Firearm Ownership and Suicide Risk: Getting more precise to reduce risks
Bryan, Bryan and Anestis recently published a valuable and illuminating paper (https://doi.org/10.1080/13811118.2020.1848672) adding important nuance to our understanding of the relationship between firearm ownership and suicide risk. It is well-known that currently, in the US, the leading cause of firearm deaths is suicide rather than homicide. We know that state suicide rates vary very closely with state rates of gun ownership. We also know that a firearm in the home is more likely to be used in an accidental or suicidal shooting than in defending against an intruder (for lots of data on this see the excellent Means Matter website: https://www.hsph.harvard.edu/means-matter/means-matter/risk/).
Bryan, Bryan and Anestis look beyond the simple binary of gun ownership and examine several other factors related to suicide risk. The most notable of these factors are the primary reason for keeping a firearm at home and how many firearms does the person have. They found that those who keep firearms at home primarily for self-protection (as opposed to hunting, recreation or as collectors) and those who have a larger number of firearms are much more likely to have loaded and easily accessible firearms (as opposed to them being kept unloaded and locked) at home and also much more likely to have thought about suicide and even taken steps to prepare for an attempt at some point than those who have fewer firearms. Also, protection-oriented firearm owners tend to own handguns-which are most likely to be used in a suicide than a long gun more commonly owned and used by hunters.
It appears that the small group of gun owners who keep large numbers of firearms for self-protection are among the people at highest risk for suicidal thoughts and behaviors. The tragic irony here then is that it is possible that the psychological factors leading people to have lots of firearms at home for protection overlap with those that put them at risk for suicide. The firearms meant to provide safety are instead heightening their risk of death. Might it be that these people who feel a deep sense of danger and threat in their external environment such that they need to keep expanding their arsenal to enhance their feelings of safety are at least partly dealing with their own aggressive and violent impulses-which can also get turned inward on themselves?
What can we learn from this new report? First, researchers need to continue to home in ever more precisely on the factors that contribute to or mitigate risk for suicide (or accident) among firearm owners. As we get more refined information about these factors, we can hopefully make more informed and empirically supported efforts to educate and legislate safer limits as we’ve begun to do in some states with “Red Flag” laws. We need to continue to educate citizens about the urgent need for safe firearm storage to safeguard children at risk for accidental shootings and those at risk for suicide (see: https://www.endfamilyfire.org/ for more on safe firearm storage). We need to consider how some cynical groups have used fear of personal vulnerability to put those who might be vulnerable to just these feelings at even greater risk for harm. And finally, clinicians need to go beyond simple questions about whether there is a firearm at home when assessing risk for suicide. We need to consider storage and access, and how vulnerable, frightened and prone to anger our patients might be when we assess ongoing risk for suicide.