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Abstract
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Suicide is the 10th leading cause of death in the United States. In 2017, 51% of the 45 390 suicides among those 18 years or older were due to firearm injury. Efforts to limit access to lethal means (eg, firearms) are an important element of suicide prevention programs and are especially relevant among US veterans and servicemembers within some military branches given their high burden of suicide and firearm-related suicide in comparison with other US adults. Two-thirds of veteran and servicemember suicides are firearm related.
A critical question is what clinicians should recommend to adults with elevated suicide risk who reside in households with firearms. Most evidence demonstrating the strong, independent association between firearm access and suicide is based on whether a firearm is present in the household. From this evidence, clinicians can reasonably recommend that at-risk patients remove firearms from their home. Other common suggestions include that firearms remain in the home but be stored unloaded or with external locking devices attached. Such recommendations are probably made because they are considered more palatable or likely to prompt behavior change than suggestions to remove firearms or perhaps because of an understandable “something is better than nothing” mentality among clinicians working to keep their patients safe. However, the evidence supporting these recommendations for adults is limited. A landmark case-control study showed that unsafely stored household firearms were associated with an increased risk of firearm injury, including suicide, among children and adolescents. However, there are differences in accessibility between a child whose parent locks up a household firearm and an adult who unloads or locks a firearm but keeps it in the home. The case-control study by Dempsey et al reports findings from the largest psychological autopsy study of US servicemember suicides ever conducted, to our knowledge, and adds to the limited literature regarding suicide risk associated with specific firearm behaviors among adults.
Investigators from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) research group compared the odds of firearm ownership and related behaviors between Army servicemembers who died by suicide during 2011-2013 and 2 groups of living controls ...
Language: en |