The experience of survivors of firearms suicide attempts: A retrospective case series

Objective: We sought to identify people who survived firearm suicide attempts to describe the acute stressors, substance use, and mental health conditions related to the attempt. Background: Most firearm deaths in the United States are the result of suicide. Because firearm suicide attempts have a case fatality rate of approximately 90%, little is known about […]

National burden of injury and deaths from shootings by police in the United States, 2015-2020

Objectives. To describe all-outcome injurious shootings by police and compare characteristics of fatal versus nonfatal injurious shootings nationally. Methods. From July 2021 to April 2023, we manually reviewed publicly available records on all 2015–2020 injurious shootings by US police, identified from Gun Violence Archive. We estimated injury frequency, case fatality rates, and relative odds of death by […]

Veteran suicide: Missed opportunities for suicide prevention within concealed pistol license curriculum

Introduction Veteran suicide is a growing topic for public health concern. Despite enhancements from the Department of Veterans Health Administration, clinicians continue to struggle to identify and engage veterans at risk for suicide. Materials and Methods Examining suicide prevention efforts, epidemiology, risk factors, and barriers to care; Substance Abuse and Mental Health Services Administration and […]

Determining who military service members deem credible to discuss firearm safety for suicide prevention

Objectives To examine rankings of credible sources for discussing secure storage within a representative sample of firearm-owning service members, and examine how combinations of demographic variables impact the ranking of credible sources. Methods The probability-based sample was collected with the help of Ipsos. Participants were US service members who owned a firearm at the time […]

Project Safe Guard: Challenges and opportunities of a universal rollout of peer-delivered lethal means safety counseling at a US military installation

Introduction The US Department of Defense recommends lethal means safety counseling (LMSC) to promote firearm injury prevention via secure storage of personal firearms. We describe the rollout of a universal, peer-delivered adaptation of Project Safe Guard (PSG)—a brief, single-session LMSC discussion—at a US Space Force installation. Method Program evaluation data were collected via anonymous, voluntary, […]

Firearm carrying and adolescent suicide risk outcomes between 2015 and 2021 across nationally representative samples

Introduction Firearms are the most frequent means of youth suicide for the 14–18-year-old age group, and adolescent firearm access confers substantial increases in the risk of suicidal behaviors. There have been significant increases in firearm purchases and firearm violence in the United States since the onset of the COVID-19 pandemic. Methods This study uses four […]

Gun violence exposure and suicide among black adults

Importance  Black individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years. Objective  To evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults. Design, Setting, and Participants  This cross-sectional study used survey data collected from a nationally representative sample of […]

A cultural script for suicide among white men in the Mountain West region of the United States

The states of the Mountain West region of the United States consistently have the highest rates of suicide in the country, a pattern particularly pronounced in older White men. Although multiple constructs have been proposed to explain this long-standing pattern, including social isolation, cultural values, and psychopathology, relatively little research has been conducted to directly […]

Examining predictors of suicide by firearm in young, middle, and late adulthood

Introduction Suicide remains a leading cause of death in the U.S., and firearms are one of the most lethal methods of suicide. This study examines personal and contextual factors that predict suicide with a firearm compared to other methods across stages of adulthood. Methods Data on adult suicide decedents from 2009 to 2019 were obtained […]

Perceptions of the utility of secure firearm storage methods as a suicide prevention tool among firearm owners who currently store their firearms loaded and unlocked

Background Although secure firearm storage can prevent firearm injury and death, secure storage is relatively rare. This tendency may be driven in part by a perceived lack of utility for secure storage in preventing suicide and other gun violence-related outcomes. Method We recruited a large (n = 3510) representative sample of residents from five US states and […]

Suicide-related behavior and firearm access among perpetrators of domestic violence subject to domestic violence protection orders

Perpetrators of domestic violence (DV) may be a population at elevated risk of suicide. Domestic violence protection orders (DVPOs) can include the removal of firearms from the individual subjected to the order (i.e., the  respondent) to protect the victim-survivor. While removal of firearms in a DVPO is designed to protect the victim-survivor; it may also […]

Suicide victims and alcohol‑related consumption in Brazil: An observational study and a narrative review of the literature

Deaths due to external causes, mainly suicide, are a severe public health problem in Brazil. Evidence shows that the tendency to impulsive behavior is exacerbated after alcohol consumption. The relationship between alcohol and suicide is poorly described in the medical literature. The study aims to analyze the relationship between victims’ blood alcohol levels and suicides […]

Stakeholder perceptions of lethal means safety counseling: A qualitative systematic review

Introduction: Lethal means safety counseling (LMSC) is an evidence-based suicide prevention intervention during which providers encourage patients to limit their access to lethal means (e.g., firearms, medications). Despite agreement about the importance of LMSC, it is underutilized in clinical practice. Methods: To better understand the individual and contextual factors that influence LMSC and its implementation, we conducted […]

Notes from the field: Firearm suicide rates, by race and ethnicity United States, 2019-2022

Suicide, including firearm suicide, remains a substantial public health concern in the United States. During the previous 2 decades, overall suicide rates and firearm suicide rates have risen by approximately one third, approaching 50,000 overall suicides during 2022, including approximately 27,000 firearm suicides (1). Firearm suicides account for approximately one half of all suicides, and […]

Women Veterans’ perspectives, experiences, and preferences for firearm lethal means counseling discussions

Aims Firearms have become an increasingly common method of suicide among women Veterans, yet this population has rarely been a focus in firearm suicide prevention research. Limited knowledge is available regarding the preferences, experiences, or needs of women Veterans with respect to firearm lethal means counseling (LMC), an evidence-based suicide prevention strategy. Understanding is necessary […]

Age and suicide impulsivity: Evidence from handgun purchase delay laws

We provide the first quasi-experimental estimates of variation in suicide impulsivity by age by examining the impact of firearm purchase delay laws by age. Prior studies of firearm purchase delay laws use traditional two-way-fixed-effects estimation, but we demonstrate that bias due to heterogenous treatment effects may have inflated previous estimates relative to our stacked-regression approach. […]

American gun violence & mental illness: Reducing risk, restoring health, respecting rights & reviving communities

Intentional injuries claimed nearly two hundred lives every day in the United States in 2020, about two-thirds of them suicides, each a story of irretrievable human loss. This essay addresses the complex intersection of injurious behavior with mental illness and access to firearms. It explores what more can be done to stop gun violence while […]

Alienation flows through the barrel of a gun: Despair, mass shootings, and suicide in an American settler colony

In what is now referred to by many as the United States, gun violence rages on. When one considers the country’s sheer number of annual gun deaths, the data is as overwhelming as it is distressing. Indeed, perhaps the only  thing outpacing the trauma and loss of life wrought by gun violence is the anguish […]

Employee attitudes toward suicide prevention and Counseling on Access to Lethal Means: Initial findings from an academic medical center implementing the Zero Suicide framework

Introduction: Zero Suicide is a strategic framework designed to transform a healthcare system’s suicide prevention activities. In 2020, University of Utah Health launched a Zero Suicide program and Counseling on Access to Lethal Means (CALM) training for its employees. In 2022, the healthcare system surveyed its workforce’s attitudes toward suicide prevention and CALM. We sought to […]

Association between the New York SAFE Act and firearm suicide and homicide: An analysis of synthetic controls, New York State, 1999-2019

Objectives. To assess the association between the New York Secure Ammunition and Firearms Enforcement Act (NY SAFE Act) and firearm suicide and homicide rates. Methods. We employed a synthetic controls approach to investigate the impact of the NY SAFE Act on firearm suicide and firearm homicide rates. We collected state-level data on firearm mortality from the Centers for […]

What the data says about gun deaths in the U.S.

More Americans died of gun-related injuries in 2021 than in any other year on record, according to the latest available statistics from the Centers for Disease Control and Prevention (CDC). That included record numbers of both gun murders and gun suicides. Despite the increase in such fatalities, the rate of gun deaths – a statistic that accounts […]

Identifying rare circumstances preceding female firearm suicides: Validating a large language model approach

Background: Firearm suicide has been more prevalent among males, but age-adjusted female firearm suicide rates increased by 20% from 2010 to 2020, outpacing the rate increase among males by about 8 percentage points, and female firearm suicide may have different contributing circumstances. In the United States, the National Violent Death Reporting System (NVDRS) is a comprehensive […]

Tackling the increasing public health impact of firearms: A call to action

The incidence of gun violence in Canada has been increasing with an 81% rise in violent offenses involving guns since 2009. One in three homicides now firearm related. 1The issue extends beyond what is publicized in the news with the RCMP reporting 80% of firearm deaths in Canada being attributed to suicide. 2 Consider the […]