Gun suicide accounts for 2/3 of fatal gun violence every year. Until recently I have always been somewhat uncomfortable lumping suicide and homicide together, if only because the nature of the event is so different, the ownership and access to the weapon is so different, hence one assumes that the mitigation strategies should be different. But following discussions with the expert suicide researchers at Harvard’s Injury Control Research Center and a review of peer-reviewed literature, I am persuaded that gun suicide is not only a fundamental gun violence problem, but understanding and responding to it might provide a map for mitigating gun homicides and gun assaults as well.
Gun suicides and gun homicides intersect In two basic ways: the lethality of the weapon and the motives and behavior of the shooter leading up to the incident itself. As to the former, guns used in suicides result in a success rate of 95%. No other suicide effort is half as effective in the final result. As for homicide, obviously the “success” rate is only about 10%, but there is no other serious injury which comes close to generating the costs and trauma that results from being wounded with a gun.
As to behavior, the degree to which impulse governs the actions of everyone who shoots themselves or others with a gun should not be overlooked. Less than 20% of all homicides occur during the commission of another, serious crime. Most gun homicides grow out of a history of disputes between individuals who know each other and the incidence of domestic abuse in homicides where the victims are women is virtually 100%. I recently discussed a report from the Violence Policy Center in which I noted that a random search of gun homicides committed by CCW-holders showed that virtually all of them grew out of arguments and fights, usually aggravated by too much to drink. Is there really a great difference between the guy who gets sick and tired of fighting with himself or sick and tired of arguing with his wife and reaches for his gun? I don’t think so, and the research on suicide and homicide tends to bear me out.
What about mitigating strategies for both types of fatalities involving guns? An article on suicide prevention among Israeli soldiers caught my eye because Israel is often touted by the pro-gun community as the model for giving civilians full access to guns with a consequent low rate of violent crime. But the policy of allowing soldiers to keep their guns with them on weekend leave also resulted in an alarmingly high rate of suicide among these soldiers, which dropped by nearly 40% when soldiers had to leave their guns secured at their base while spending weekends at home. Anyone who thinks there’s no connection between suicide and gun access needs to look honestly at what happened in Israel before and after access to guns was denied.
The pro-gun folks would like to believe that gun fatalities have nothing to do with guns and are all about crime. There’s a simple logic to that argument except for the fact that every single gun involved in a criminal event first started out as a legal gun. For that matter, most of the guns in suicides either were legally owned by the suicide victim or belonged to another family member who legally purchased the gun.
The usual response from the gun-safety community is to push for an expansion of CAP laws, and clearly such laws do have a mitigating effect when it comes to keeping kids away from guns. But let me break the news to you gently – the big problem with such laws is that the only way that someone can use a gun is to unlock where the gun is stored or unlock the gun itself. And the problem we face with both gun suicides and gun homicides is figuring out how to spot the impulsive, destructive behavior of certain people before they get their hands on a gun.
Apr 14, 2015 @ 12:42:30
In general, people try to kill themselves for six reasons:
1. They’re depressed. This is without question the most common reason people commit suicide. Severe depression is always accompanied by a pervasive sense of suffering as well as the belief that escape from it is hopeless. The pain of existence often becomes too much for severely depressed people to bear. The state of depression warps their thinking, allowing ideas like “Everyone would all be better off without me” to make rational sense. They shouldn’t be blamed for falling prey to such distorted thoughts any more than a heart patient should be blamed for experiencing chest pain: it’s simply the nature of their disease.
Because depression, as we all know, is almost always treatable, we should all seek to recognize its presence in our close friends and loved ones. Often people suffer with it silently, planning suicide without anyone ever knowing. Despite making both parties uncomfortable, inquiring directly about suicidal thoughts in my experience almost always yields a honest response. If you suspect someone might be depressed, don’t allow your tendency to deny the possibility of suicidal ideation prevent you from asking about it.
2. They’re psychotic. Malevolent inner voices often command self-destruction for unintelligible reasons. Psychosis is much harder to mask than depression — and arguably even more tragic. The worldwide incidence of schizophrenia is 1% and often strikes otherwise healthy, high-performing individuals, whose lives, though manageable with medication, never fulfill their original promise.
Schizophrenics are just as likely to talk freely about the voices commanding them to kill themselves as not, and also, in my experience, give honest answers about thoughts of suicide when asked directly. Psychosis, too, is treatable and usually must be for a schizophrenic to be able to function at all. Untreated or poorly treated psychosis almost always requires hospital admission to a locked ward until the voices lose their commanding power.
3. They’re impulsive. Often related to drugs and alcohol, some people become maudlin and impulsively attempt to end their own lives. Once sobered and calmed, these people usually feel emphatically ashamed. The remorse is usually genuine, and whether or not they’ll ever attempt suicide again is unpredictable. They may try it again the very next time they become drunk or high, or never again in their lifetime. Hospital admission is, therefore, not usually indicated. Substance abuse and the underlying reasons for it are generally a greater concern in these people and should be addressed as aggressively as possible.
4. They’re crying out for help and don’t know how else to get it. These people don’t usually want to die but do want to alert those around them that something is seriously wrong. They often don’t believe they will die, frequently choosing methods they don’t think can kill them in order to strike out at someone who’s hurt them—but are sometimes tragically misinformed. The prototypical example of this is a young teenage girl suffering genuine angst because of a relationship, either with a friend, boyfriend, or parent who swallows a bottle of Tylenol—not realizing that in high enough doses Tylenol causes irreversible liver damage.
I’ve watched more than one teenager die a horrible death in an ICU days after such an ingestion when remorse has already cured them of their desire to die and their true goal of alerting those close to them of their distress has been achieved.
5. They have a philosophical desire to die. The decision to commit suicide for some is based on a reasoned decision often motivated by the presence of a painful terminal illness from which little to no hope of reprieve exists. These people aren’t depressed, psychotic, maudlin, or crying out for help. They’re trying to take control of their destiny and alleviate their own suffering, which usually can only be done in death. They often look at their choice to commit suicide as a way to shorten a dying that will happen regardless. In my personal view, if such people are evaluated by a qualified professional who can reliably exclude the other possibilities for why suicide is desired, these people should be allowed to die at their own hands.
6. They’ve made a mistake. This is a recent, tragic phenomenon in which typically young people flirt with oxygen deprivation for the high it brings and simply go too far. The only defense against this, it seems to me, is education.
The wounds suicide leaves in the lives of those left behind by it are often deep and long lasting. The apparent senselessness of suicide often fuels the most significant pain survivors feel. Thinking we all deal better with tragedy when we understand its underpinnings, I’ve offered the preceding paragraphs in hopes that anyone reading this who’s been left behind by a suicide might be able to more easily find a way to move on, to relinquish their guilt and anger, and find closure. Despite the abrupt way you may have been left, those don’t have to be the only two emotions you’re doomed to feel about the one who left you.
Alex Lickerman is an internal medicine physician at the University of Chicago who blogs at Happiness in this World. He is the author of The Undefeated Mind: On the Science of Constructing an Indestructible Self.
Having a gun is just a very effective means to the end. Restricting access does nothing for the underlying reason that someone want to kill themselves. Much like having the gun doesn’t cause someone to commit a crime. It’s more likely that people wanting to engage in those types of behavior choose to use the most effective tool for that action.
Those who choose other means to commit suicide probably fit into the 4th category above as a cry out for help and do not really want to die.
With a society as large and diverse as ours, the law of diminishing returns would suggest that whatever benefit from additional laws would not produce any significant decrease in this area, unless substantial restrictions are placed on all citizens and the right to keep and bear arms. As I have said over and over, I am not going to give away my rights and freedom so that you or anyone else can have the illusion of safety.
People are responsible for their children. If a child is harmed due to negligence on the part of a parent or other adult, then we have laws and penalties for that. It has been shown that just adding additional penalties does not have a significant effect in altering people’s actions but only works as a means to exact more retribution on the accused. So says the theory that the death penalty doesn’t work in preventing crime.
So no suicide should not be lumped in with general violance. Especially when trying to artificially impact the debate on guns in our country. If you truly feel that gun violence is the issue, then stick to the10,000-12,000 committed in criminal acts. You won’t or can’t and that’s why you all are trying very hard to lump in anything and everything you can to make the numbers larger.
In the end, we are all just human with the same failings that humans have always had. People will continue to neglect their children leading to some death and dismemberment. People will still harm others. People will still feel unable to deal with the life they have been given and take their own life. No matter how hard you try, you can’t baby proof the world.
Apr 14, 2015 @ 17:35:40
I really don’t mind people disagreeing with what I say. But I wish they would at least take the trouble to read what I have to say before disagreeing with it.
Apr 14, 2015 @ 19:17:34
“The pro-gun folks would like to believe that gun fatalities have nothing to do with guns and are all about crime. There’s a simple logic to that argument except for the fact that every single gun involved in a criminal event first started out as a legal gun. For that matter, most of the guns in suicides either were legally owned by the suicide victim or belonged to another family member who legally purchased the gun.”
“What about mitigating strategies for both types of fatalities involving guns? An article on suicide prevention among Israeli soldiers caught my eye because Israel is often touted by the pro-gun community as the model for giving civilians full access to guns with a consequent low rate of violent crime. But the policy of allowing soldiers to keep their guns with them on weekend leave also resulted in an alarmingly high rate of suicide among these soldiers, which dropped by nearly 40% when soldiers had to leave their guns secured at their base while spending weekends at home. Anyone who thinks there’s no connection between suicide and gun access needs to look honestly at what happened in Israel before and after access to guns was denied.”
Here is what you wrote. Your own words speak towards limiting me and everyone else in the access to guns. To where would I be required to keep my guns so to be like the Israelis? Being forced to surrender my arms to a government storage facility or to some other private gun club kinda defeats the whole purpose of the 2nd, but that’s the point right?
So all guns started out as legal, so what, so does just about everything else. Cars, computers, prescription medicine, and many other things that are abused and misused. It’s funny at just how regulated pharmaceuticals are yet we have rampant abuse. So lets just copy what has worked so well with regards to drugs, both legal and illegal, and apply it to firearms.
You like to play this game that you’re being misquoted. You can save that BS. You know full well what you are trying to say. You think that you are clever in lawyering your way with verbal gymnastics and semantics.
“The usual response from the gun-safety community is to push for an expansion of CAP laws, and clearly such laws do have a mitigating effect when it comes to keeping kids away from guns. But let me break the news to you gently – the big problem with such laws is that the only way that someone can use a gun is to unlock where the gun is stored or unlock the gun itself. And the problem we face with both gun suicides and gun homicides is figuring out how to spot the impulsive, destructive behavior of certain people before they get their hands on a gun.”
You put this little closer on but what are you trying to say when you combine this with your earlier statements? Just what is the implication one is to make? You sure didn’t address any of my questions. In a free society where we have the right to keep and bear arms, preemptive laws that are effective may not be consistent with the aforementioned right.
You see, this is where you set up what you really want. You sound like what you’re trying to advance is an elitist notion that only a select few should be able to enjoy the right to keep and bear arms, like you. The historical problem with elitism is that everyone thinks that their way is the right way. Our founding fathers had a brilliant notion to embody our rights in a constitution. Even then as is now, elitist thought has been bandied about as the way it ought to be. There are those that think that they know better than others on how to live. Now, I’m a pretty smart guy that has a masters and have been around the world 3 times, and the only life that I want to control is mine and the ability to teach my children how to live theirs.
I think as a society that we have too many laws in first place. Somethings just can’t be left up to chance and a society does need rules, but just having more laws doesn’t mean it’s better for society.
Apr 16, 2015 @ 11:22:20
You are one of the most distasteful smug ass holes I have ever seen.
Most of your post sound like this
I’m not racist but “insert something racist”
I’m not anti gun but “insert the standard antigun bullshit that has been disproved many times’
Austrailia and Japan both have highly restricted gun laws and better health care than the us but both have far higher rates of suicide
For people who hang themselves I’d that tope violence?
For people who jump off a bridge is that gravity violence?
Suicide sucks and is a perminant solution to a temporary problem.
Your solution is to restrict everyone’s rights based on the 1.5% of the population that will suffer from a serious mental illness or addiction.
If you read the NY SAFE act it does nothing but violate federal HIPPA law. People have lost their right to self protection because 25 years ago they took xanax
You are the worse kind of gun sales man behind one who willing did fenced salea someone who was in it only for money and not any kind of passion.
Apr 26, 2015 @ 17:55:32
Unconvincing, for the following reasons. While a bullet to the head is a violent form of suicide there are other violent ways, yet we do not refer to them as “car violence”, “bridge volence”, or “gravity impact violence”. The proper terminology refers to the act, not the proximal instrument – not “gun violence” but suicide by gunshot.
Further, in the cases where dual ideation of suicide and murder is present it’s not surprsing that the subject would choose a gun as the most efficient and convenient means. But other motivations could alter the choice of murder weapon, motivations such as silence or perhaps the sheer enjoyment of the act, as a California murderer recently demonstrated by stabbing to death the first three of his six victims, or an opportunity to take a greater number of victims, such as the pilot who crashed the passenger plane in the Alps.
And the trouble with “access” to a gun being part of the problem is that such “access” is created by a deliberate act of bringing a gun into what proved to be a very risky situation – a home where suicide and/or homicide were real possibilities. There may be many such homes but they are an abnormal minority – yet in each case someone brought in a gun for some reason. That is a vital part of the chain of events, yet it is routinely ignored when it comes to anti gun rhetoric – the “presence of a gun” as if it appeared out of thin air, becomes a cause of its own.
I can’t really access much of the Israel article. All it says is “adolescents” at home with guns over the weekend, nothing about the age group, type of guns, or behavior during the weekend, any antecedent risk factors.
As for, “every single gun involved in a criminal event first started out as a legal
gun”, it was either stolen, straw purchased, illegally purchased privately, or was “legal” up until the crime committed with it. It’s not that, “gun fatalities have nothing to do with guns and are all about crime”, it’s about the motivations and choices people make that constitute risky behavior.
“Less than 20% of all homicides occur during the commission of another, serious crime. Most gun homicides grow out of a history of disputes between individuals who know each other and the incidence of domestic abuse …” I’m sure criminals in the same illegal drug business in a neighborhood know each other and have a history of disputes that sometimes end in homicide by firearm. Other kinds of disputes, including domestic abuse, if allowed to escalate can also end in gunfire. Whatever the pattern, the people are engaged in hazardous activities and environments.
“And the problem we face with both gun suicides and gun homicides is figuring out how to spot the impulsive, destructive behavior of certain people before they get their hands on a gun.” That is “a” problem, not necessarily “the” problem or even most of it. The problem is prevention; part of the method is understanding and paying attention to the warning signs. But sometimes, perhaps often, they are not visible or sufficiently evident.
I think most of us would agree that there are some people – a small minority of the population – are at elevated risk if they are around guns. And some of them might be helped if they could be separated from guns, people that are at risk of impulsive deadly violence and/or suicide, lurching out of character for brief moments of crisis. These folks should be encouraged to come out, most importantly to themselves at least, and face their risks and personal issues. We can appeal to their awareness of what’s in their hearts and their will to live and do the right thing, stay out of prison if nothing else. We changed the dynamics over PTSD and drunk driving and helped a lot of people. Don’t drive unless you’re in good shape. Don’t have a gun around if you think you might harm yourself or others, and get help so you’ll have a better life, greater freedom from terrible risk, a chance at real happiness and dignity.
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