Understanding Risk and Implementing Data-Driven Solutions for Firearm Suicide

• Published date: 01 November 2022
• DOI: http://doi.org/10.1177/00027162231173321
• Author: Michael D. Anestis,Allison E. Bond,Shelby L. Bandel
• Date: 01 November 2022
• Subject Matter: The Efficacy of Interventions

204 ANNALS, AAPSS, 704, November 2022

DOI: 10.1177/00027162231173321

Understanding

Risk and

Implementing

Data-Driven

Solutions for

Firearm Suicide

By

MICHAEL D. ANESTIS,

ALLISON E. BOND,

and

SHELBY L. BANDEL

1173321ANN THE ANNALS OF THE AMERICAN ACADEMYRISK AND SOLUTIONS FOR FIREARM SUICIDE

research-article2023

Each year, firearms account for half of all the suicide

deaths in the U.S. Research has shown that, worldwide,

the most effective way to prevent suicide is so-called

means safety: making the tools and methods of suicide

less accessible and less lethal. In the U.S., research has

shown, time and again, that access to firearms increases

the risk for suicide death, particularly when firearms

are not stored safely. Means safety, therefore, could be

a powerful tool in reducing suicide deaths in America,

where firearms are highly lethal, widely available, and

frequently used within a specific geographic area. For

this nation to sustainably lower its suicide rate, the issue

of access to firearms is pivotal. We argue for a public

health approach to suicide prevention: one that would

improve data linkage; promote the effective upstream

use of interventions like lethal means counseling and

safe firearm storage messaging; and deploy more sys-

tematic efforts to identify and understand subcommu-

nities of firearm owners, including those who obtained

their firearms illegally.

Keywords: suicide; means safety; firearms; secure

storage; means restriction

Of the 45,979 individuals who died by sui-

cide in the U.S. in 2020, 24,292 (52.8

Correspondence: mda141@sph.rutgers.edu

Michael D. Anestis is the executive director of the New

Jersey Gun Violence Research Center and an associate

professor in the Department of Urban-Global Public

Health at Rutgers. His research interests include fire-

arm suicide prevention within both military and civil-

ian populations.

Allison E. Bond is a clinical psychology PhD student at

Rutgers University and is a graduate research assistant

at the New Jersey Gun Violence Research Center. Her

research interests include firearm suicide prevention,

with a particular focus on effective messaging to pro-

mote secure firearm storage.

Shelby L. Bandel is a clinical psychology PhD student

at Rutgers University and is a graduate research assis-

tant at the New Jersey Gun Violence Research Center.

Her research interests include firearm suicide preven-

tion as well as societal and demographic factors associ-

ated with secure firearm storage.

RISK AND SOLUTIONS FOR FIREARM SUICIDE 205

percent) died as the result of self-inflicted gunshot wounds (Centers for Disease

Control and Prevention [CDC] 2022)—this, despite the fact that firearms are

used in fewer than 5 percent of all suicide attempts nationwide (CDC 2022).

That is, when individuals attempt suicide in the U.S., they rarely opt to use a

firearm; yet, when an individual dies by suicide, more often than not a firearm is

the cause of death. This disparity in frequency of use and proportion of deaths

accounted for can be explained in large part by the uniquely high fatality rate of

firearms, which is estimated at 85 to 95 percent, as compared to fewer than 5

percent for all other methods combined (e.g., Spicer and Miller 2000).

As with other forms of gun violence, our ability to effectively address the issue

of firearm suicide has been hindered by a lack of federal research funding, which

severely limited scientific investigations until funding lines began emerging only

in recent years. Despite this substantial obstacle, a growing body of research has

helped clarify the ways in which firearms contribute to suicide risk in specific

communities and has indicated steps that can be taken to mitigate that risk. In

this article, we outline the nature of firearm suicide risk and the existing tools that

have proven useful in preventing firearm suicide. Further, we outline and argue

for a public health approach centered on more robust data and effective messag-

ing as a path towards making substantially more progress in preventing firearm

suicide.

The Magnitude of the Problem of Firearm Suicide

Although often overlooked in conversations about gun violence, firearm suicide

accounted for a nearly identical number of deaths as homicide by all methods

combined in 2020 (24,292 vs. 24,576) and represented a death count 25.3 per-

cent higher than that of the 19,384 firearm homicide deaths that year (CDC

2022). The sheer number of deaths highlights that firearm suicide is a profound

public health concern in need of greater attention nationwide.

The age-adjusted firearm suicide rate in 2020—6.93 per 100,000—represents

a 17.9 percent increase over the rate 20 years earlier, and a recent plateau in the

national firearm suicide rate marks a modest shift from a trend of annual

increases that began around the turn of the twenty-first century. Throughout this

time, firearms have consistently accounted for approximately half of all U.S. sui-

cide deaths. Moreover, firearm suicides have accounted for nearly two-thirds of

all U.S. firearm deaths. Table 1 shows shifts in the age-adjusted firearm suicide

rate by sex and age cohort between 2000 and 2020 and highlights stark increases

for several groups over this time period.

The disproportionate role of firearms in U.S. suicides can be explained largely

by this method’s uniquely high case fatality rate. Using the National Vital

Statistics System, Conner, Azrael, and Miller (2019) examined records from

309,377 U.S. suicide decedents and found that firearms have an 89.6 percent

case fatality rate, as compared to 56.4 percent for drowning, 52.7 percent for

hanging, 30.5 percent for gas, 27.9 percent for jumping, and only 1.9 percent for