08/05/2013 10:34 am ET Updated Oct 05, 2013

The Gun Violence We Never Talk About

Last year there were roughly 11,000 homicides committed with a gun. There's endless talk about how the U.S. is much more violent, and really much more gun violent than any other advanced country, and we need to do something about it. The NRA says that we need more armed citizens. Brady says we need fewer guns. Both sides always talk about guns and crime.

But there's another kind of gun violence that we never talk about. For every person who was shot with a gun in a crime, more than two people (roughly 19,000) shot themselves with guns. That's right. Gun suicide is nearly twice as common as gun homicide, and I don't notice anything in the proposed bills floating through Congress that mentions this issue at all.

Everyone in Washington wants to add mental health records to NICS. Maybe that would prevent some crazy person from buying a gun and walking into a school or college to shoot a whole bunch of people, but it wouldn't prevent gun suicides. In the majority of suicides, the victim actually saw a health professional within the last two weeks of their lives. One of the real problems with suicide is its impulsive nature.

Suicide is also private. Coroners and medical examiners are very careful when it comes to dealing with homicides, but suicides are seen as shameful, so even the cause of death is often stated as something else. For a country that is obsessed with health, we draw a line when it comes to mental health. At best we it discuss rarely, at worst we ignore it completely.

Precisely because it's private and impulsive, a gun is the perfect tool to use if someone decides to end their life. You don't have to find a rooftop that you can get to, you don't have to figure out how to tie a good knot around your neck, you don't have to cram a fistful of pills down your throat. No wonder that guns are successful in more than 85 percent of the times they are used as a life-ending device, whereas hangings work only 50 percent of the time and more than 90 percent of pill overdoses result in a quick trip to the local hospital to have your stomach pumped out.

More than half the victims of gun suicides are white males, ages 30 to 50. They are married, employed, husbands and fathers. Their deaths surely cause as much grief and family hardship as the deaths of violent crime victims.

The NRA has gone off the deep end with their bizarre attempt to criminalize discussions between physicians and patients about the ownership of guns. When a patient tells a physician that he is feeling depressed, the doctor always asks whether the depression has provoked life-ending thoughts. And if the patient responds in the affirmative, how can the physician or other medical professional then not ask if the patient has access to a gun? If anyone now feels obliged to respond with the obligatory defense of the 2nd Amendment, do me and the other readers a favor and don't waste our time.

It's a no-brainer that people who use guns to commit crimes need to be held fully accountable for their behavior and for the damages caused by the gun. But people who use guns to kill themselves can't be held responsible because if they were able to think rationally, they wouldn't try to kill themselves in the first place. If we need a national strategy to deal with gun violence, it's a strategy to deal with suicide, and that's a discussion that hasn't yet occurred.