IN RESPONSE: Dr. Ertle discusses the implications of safe storage specific to older adults and the substitution of other methods of suicide if firearms are not available. Studies show that associations between firearm ownership and risk for suicide in persons aged 50 years or older are similar to those among other age groups. Risk for suicide is higher in older adults worldwide, but this fact is not solely explained by the availability of firearms. Of note, the case fatality of firearm suicide attempts is far higher than that of suicide attempts by other means. Although those who make serious attempts to die by suicide may use other means, these means are less likely to be fatal. Some countries with a lower prevalence of firearm ownership may have higher rates of suicide among older adults; however, variation in firearm ownership is not the only difference between the United States and Japan or China. Complex cultural differences in such factors as health care, socialization, beliefs held by older adults, stigma surrounding mental health, and honor may also partially explain higher rates of suicide despite limited firearm access. We recognize that limiting access alone is not sufficient to prevent all suicides; however, it does represent 1 potential opportunity for prevention.
Language: en
", language="en", issn="0003-4819", doi="10.7326/L19-0602", url="http://dx.doi.org/10.7326/L19-0602" }