Can the National Call to Prevent Gun Violence Reduce Suicides?

Several state and federal laws are designed to restrict access to firearms by those who may be at risk of using them for suicide. Such laws, for example, may require background checks or permits to own a firearm, prohibit persons with a history of some types of court-mandated mental health treatment from being gun owners, impose minimum age requirements for possessing or owning a gun, and mandate waiting periods before purchasing a gun. The 1994 Brady Act imposes federal background check requirements for guns purchased from licensed dealers, and some states have expanded this requirement to all firearm sales and transfers. The databases used by states to conduct background checks vary, and the empirical evidence linking these laws with reductions in suicide is limited. One of the more convincing studies found that states that enacted background checks that examined buyers’ histories of certain mental health–related incidents experienced an approximate 3% reduction in total suicides (3). On the basis of these results and evidence from one additional study, we concluded in a recent synthesis of available research that there is some, but limited, evidence that background checks reduce suicide rates (1). On the other hand, the evidence that permitting requirements, waiting periods, or similar policies led to reduced suicide rates either did not meet our criteria or was inconclusive.

Policies are also used to force people at risk of using firearms for suicide to surrender their guns. Federal law establishes categories of people who are prohibited from possessing a firearm, and some states have laws requiring the forfeiture of firearms by gun owners who lose their right to possess a firearm, if, for instance, they are convicted of a felony. Several states have recently passed laws allowing police or family members to seek a court order to temporarily seize firearms from individuals deemed to be at imminent risk to themselves or others. Research is emerging that suggests that these laws may be associated with some reductions in suicides (4,5). However, skeptics believe these laws could allow abridgement of Second Amendment rights for misinformed or invalid reasons (6).

As many mental health professionals are aware, it is also possible to persuade gun owners to voluntarily remove guns from their homes when they or someone they live with is at risk of using them for suicide. Such conversations between providers and their patients have been recommended as a suicide prevention strategy, although the effects of these interventions are not well established. Although some states have proposed laws that restrict physicians from inquiring about gun ownership, these rules do not apply if the safety of the patient or others may be at stake (7). In some states, the temporary transfer of firearms from a suicidal individual to a private citizen may require a background check for the recipient, although gun retailers, local police departments, gun clubs, or pawn shops could also provide temporary storage options.

Child access prevention laws allow for the prosecution of adults who intentionally or through carelessness allow children to have unsupervised access to firearms. Such laws require gun owners to store their weapons with gun locks or in gun safes. Such laws reduce child self-injuries, including, but not limited to, suicide (1).

In addition to policies requiring safe storage, efforts to promote the safe storage of firearms include media campaigns designed to promote safe storage practices. Only one such media campaign has been rigorously evaluated, finding no statistically significant effects (8).

Just as they can encourage the temporary transfer of guns outside of the home, health care providers can also encourage the safe storage of firearms among their patients or patients’ families. Although rigorous evaluations have yet to be conducted among mental health professionals, interventions in which pediatricians and family physicians inquire about guns, counsel on safe storage, and provide free storage devices to patients improved their gun-owning patients’ storage practices (9). However, how these storage practices may translate into reductions in suicide has yet to be established.