More stringent gun laws can save lives, while less stringent ones can lead to more deaths — that’s the major takeaway from a series of new studies examining the impact of various gun policies on suicide rates in states across the U.S.
Suicide is the 10th-leading cause of death in the U.S., taking the lives of an estimated 41,000 Americans annually. In more than half of these cases, the person uses a firearm. This is no coincidence: Guns are widely available and easily accessible across the country, and they are by far the most lethal method of suicide.
But as new research shows, smarter gun policies have the potential to change this. We already know that gun laws save lives by reducing murders and accidental shootings. As we commemorate World Suicide Prevention Day today, Sep. 10, here’s a look at three new studies showing how gun laws can also be used to address the preventable scourge of suicide.
Gun licensing laws: A tale of two states
The first study, which was published in the October issue of Preventive Medicine, found that gun suicides plummeted in Connecticut after the state passed a law requiring individuals to acquire a license before buying a gun. In Missouri, meanwhile, gun suicides spiked after a similar law was repealed there.
Based on an analysis of state-level suicide data from 1981–2012, researchers from Johns Hopkins University estimated that Connecticut’s 1995 law requiring individuals to obtain a permit or license to purchase a handgun was associated with a 15.4 percent reduction in firearm suicide rates, while Missouri’s repeal of its handgun purchaser licensing law in 2007 was associated with a 16.1 percent increase in firearm suicide rates. This was true even after controlling for confounding variables, like demographic factors and state unemployment rates, as well as national trends in suicide.
Importantly, the authors note that the reduction in firearm suicides in Connecticut and the increase in Missouri were not associated with significant changes in the rates of suicides by other means, contradicting the false but oft-repeated notion that restricting firearms won’t affect the overall suicide rate because people will just find another way to do it.
“Although these laws were not designed to reduce suicides, many of the risk factors that disqualify someone from legal gun ownership – domestic violence, history of committing violent crimes, substance abuse, severe mental illness and adolescence – are also risk factors for suicide,” explains study author Cassandra Crifasi, PhD, MPH, an assistant scientist with the Johns Hopkins Center for Gun Policy and Research, part of the Johns Hopkins Bloomberg School of Public Health.
‘When you make a highly lethal method less available… fewer people die’
In a second study, published last month in The American Journal of Public Health, researchers looked at the impact of four different types of firearm laws — waiting periods for gun purchases, universal background checks, gun locks, and open carrying regulations — on suicide rates. Using publicly available data on statewide firearm laws, suicide rates and demographic characteristics, the researchers found that each of the four laws was associated with a significantly lower rate of suicide by firearm as well as a lower overall rate of suicide, even after controlling for population density, race and ethnicity, education, poverty and age.
In 11 states with waiting periods, the longer the waiting period, the lower the gun suicide rate. Compared with states without the laws, background checks were associated with a 53 percent lower gun suicide rate, gun locks with a 68 percent lower rate, and restrictions on open carrying a 42 percent lower rate.
Looking at trends over time, states that implemented any of these four laws saw a decreased suicide rate in subsequent years, whereas the only state that repealed one of these laws saw an increased suicide rate, the analysis revealed.
“With respect to the laws themselves and how they impact suicide in general, we believe one of the primary mechanisms here is the simple removal of the attempt method most likely to result in death,” said the study’s lead author, Dr. Michael D. Anestis, an assistant professor of psychology at the University of Southern Mississippi. “… [M]ost individuals who attempt [suicide] using a gun ultimately die, whereas other methods are much more frequently non-lethal. When you make a highly lethal method less available…. fewer people die.”
In follow-up analyses, the researchers found that the drop in overall suicide rates was attributable to a steep decline in the proportion of suicides by firearms — in other words, firearm suicides dropped even as suicides by other methods remained constant, indicating that people weren’t simply switching from guns to another method.
Another study published last month in The American Journal of Public Health, which involved a different group of researchers but the same lead author, Dr. Anestis, looked at the effects of three other types of gun laws: those requiring a permit to purchase a handgun, a license to own one and mandatory registration of handguns.
Again, states with such laws had significantly lower rates of suicide by firearm, as well as lower overall suicide rates. And once again, the decline in overall suicides was accounted for by a steep drop in the proportion of suicides by firearm. In longitudinal analyses, the researchers found that implementation of gun licensing laws was immediately followed by a decrease in firearm suicides, further strengthening the case that ease of access to guns is a major risk factor for suicide.
“The results are thus supportive of the potential of handgun legislation to have an impact on suicide rates,” the researchers concluded.
Another interesting detail gleaned from the reports by Dr. Anestis and colleagues: The states with the highest suicide rates, in descending order, are Wyoming, Alaska, Montana, Nevada, New Mexico, Idaho, Oregon, Colorado, South Dakota and Utah. Half of them are on the Brady Campaign to prevent Gun Violence’s 2013 list of the 10 state with the most lenient gun laws, and seven of the states with the highest suicide rates received F’s on the Brady scorecard for safe gun regulations.
No law can completely eliminate suicides, Dr. Anestis said, but the evidence “indicates that legislation may have a meaningful and profound impact, saving lives that would otherwise be lost.”
These new studies confirm previous findings that more guns result in more suicides, but they add some of the first in-depth data on how specific policy changes can actually impact suicide risk over time. Key to the studies is the affirmation that means matter — that limiting a suicidal person’s access to highly lethal means reduces the likelihood that they will die by suicide.
Firearms are the most lethal method of suicide in the U.S. While guns are involved in just 5.6 percent of suicide attempts, they account for 55 percent of suicide fatalities. Indeed, more people in this country kill themselves with guns than with all other intentional means combined, including hanging, poisoning or overdose, jumping, or cutting. That’s because about 85 percent of suicide attempts involving guns result in death, making firearms the deadliest method of suicide in the United States, according to the Centers for Disease Control and Prevention. In comparison, intentional overdose/poisoning results in death in 2 percent of cases.
Suicides are often impulsive decisions, made without much planning or forethought. That’s especially true in gun suicides, where the majority of victims don’t have a documented serious mental illness. If someone in a crisis simply can’t access a gun quickly, they may not try suicide at all, or they may try a less-lethal means that offers more chance that they’ll be saved. And 90 percent of people who survive a suicide attempt don’t go on to take their own lives at a later time.
“Contrary to popular belief, suicidal thoughts are often transient, which is why delaying access to a firearm during a period of crisis could prevent suicide,” said Daniel Webster, director of the Johns Hopkins Center for Gun Policy and Research, and lead author of the study in Preventive Medicine.
This has been demonstrated in a number of “natural experiments,” including when, in 2006, the Israeli Defense Forces banned soldiers from bringing their rifles home with them on the weekends in an effort to tackle rising suicide rates. The result of this simple change? Suicides fell by 40 percent, according to a study by Israeli psychiatrists. Similar conclusions have been drawn from restricting other highly lethal suicide means, like putting up safety nets under bridges and other suicide “hotspots”.
Making a lethal method like firearms unavailable at the moment in which someone is in a suicidal crisis can keep them alive. Again, suicidal states are transient and temporary; they fluctuate over time. Making it more difficult for a suicidal person to access firearms can provide them the time and space necessary to awaken from the trance of acute suicidality, to get to the help they need and, ultimately, save their lives.
If you or someone you know is in crisis or in need of immediate help, call 1-800-273-TALK (8255). This is The National Suicide Prevention Lifeline, a free hotline available 24 hours a day to anyone in emotional distress or suicidal crisis.