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Suicide Gun Deaths Require More Prevention

Suicide Gun Deaths Require More Prevention
By Melinda Moore and Julie Cerel

The tragedy at Sandy Hook Elementary School and other places around the country have left political leaders struggling with the best way of stemming violent gun deaths. Most of these deaths have been characterized as outrageous acts of violence upon innocent victims, when, in fact, the majority of violent gun deaths in the United States are acts of aggression of people on themselves. In Kentucky, 70 percent of violent gun deaths are suicide, not homicide.

The National Violent Death Reporting System (NVDRS) captures detailed information on all violent deaths from multiple sources in 18 states that have funding to participate. Kentucky is part of this system and currently ranks #1 in rate of suicide gun death.

Gun control advocates argue that restricting guns might prevent individuals from inflicting harm on others. Wouldn’t restricting guns have the added effect of protecting the suicidal during their most lethal crises? Not necessarily so.

According to Dr. Sabrina Walsh of the Kentucky Violent Death Reporting System, data in other states suggest that gun control restrictions result in suicide deaths by other means. Data from NVDRS states, such as Massachusetts and New Jersey with more stringent gun control measures, have increased suicide deaths by suffocation and hanging than the other funded states with less stringent laws. Experiments in other countries have also had disappointing results. Evidence from Australia demonstrates that there was no impact of the 1996 firearms restrictions on firearm suicide rates among young people.

So, if self-inflicted gun deaths represent the preponderance of violent gun deaths and we know from other states and limited data from other countries that means restriction does not always work, why hasn’t suicide prevention been part of the larger discussion of stemming gun violence? We know empirically from other public health initiatives addressing seat belts, drunk driving, heart disease, and cancer that prevention is effective if sufficient resources are dedicated to targeted areas of intervention. Preventing individuals from using any means necessary to end their own lives seems to be a reasonable step toward ending gun-related deaths. Additionally, working with the gun industry may be necessary. Instead of gun control and gun rights advocates working at polar extremes, perhaps, all parties need to come to the table to develop effective solutions and mechanisms.

The Department of Defense is attempting to address its own problems around suicide, as suicide deaths of active duty service members eclipsed combat deaths this past year. The Military Suicide Bereavement Study at the University of Kentucky is part of that effort. The research team at UK has heard countless stories involving families, health care providers, and employers who simply did not know what to do when their loved one, friend, or patient threatened suicide. Many of these stories involve the explicit use of guns. More effective education of “gatekeepers,” including families of the mentally ill, health care providers, school personnel, and the public is a critical step. Last year, Washington State passed an initiative directed at providing training for mental health providers and school personnel. The Kentucky legislature is currently considering Senate Bill 72, which is modeled on Washington State’s legislation and would be a good first step in the direction of broad education of those who can make a difference.

Kentucky has a robust suicide prevention community, fueled primarily by the energy of committed individuals who have lost a loved one to suicide. Despite this synergy and interest statewide, since 2007 Kentucky has had only one full-time suicide prevention coordinator, whose job it has been to train thousands of “gatekeepers” and disseminate suicide prevention information to school districts statewide. Recent federal Substance Abuse and Mental Health Services grants have allowed for expansion in this training and outreach work, however, these are federal dollars that are soon to dry up and with it any personnel to do this critical life-saving work. Additionally, Kentucky lacks a suicide fatality review mechanism by which professionals in mental health, law enforcement, and health care might be able to identify targeted strategies for intervention and prevention of these deaths.

Those in the suicide prevention world know all too well the cultural stigma that provides sufficient barrier to increasing capacity or institutionalizing substantive prevention efforts to make a real difference. Kentucky is at a crossroads, however, and real decisions to fund suicide prevention broadly – as a way of decreasing violence and saving lives that are worth saving – is squarely on the table. Being known as #1 in something is usually cause for celebration; in this case, it is cause for that familiar emotional upwelling, grief, disgust, and helplessness.

Melinda Moore, Ph.D., is a clinical psychology postdoctoral research fellow on and Julie Cerel, Ph.D., is the Principal Investigator of the Military Suicide Bereavement Study. For more information, please contact julie.cerel@uky.edu.

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