Means Matter

Over 22,000 people died by gun-induced suicide in 2016; more than 2/3rds of all gun-related deaths and about 1/2 of all suicides.[1] They did not have to die. In states where guns are more prevalent, such as Wyoming, where 63% of households own guns, suicide rates are higher than in states where guns are less prevalent.[2] Stricter gun control and better gun-ownership education are important tools to reduce suicide.

Most suicide attempts occur with little planning. A study of hospitalized Chinese suicide-survivors reported that almost 25% had considered suicide for less than 10 minutes before their attempt, while over 50% had considered suicide for less than 2 hours.[3] This data is corroborated in many other studies.[4]

The anguish that induces suicide is often temporary and humans are notoriously bad at predicting how we will feel in the future. This leads to very high post-attempt long-term survival rates. About 75% of people who attempt but fail at suicide will never try to kill themselves again. Over 90% will not die from suicide at all, even if they do try again.[5] These facts are not meant to diminish the very real importance of the notion that people who attempt to commit suicide should receive social support. Attempt is the one of the strongest risk factors for suicide.[6] The message is, however, that reducing the lethality of the first suicide attempt, and any subsequent attempts, will lead to a reduction in overall suicides.

Guns are by far the most lethal suicide method:[7]







Means reduction methods have already been proven effective for less politically-sensitive means.
Suicides decreased in parts of Asia and the Pacific Islands when the toxicity of pesticides, a leading means of suicide, was reduced.[8] Suicides also decreased dramatically when the United Kingdom introduced carbon monoxide-free natural gas as a replacement for coal gas, the inhalation of which was a leading cause of suicide in pre-WWII Britain.[9] We accept the proven logic of means reduction when we install bridge barriers to make access more difficult. There is no reason to think that reducing access to guns should be any less effective.[10]
I am far from the first person to point this out. The Washington Post had an article on this topic in July 2016.[11] Reuters chronicled a study just two months ago.[12] The New York Times Editorial Board made their New Years’ wish in December 2015.[13] And Harvard’s T.H. Chan School of Public Health has an amazingly informative website, from where I unabashedly pulled much of this information after getting interested in the topic, which provides educational material.[14]
Yet these voices get lost in the wind. Mass shootings, terrible atrocities to be sure, elicit loud siren calls for reform. Meanwhile, the daily tragedy of individual suicides, stacking up one-by-one until the misery of loved ones is dwarfed only by the body count, goes unheeded. If the topic of weapons in America comes up at your Thanksgiving dinner table, add suicide prevention to the menu. Lives depend on it.



[1] https://fivethirtyeight.com/features/gun-deaths/
[2] Matthew Miller, Household firearm ownership and risk of suicide across the 50 United States, 62(4) J. Trauma 1029 (2007).
[3] I apologize for the lack of citation, but this data came from a recent lunch talk on suicide from Darwin College, University of Cambridge, at their Thursday lunch seminar series.
[4] https://www.hsph.harvard.edu/means-matter/means-matter/duration/
[5] https://www.hsph.harvard.edu/means-matter/means-matter/survival/
[6] Id.
[7] R.S. Spicer and T.R. Miller, Suicide acts in 8 states: incidence and case fatality rates by demographics and method, 90(12) American Journal of Public Health 1885 (2000).
[8] E.g., Fernando Gunnell et. al., The impact of pesticide regulations on suicide in Sri Lanka, 36(6) Int. J. Epidemiol. 1235 (2007).
[9] Kreitman, The coal gas story. United Kingdom suicide rates, 1960-71, 30(2) Br. J. Prev. Soc. Med. 86 (1976).
[10] Michael Anestis et. al., Handgun Legislation and Changes in Statewide Overall Suicide Rates, 107(4) Am. J. of Pub. Health 579 (Apr. 1, 2017).
[11] Kim Soffen, To reduce suicides, look at guns, The Washington Post (July 13, 2016).
[12] Lisa Rapaport, Guns help explain difference in urban and rural suicide rates, Reuters Health (Sept. 21, 2017).
[13] The Editorial Board, To Reduce Suicides, Keep the Guns Away, The NY Times (Dec. 14, 2015).
[14] https://www.hsph.harvard.edu/means-matter/

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