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The Real Mental Health Issue in Gun Violence

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The recent debates about gun control and the false links being made between mental illness and violence have missed a critical issue -- that the leading cause of death by guns is suicide. In this country, firearms are the most common method of suicide and result in nearly twice as many suicides than homicides each year.

As was highlighted in a recent New York Times article on suicide rates and guns, access to firearms increases people's risk for suicide because acts of suicide are often impulsive, and guns leave people with little opportunity to change their minds. While more than 90 percent of people who survive a suicide attempt will not go on to later to complete suicide, people generally do not survive self-inflicted gunshot blasts. States with more guns have dramatically higher rates of suicide -- a gap that is mostly explained by differences in the number of gun-related suicides.

No matter our beliefs about gun control, the debate about how to reduce gun violence should really be a debate about effective means for suicide prevention. Research shows that when access to a highly-lethal and leading suicide method is reduced, the overall suicide rate decreases.

Means Matter, a suicide prevention campaign run by the Harvard School of Public Health, promotes the idea that how people kill themselves can be as important as why, and that reducing access to highly-lethal means, like guns, is a simple way to save lives. At the Mental Health Association of New York City, we are working to advance this message and means restriction approach as an effective strategy for preventing suicide. Restricting access is not about gun control, but safe dispensation, use and storage of legal firearms. These gun safety measures increase the time that passes between impulse and action, and therefore increase chances of survival.

Restricting access to firearms is also about counseling, education, and influencing human behavior in ways that are mindful about individual, family and community safety. A few practical, community-based approaches to reducing access to lethal means were noted in the 2012 National Strategy for Suicide Prevention (NSSP), a report of the U.S. Surgeon General.

One approach involves educating health and mental health providers to assess for risk of suicide, and if a person appears at risk, teach the provider how to counsel the person about restricting his/her access to lethal means. This "lethal means counseling" involves inquiring of the individual and his/her family members about whether there are firearms and other lethal means at home and working with them to limit access until the individual is no longer in crisis. Local law enforcement or a trusted family member or friend may be able to temporarily store the firearm until the circumstances improve.

To get this approach implemented on a wide scale, professional groups can add lethal means counseling protocols to their current suicide prevention protocols. Providers can also get trained in firearm safety counseling models, such as New Hampshire's CALM Training (Counseling on Access to Lethal Means).

Another way to reduce access to lethal means, which has been promoted by the Means Matter campaign, is to partner with firearms dealers, gun shop owners, and the gun-owning community to increase their involvement in promoting suicide prevention. This might include:

  • Incorporating suicide prevention awareness as part of basic firearm safety training.
  • Developing and sharing guidelines with gun store/firing range owners about how to recognize a customer in emotional distress and avoid selling or renting a firearm to a customer when such warning signs are present.
  • Encouraging gun store and firing range owners to display and distribute suicide prevention materials and to include the warning signs of suicide in brochures and websites promoting firearm safety.

As former Surgeon General of the United States, Dr. David Satcher, said, "Suicide is our most preventable death." So while our attention is focused on confronting gun deaths in this nation, we must not ignore these preventable deaths that take place every day, often hidden from the public eye.

Let us use this opportunity to save lives by doing something about the most common way in which guns cause death in America. Reducing access to lethal means can be the difference between a loved one's darkest hour and their final hour.

It is also important to remember that we must all promote access to "lifesaving means," or services that can be readily available at all times to connect with and assist persons in crisis. If you, or a loved one, is in distress, please call the National Suicide Prevention Lifeline at 800-273-TALK (8255) for confidential crisis support 24/7. You are not alone. Help is available.

For more by Kimberly Williams, click here.

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