With Gun Suicides at High, Safety Measures Should Be Discussed With At-Risk Patients

The most recent provisional data from the Centers for Disease Control and Prevention (CDC) demonstrates that suicide, including firearm suicide, remains a substantial public health concern: In 2022, deaths by suicide in the United States reached almost 50,000—the highest number ever recorded. And more than half, approximately 27,000 of those deaths, involved firearms.

This represents an overall increase of 11% in the firearm suicide rate since 2019. Higher rate increases were seen for certain sociodemographic groups, such as Blacks and Hispanics (42% and 28%, respectively) and young people between the ages of 10 and 24 (15%). The largest rate increase from 2019 (66%) occurred among American Indian or Alaska Native persons.

These numbers point to the need for effective suicide risk screenings by health care professionals and provision of prevention services, including lethal means safety counseling. That can help to ensure that more people who are at risk of suicide have plans in place to limit access to objects that could be used in a suicide attempt—including firearms—in the event of suicidal thoughts or behaviors.

Multiple social and structural factors likely contributed to the increase in suicide deaths. Among those could be lack of access to mental health care, unemployment, social isolation, and substance use—all of which were exacerbated by the COVID-19 pandemic. A surge in firearm sales during the pandemic also may have played a role. One nationwide survey found that nearly 1 in 5 American households purchased a gun between 2020 and 2022 and 5% of those were first-time buyers. The data shows that increasing proportions of new gun owners are female, Black, Hispanic, and young compared with gun owners in America before the pandemic.

More than half of gun-related deaths in America are suicides. Additionally, guns are the most lethal method for suicides; research shows that restricting or limiting access to them can reduce the number of fatal suicide attempts. The CDC has found that suicide attempts by firearm are 85% to 90% fatal, compared with 5% of all other means combined. Moreover, gun ownership has been associated with a significantly elevated and enduring risk of suicide by firearm.  

Prevention through lethal means safety counseling

Research shows that about half of people who die by suicide see a health care professional in the month before their death. That means that providers can play an important role in prevention for those at risk. Once a provider screens and assesses that a person is at risk for suicide, they can collaboratively develop a safety plan, a brief document written in the person’s own words with information that the person can use during a suicidal crisis. The plan should include any warning signs for that individual, as well as coping strategies, sources of support to contact, and steps to keep the environment safe by restricting access to lethal means such as firearms.

Given the high rate of firearm suicides, lethal means counseling should be a critical component of safety planning. The provider or counselor should offer options to limit or restrict access to firearms, a clear evidence-based method to lower firearm suicide rates. Despite common misconceptions, restricting access to firearms does not increase the risk for suicide using other means.

For health care providers, tools such as screening and safety planning help identify and protect people experiencing suicidal thoughts from easily accessing lethal means. Specifically, broader use of interventions to reduce or limit access to firearms for people with suicide risk can help to prevent suicides.

Farzana Akkas works on The Pew Charitable Trusts’ suicide risk reduction project.