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The conversation about suicides in the U.S. needs to include guns. Here's why.

Not all suicides are completed with a gun — but in the U.S., most are.

Each time a high-profile celebrity dies by suicide, we seem to start a fresh conversation about suicide statistics in America.

In half of U.S. states, suicide rates have climbed 30% or more in the past two decades. Only Nevada saw a decline during that time — a mere 1%, which still puts the state higher than the national average.


Questions of why and what we can do about suicide dominate, leading to discussions revolving around mental health stigma and access to mental health care. And, indeed, those are vital pieces of the puzzle.

But there's another piece we don't talk about enough. If we want to reduce suicide statistics, we have to include the most common and lethal means of suicide in the U.S.: self-inflicted gunshot.

Research shows that when it comes to suicide, method matters. And firearm is by far the most deadly.

In some ways, focusing on a handful of celebrity suicides distracts from the research on U.S. suicide rates overall.

While we can't always know why Americans die by suicide, we do know how: Suicide by firearm kills more people than all other suicide methods combined. And while women are three times more likely to attempt suicide than men, men are four times as likely to die by suicide as women.

Why the discrepancy? All signs point to the fact that men tend to choose more violent and lethal methods of suicide.

And guns are by far the most lethal means. Of non-firearm suicide attempts, about 90% are unsuccessful, while about 90% of firearm suicides are successful. That makes access to guns a prime factor in suicide risk.

Many suicides are actually impulsive acts. That matters too.

One thing that gets missed in our discourse on suicide is that while some suicide attempts are a culmination of years of internal struggle with mental illness, many — and perhaps most — are not.

According to the New England Journal of Medicine, one-third to four-fifths of people who attempt suicide are reacting to a current major stressor, not taking a long-premeditated action.

But suicide by firearm doesn't afford people a chance to change their mind or get a second chance. Most people who attempt suicide don't really want to end their lives; they want to end their pain. A gun allows a suicidal person to take split-second action, whereas most other means allow a person to stop mid-attempt or for another person to intervene.

While we're addressing how to prevent suicidal ideation, we need to consider easy access to the most lethal means of suicide.

Research shows that having access to a gun drastically increases the likelihood of a successful suicide attempt.

According to a Harvard University analysis, states with the highest rates of gun ownership had rates of gun suicide 3.7 times higher for men and 7.9 times higher for women than those with lowest gun ownership. Other methods of suicide were about equal.

For all demographics, the easier guns are to access, the higher the risk of completed suicide.

And it's not because gun owners are more suicidal. Catherine Barber, director of the suicide prevention effort Means Matter, said:

"When we compared people in gun-owning households to people not in gun-owning households, there was no difference in terms of rates of mental illness or in terms of the proportion saying that they had seriously considered suicide. Actually, among gun owners, a smaller proportion say that they had attempted suicide. So it's not that gun owners are more suicidal. It's that they're more likely to die in the event that they become suicidal, because they are using a gun."

In light of the facts, we clearly need to do more to curb access to guns for people at risk for suicide.

If we're serious about suicide prevention in the U.S., we have to include gun control in the conversation.

And conversely, if we're serious about reducing our gun death rate, we need to include suicide in our discussions. In the U.S., the statistics are strongly linked, a fact we shouldn't overlook.  

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