar and anxiety disorders and childhood psychiatric disorders.  Their combined expertise provides state of the art clinical care for patients, and training for the next generation of psychiatrists and psychiatric researchers.

Columbia University Medical Center provides international leadership in basic, preclinical, and clinical research; medical and health sciences education; and patient care. The medical center trains future leaders and includes the dedicated work of many physicians, scientists, public health professionals, dentists, and nurses at the College of Physicians and Surgeons, the Mailman School of Public Health, the College of Dental Medicine, the School of Nursing, the biomedical departments of the Graduate School of Arts and Sciences, and allied research centers and institutions. Columbia University Medical Center is home to the largest medical research enterprise in New York City and State and one of the largest faculty medical practices in the Northeast. For more information, visit cumc.columbia.edu or columbiadoctors.org.