People Who Commit Suicide by Firearm are Less Likely to Have Sought Treatment

People who die by suicide using a firearm as a means of death are less likely to seek treatment, more likely to die on their first attempt, and more likely to tell people about their suicidal ideations and plans, according to a new study published in JAMA Network Open. The results highlight the importance of community-based interventions being put in place to prevent the risk of suicide.

In the United States, suicide rates have gone up appreciably – by 33% over the last 18 years. The increase emphasizes the need for alternative approaches to reduce suicide risk, and one way of doing so is through means safety. In the US, one way to increase the efficacy of means safety is by assessing those who have ended their lives by use of a firearm. Researchers of a sought to discern any differences in his population of interest compared with those who committed suicide by other means (e.g., poising or hanging).

Researchers conducted a cross-sectional study in which they collated data on 234,652 suicide decedents from 2003 to 2018 (died by firearm, n = 117,126, died by another method, n = 117,526). The main outcomes of interest were treatment for mental health and substance use at the time of death, previous treatment for mental health and substance use, history of suicidal ideation or plans, history of suicide attempts, and disclosure of suicidal plans and thoughts.

The analysis revealed that people who committed suicide via firearm were more likely to have disclosed thoughts or plans of suicide within the month prior to death (odds ratio [OR]=1.16 [95% CI, 1.13-1.18]) and were less likely to have previously attempted suicide (OR=0.44; 95% CI, 0.43-0.46]). The researchers observed that compared with those who died by poisoning, people who used a gun were more likely to have had a history of suicidal thoughts or plans (OR=1.19; 95% CI, 1.15-1.23) and to have disclosed their thoughts or plans of suicide within the month prior to death (OR=1.06; 95% CI, 1.03-1.10). Compared with those who died by hanging, those who used a firearm were more likely to have disclosed their thoughts or plans of suicide to another person within the month prior to their death (OR, 1.14 [95% CI, 1.11-1.17]).

“All of the people in our sample died by suicide—so each person represents a tragic ending—but our findings highlight that we struggle to prevent suicide by firearm because the people who choose to use a firearm often are not showing signs of suicide risk and do not seek out care that might otherwise help them,” said co-author Michael Anestis, executive director of the New Jersey Gun Violence Research Center and an associate professor of Urban-Global Public Health at Rutgers School of Public Health via a press release about the study.

 

“These findings provide information that suggests who is at risk to die by firearm suicide. Community-based interventions in suicide prevention could help reduce access to firearms during a time of crisis. The finding that firearm suicide decedents were more likely to disclose their suicidal thoughts or plans provides an important avenue for prevention,” the researchers concluded.