Gun owners with a history of suicidal thoughts less likely to report them, study finds
This story is about suicide. If you or someone you know is in crisis, call National Suicide Prevention Lifeline at 800-273-8255, text HOME to 741741 or visit SpeakingOfSuicide.com/resources for additional resources.
Although the stigma around mental health has dissipated in recent years, talking about these struggles, especially suicide, is more important than ever.
Last month, singer Naomi Judd committed suicide by gunshot. And research from late April found that teen suicides increased in many states in 2020. In July, the National Suicide Hotline received a designated three-digit callsign – 988. And overall, the rate of Suicide in the United States has increased more than 30% since 2000, making it the 12th leading cause of death in the country, according to the American Foundation for Suicide Prevention.
A positive point that the experts point out? Suicide is preventable. An important prevention tool that healthcare professionals use is screening patients for suicidal thoughts when seeking therapy, psychiatric care, or medical attention in emergency room situations.
But a new study from Ohio State University Wexner Medical Center, based on online surveys of 10,625 American adults taken between March and April 2020, demonstrates the shortcomings in the type of questions asked during these screenings, particularly when ‘we’re talking to gun owners.
Gun owners and suicide
The study measured patterns of passive (thoughts alone) and active (recently attempted or approached) suicidal ideation and behavior. The results showed that the patterns were similar among gun owners and non-gun owners who had a lower likelihood of suicidal behavior, but when comparing gun owners and non-gun owners who had active suicidal ideation and behavior, the patterns were different.
In particular, among the group of individuals who had recently attempted or become close to suicide, gun owners were less likely than non-gun owners to report having had suicidal thoughts – a concerning finding since guns remain the primary method of suicide in America. Research indicates that gun owners think about suicide differently than non-gun owners, suggesting a need for different suicide screening questions.
“The traditional method of screening for suicide is to ask people questions like, ‘Do you want to die? or, ‘Did you wish you were dead?’ and then escalate a series of questions from there,” explained Craig Bryan, Psy.D., one of the study authors and a clinical psychologist at The Ohio State University College of Medicine. “But what we’ve learned is that gun owners don’t interpret their intentions as being related to death and will answer these questions differently than non-gun owners.” he declared.
For many people, suicide is not about wanting to die but rather about wanting to escape his life or a bad situation, Bryan told TODAY, adding that gun owners are unique because “they have a deadly method of escape at the ready that they can turn to in a moment. extreme distress”.
“We’ve learned that gun owners and non-gun owners are very different when it comes to the types of suicidal thoughts they say they’ve had,” Bryan explained. “The main difference being that gun owners were much, much less likely to say they had thoughts about wanting to die.”
Cindy Graham, Ph.D., a clinical psychologist at Brighter Hope Wellness Center in Maryland, told TODAY that risk assessment for mental health professionals already includes a “range of questions with the goal of detecting passive and active suicidal ideation,” but she agrees with the study’s findings that increased screening is needed to reduce suicide rates.
“Broader questions about suicide plans and opportunities help clarify who is at risk for suicide in moments of impulsiveness,” she said.
Why are guns the main method of suicide in the United States?
The “suicide coupling” theory may explain how firearms became a prominent method of suicide in the United States. The concept of coupling was popularized by author Malcolm Gladwell in his book “Talking to Strangers”, where he defines it as “the idea that behaviors are linked to very specific circumstances and conditions.
In the context of suicide, coupling means that when a person strongly associates a behavior with a specific method, they are more likely to end their lives this way if the method continues to be present and available, and they are less likely to do so once access to that method is removed.
“As we understand coupling and guns, there are strong implications that if fewer people owned guns, there would be fewer suicides, much like the limited access to bridges commonly associated with suicide will has been shown to limit the number of suicides in this area,” Bryan mentioned. “We believe there is an association with the convenience of this method that is unique to our country.”
Although the Ohio State University study shows that gun owners are less likely to report suicidal thoughts, it also shows that they were more likely to have thought about how they would like to end their lives. “Gun owners who regularly see a gun in their home may imagine themselves using it for suicidal behavior,” Bryan explained.
This visualization coupled with convenient access to a deadly weapon can cause them to want to kill themselves “in a moment that becomes emotionally charged.”
Ask better questions
One of the improvements Bryan hopes will come from the study is a change in the way medical professionals screen patients for suicidal ideation.
“We’ve known for many decades that about half of those who commit suicide deny suicidal ideation in advance,” Bryan said. “What we tried to understand by doing this study is how we were missing that. Realizing how different groups think about suicide is an important first step.
Bryan suggested that investigators frame questions around the desire to escape one’s life (as opposed to “wanting to die”) and ask about different types of suicidal thoughts to ensure that more suicidal people are discovered and helped.
Barbara Stanley, Ph.D., professor of medical psychology at Columbia University, agreed that asking better screening questions is crucial, but said some tools already exist; more medical professionals just need to be aware and willing to use them.
“There are screening tools that only take a few minutes to administer and that ask the questions that (this study) is referring to,” she said. She cited the C-SSRS, Columbia Suicide Severity Rating Scale, as an example. “These screening questions cover passive, active, suicidal intent, suicidal intent with a plan, and recent suicidal behavior.”
Bryan said he hopes identifying a wider range of individuals with suicidal thoughts will save more lives.
“People are being screened by school guidance counselors and in just about every medical setting at this point,” he said. “But maybe we’re just not asking the right questions.”