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 […]

Firearm possession rates in home countries and firearm suicide rates among US- and foreign-born suicide decedents in the United States: Analysis of combined data from the National Violent Death Reporting System and the Small Arms Survey

Background: Suicide by firearms is a serious public health issue in the United States. However, little research has been conducted on the relationship between cultural backgrounds and suicide by firearms, specifically in those born and raised in the United States compared to those who have immigrated to the United States. Objective: To better understand the […]

Women Veterans’ experiences discussing household firearms with their intimate partners: Collaborative, devalued, and deferential relational types

Background Rates of firearm suicide have increased among women Veterans. Discussing firearm access and reducing access to lethal means of suicide when suicide risk is heightened are central tenets of suicide prevention, as is tailoring suicide prevention strategies to specific populations. While research has begun to explore how to optimize firearm lethal means safety counseling […]

U.S. gun violence in 2021: An accounting of a public health crisis

Gun violence is an ongoing public health crisis in the United States that impacts the health and wellbeing of all of us. In 2020, during the first year of the COVID-19 pandemic, the U.S. experienced an unprecedented spike in gun homicides. Many believed that this spike would be short-lived; levels of gun violence would subside […]

Physical health problems as a suicide precipitant: Associations with other risk factors and suicide methods in three age groups of older decedents

Background and Objectives: Physical health problems are a significant late-life suicide precipitant. This study’s purpose was to examine differences in (i) other suicide precipitants and psychiatric/substance use problems, and (ii) suicide methods (firearms, hanging/suffocation, and poisoning) in 3 age groups (55–64, 65–74, and 75+) of older suicide decedents who had physical health problems as a […]

Women veterans’ experiences discussing household firearms with their intimate partners: Collaborative, devalued, and deferential relational types

Background: Rates of firearm suicide have increased among women Veterans. Discussing firearm access and reducing access to lethal means of suicide when suicide risk is heightened are central tenets of suicide prevention, as is tailoring suicide prevention strategies to specific populations. While research has begun to explore how to optimize firearm lethal means safety counseling with […]

Trends in mortality from poisonings, firearms, and all other injuries by intent in the US, 1999-2020

Importance: Although deaths due to external causes are a leading cause of mortality in the US, trends over time by intent and demographic characteristics remain poorly understood. Objective: To examine national trends in mortality rates due to external causes from 1999 to 2020 by intent (homicide, suicide, unintentional, and undetermined) and demographic characteristics. External causes were defined […]

Leveraging community, context, data, and resources to inform suicide prevention strategies

Colorado has consistently had one of the highest rates of suicide in the United States, and El Paso County has the highest number of suicide and firearm-related suicide deaths within the state. Community-based solutions like those of the Suicide Prevention Collaborative of El Paso County may be more effective in preventing suicide as they are […]

Firearms access among pediatric patients at risk for suicide

Background: Approximately 2,900 youth who die by suicide each year in the United States use a firearm. To inform lethal means safety counseling efforts, this study aimed to describe firearm access among youth deemed at risk for suicide in pediatric medical settings. Methods: Youth who presented to one of four urban pediatric medical centers were screened for […]

Changing trends in suicide mortality and firearm involvement among black young adults in the United States, 1999-2019

The suicide rate among adolescents and young adults in the United States increased 57% between 2007 and 2018, from 6.8 to 10.7 deaths per 100 000 individuals. Recent research characterized as alarming the increases in overall suicide rates among young Black and other racial/ethnic minority populations. To assess the temporal trends in overall suicide and […]

Associations between firearm and suicide rates: A replication of Kleck (2021)

Objective: Using data from n = 194 nation-states, Kleck found that firearm availability was only associated with firearm suicide rates, but not total or non-firearm suicides. He thus concluded that while firearm availability influences how people commit suicide, it does not affect total numbers. However, the study contains numerous logical and methodological issues and is at odds with […]

Association of medical conditions and firearm suicide among legal handgun purchasers in California: A case–control study

Background Suicide is a pressing public health problem, and firearm owners are at especially elevated risk. Certain health conditions are markers of suicide risk, but more research is needed on clinical risk markers for suicide among firearm owners specifically. Our goal was to examine associations of emergency department and inpatient hospital visits for behavioral and […]

Witnessing community violence, gun carrying, and associations with substance use and suicide risk among high school students: Youth Risk Behavior Survey, United States, 2021

Community violence, including homicides involving firearms, is a significant public health concern. From 2019 to 2020, firearm-related homicides increased by 39% for youths and young adults aged 10–24 years, and rates of suicide by firearm increased by approximately 15% among the same age group. Findings from the nationally representative 2021 Youth Risk Behavior Survey were […]

Selection and use of firearm and medication locking devices in a lethal means counseling intervention

Background: While some suicide prevention initiatives distribute locking devices for firearms and medication, little evidence exists to guide the selection of devices. Aims: This study aimed to describe safety standards for locking devices and compare parental acceptance rates for different types of devices. Method: As part of the larger SAFETY Study, behavioral health clinicians provided free locking devices to parents […]

Vehicle firearm storage: Prevalence and correlates in a sample of male firearm owners

Abstract Previous research has linked unsafe firearm storage practices and other ownership-related characteristics to key factors that facilitate the transition from suicidal thoughts to suicidal behaviors (i.e., acquired capability for suicide). This research has not investigated the extent to which firearm owners store firearms in their vehicles, a factor that increases ready access to the […]

Characteristics and context of veterans experiencing serious suicidal ideation or suicide attempt by firearm which led to hospitalization

Objective: Suicide by former United States military service members is of great public health concern, and one area, veterans’ suicide attempts involving firearms, is understudied. One group that has a unique perspective on this are veterans with a psychiatric admission following a firearm-related suicide crisis, such as making a suicide plan or a suicide rehearsal with […]

Exploring prospective predictors of completed suicides: Evidence from the general social survey

Background: This study was based on over 30,000 respondents who completed General Social Surveys between 1978 and 2002. Aims: We approached these respondents prospectively, comparing and contrasting the responses of those who subsequently died by suicide (N = 141) with those who died from all other causes (N = 9,115). Method: We employed chi-square and logistic regression analyses […]