Thursday, June 11, 2020

Suicide Risk Increases Immediately After Gun Purchase

A study published in the New England Journal of Medicine expands on past research on the association between access to guns and suicide, finding that handgun ownership is associated with an elevated risk of suicide by firearm, particularly immediately after the gun is acquired.

Since the COVID-19 pandemic began, gun sales have sharply increased, an accompanying commentary pointed out. In March, Americans bought nearly two million guns, marking the second-highest monthly total since 1998, when the Federal Bureau of Investigation (FBI) began publishing such data.

“How will the current surge of gun purchases affect firearm-related violence?” wrote Chana A. Sacks, M.D., M.P.H., and Stephen J. Bartels, M.D., in their commentary. “With an additional 2 million guns now in households across the country at a time of widespread unemployment, social isolation, and acute national stress that is unprecedented in our lifetime, we urgently need to find out.”

Lead author David M. Studdert, LL.B., Sc.D., of the Stanford Law School and School of Medicine and colleagues tracked firearm ownership and mortality over 12 years (2004-2016) among 26.3 million adults in California. They used the California Statewide Voter Registration Database to form the cohort, as the database updates its information on registered voters in the state every year.

The researchers then used the California Department of Justice’s Dealer Record of Sale for details on which cohort members acquired handguns and when. Additionally, the California Death Statistical Master Files provided records of all deaths reported during the study period.

In total, 676,425 members of the cohort acquired one or more handguns during the study period, and 17,894 died of suicide, of which 6,691 were suicides by firearm. “Handgun owners had lower rates of all-cause mortality than nonowners but substantially higher rates of suicide,” the authors wrote.

The rate of suicide by firearm among handgun owners peaked immediately after the gun purchase (within 30 days) but remained relatively higher 12 years later. Fifty-two percent of all suicides by firearm among handgun owners occurred more than a year after acquisition of a gun.

Women accounted for only 16% of all suicides by firearm, but the rate of suicide by any method among female handgun owners was seven times higher compared with female nonowners. The corresponding suicide rate among male handgun owners was three times as high as that of nonowners.

The findings have several implications for clinical care and suicide prevention, wrote Sacks and Bartels in their commentary. Assessments of suicide risk should include questions about recent gun ownership and access to firearms, for example, and women, as well as men, should be questioned about gun ownership, they wrote.

“Fifty-nine people were killed in the mass shooting in Las Vegas in 2017, the deadliest in U.S. history. Approximately the same number die each day in the United States from suicide by firearm,” Studdert and colleagues concluded. “Many of these deaths are preventable.”

(Image: iStock/artas)

Time for Action: APA to Hold Town Hall on Structural Racism


APA President Jeffrey Geller, M.D., M.P.H., will lead a webinar town hall on Monday, June 15, at 8 p.m. EDT with distinguished panelists on the topic of structural racism experienced by Black Americans. The panelists include Danielle Hairston, M.D.; Thea James, M.D.; Ayana Jordan, M.D., Ph.D.; and Walter E. Wilson Jr., M.D., M.H.A. The discussion will be followed by a Q&A session with APA members about the way forward for our organization.

Learn More and Register Now