Background

Nearly 23,000 Americans die by firearm suicide every year. In 2018, the most recent year of data available, 24,432 Americans died by firearm suicide.28 In the past decade, we have lost over 214,000 Americans to firearm suicide. This is almost twice as many Americans as were killed in World War I.9

Suicides make up three in every five gun deaths and half of all suicides are by firearm.28 While suicide is not a uniquely American problem, the firearm suicide rate in America is 8 times higher than in other industrialized countries.10

Intersection of Firearms and Suicide

Evidence consistently shows that access to firearms increases the risk of suicide. 11,12,13,14,15,16,17Access to a gun in the home increases the odds of suicide more than three-fold.18 Firearms are so dangerous when someone is at risk for suicide because they are the most lethal suicide attempt method.

Though research shows that few individuals substitute means for suicide if their preferred method is not available, if firearms are not available, the person at risk for suicide is much more likely to survive even if they attempt using another method.19 Delaying a suicide attempt can also allow suicidal crises to pass and lead to fewer suicides. Ninety percent of individuals who attempt suicide do not eventually go on to die by suicide.20 The use of a firearm in a suicide attempt often means there is no second chance.

Guns increase the risk of suicide for anyone living in the home, including children. A recent study found that household gun ownership was the best predictor of youth suicide. For every 10 percentage-point increase in estimated household gun ownership, the suicide rate among youths ages 14-19 years increased nearly 27%.21 Reducing access to lethal means, such as firearms, is critical to saving lives.

In short, ensuring that someone does not have access to a firearm during a potential suicidal crisis can often be the difference between life and death.

Lethality of Firearms

Firearms are uniquely lethal. Suicide attempts by firearm are almost always deadly — 9 out of 10 firearm suicide attempts result in death.22 By comparison, the most frequently chosen methods of suicide attempt, such as poisoning and cutting/piercing, are much less lethal, resulting in death just 0.5-2% and 1-3% of attempts, respectively.23 Further, the vast majority (90%) of those who attempt suicide and survive will not go on to die by suicide.24 Reducing access to firearms for those who are suicidal both reduces the number of suicides and makes those who do attempt more likely to survive.

Prevent Firearm Suicide

Prevent Firearm Suicide is a project of the Ed Fund that was developed to raise awareness about how temporarily reducing access to firearms during periods of high risk for suicide is life-saving. PreventFirearmSuicide.com shares effective, evidence-based interventions for firearm suicide prevention; information on the intersection of firearms and suicide including risk factors and statistics; state-level firearm suicide for all 50 states; and includes a robust resource library of educational materials, initiatives, research, and other resources about firearm suicide prevention and means safety. For more information, please visit PreventFirearmSuicide.com.

Preventing Firearm Suicide

Firearms and suicidality are a lethal combination. Temporarily reducing access to lethal means — putting time and space between someone who may attempt suicide and lethal means, specifically firearms — makes it more likely they will survive a suicide attempt.25 Though a person may consider suicide for a long time (providing opportunities for intervention and risk reduction), suicidal crises peak relatively quickly for many people. Given the lethality of firearms, access to firearms during that high-risk time period is a key factor in whether or not a person will survive.

While having a gun does not make a person more suicidal, access to guns does increase the risk that an individual will die by suicide if they attempt. Suicide attempts with firearms are nearly always lethal, whereas attempts with the other most commonly used methods are lethal less than 2% of the time.26

Suicide prevention and intervention create opportunities to access resources and treatment, build connections, and explore other options that may be difficult to see in the midst of suffering. Reducing access to lethal means is an effective suicide prevention intervention that may lead to (1) substituting means (which is less common) or (2) temporarily or permanently delaying suicide attempts. If suicide attempts are delayed altogether without means substitution, the suicidal crises again may pass and result in fewer suicides. Through either path, temporarily reducing access to firearms for individuals who are at an elevated risk of suicide is likely to reduce suicide rates at the population level.

 

Source: Barber CW & Miller MJ. (2014). Reducing a suicidal person’s access to lethal means of suicide: A research agenda. American Journal of Preventive Medicine.

Effective, evidence-based interventions that focus on limiting access to lethal means for firearm suicide prevention exist at several levels of intervention: individual, relationship, community, and societal. For more detailed explanations of these interventions, visit PreventFirearmSuicide.com using the links below:

  • Individual: Safer firearm storage
  • Relationship: Lethal means safety counseling
  • Community: Educating gun owners about suicide prevention through programs such as the Gun Shop Project
  • Societal: Extreme risk laws and other policies that temporarily reduce access to firearms by individuals who may be at risk of suicide

“Firearm suicide is preventable. An individual who knows that they are at a higher risk of suicidality can take steps to protect themselves — like pursuing safer storage options or not having a gun in the home at all. A family member or friend may help the individual store their firearms more safely, while a medical professional can provide lethal means safety counseling as part of their care. The person’s community can enact change through gun shop projects. And our society can work to pass stronger gun laws, such as extreme risk laws, to provide tools that have been shown to reduce firearm suicides. At each level of the social ecological model, there are tools that work in concert to save lives. By applying them simultaneously, we can create a multi-pronged strategy to address our firearm suicide problem.”

- Adelyn Allchin, Senior Director of Public Health and Policy

Firearm Suicide in the United States

The firearm suicide epidemic is growing — 578 more people died by firearm suicide in 2018 than in 2017. The number and rate of firearm suicides have increased every year since 2006, except for 2014. The firearm suicide rate increased by 19% over the last decade (2009-2018).3

Firearm Suicide Deaths in the United States,
2009-2018

Number of deaths

Source: CDC WONDER.

Firearm Suicide Rate in the United States,
2009-2018

Age-adjusted rate per 100,000

Source: CDC WONDER.

All rates listed are age-adjusted in order to allow for accurate comparisons between populations with differing age distributions.

Geographical Variations

Firearm suicide impacts communities across the country, but is more prevalent in some states. Suicide rates (by firearm and by other means) are generally higher in places where household firearm ownership is more common.27

Firearm suicide rates also vary greatly within states. In general, firearm suicide rates are higher in rural areas than in urban areas. Americans who live in non-metro (rural) areas are roughly twice as likely to die by firearm suicide compared to those living in large metro areas.28

While it is important to look at the overall firearm suicide rates for states, we must also recognize that firearm suicides are a localized problem with significant variation across small geographic distances.

Firearm Suicide Rates by State, 2018

  • 0.94 to 5.34
  • 5.35 to 9.75
  • 9.76 to 14.16
  • 14.17 to 18.41

Source: CDC WONDER.

All rates listed are age-adjusted in order to allow for accurate comparisons between populations with differing age distributions.

Note: The CDC considers firearm suicide rates based on fewer than 20 deaths “statistically unreliable” and suppresses firearm suicide rates based on fewer than 10 deaths. Fewer than 20 firearm suicides were reported during 2018 for DC. Since a single year of data did not produce a reliable rate and would exclude DC from the above graphics, we chose instead to use DC’s firearm suicide rate spanning the most recent three years (2016-2018) in order to include it for comparison.

Disparities Across Demographics

Firearm suicide impacts different populations in different ways. This is important because knowing how different groups of people are at risk can help tailor prevention programs, including firearm safety interventions.

While no population is immune from firearm suicide, some demographic groups are at higher risk. For example, males die by firearm suicide at overwhelmingly higher rates than do females.3 Looking at rates by sex, race, and age together can help to paint a better picture of firearm suicide in the United States.

By Sex

While females are more likely than males to attempt suicide, males are more likely to die by suicide.29 On average, for every female who dies by firearm suicide, at least 6 males die by firearm suicide.30 As such, across all racial and ethnic backgrounds, males have higher rates of firearm suicide and suicide overall. This is primarily due to the fact that males are more likely than females to use a more lethal suicide attempt method, such as firearms. Suicide attempts among males are eight times more likely to involve firearms than attempts among females.31 On average, 56% of suicide deaths among males are by firearm, whereas 31% of suicides among females are by firearm.32

Firearm Suicide Deaths by Sex,
2018

Male

86%

Female

14%

Source: CDC WONDER.

By Race, Ethnicity, and Age

Overall, firearm suicide rates are highest among White people, followed by American Indian/Alaska Native people.3

Firearm suicide risk is highest among people age 75 and older across the population as a whole, but that is primarily due to the very high rate of suicide among White males in that age group. However, firearm suicide rates peak at younger ages for other demographic groups. While the highest rates of firearm suicide among White and Hispanic/Latino males are among those 75+, the firearm suicide rates for other demographics (American Indian/Alaska Native, Asian/Pacific Islander, and Black) are highest at ages 20-34.3

For Asian/Pacific Islander women, Black women, and Hispanic/Latino women, the firearm suicide rate is highest among 20-34 year-olds. For White women, the firearm suicide rate is highest among 35-54 year-olds.3

Female Firearm Suicide Rates by
Race, Ethnicity, and Age, 2018

Rate per 100,000

Age group

American Indian/Alaska Native
Asian/Pacific Islander
Black
White (non-Latino)
Hispanic/Latino (any race)

Source: CDC WONDER.

Note: The CDC considers firearm suicide rates based on fewer than 20 deaths “statistically unreliable” and suppresses firearm suicide rates based on fewer than 20 deaths. Fewer than 20 firearm suicides were reported during this time for the following races and therefore are omitted from the above chart: American Indian/Alaska Native females, all ages; Asian/Pacific Islander females ages 0-19, 55-74, and 75+; Black females ages 75+; and Hispanic/Latino (any race) females ages 0-19 and 75+.

Male Firearm Suicide Rates by
Race, Ethnicity, and Age, 2018

Rate per 100,000

Age group

American Indian/Alaska Native
Asian/Pacific Islander
Black
White (non-Latino)
Hispanic/Latino (any race)

Source: CDC WONDER.

Note: The CDC considers firearm suicide rates based on fewer than 20 deaths “statistically unreliable” and suppresses firearm suicide rates based on fewer than 20 deaths. Fewer than 20 firearm suicides were reported during this time for the following races and therefore are omitted from the above chart: American Indian/Alaska Native males ages 75+ and Asian/Pacific Islander males ages 75+.

Military Service Members, Veterans, and Military Families

Military service members, veterans, and military families are at heightened risk for firearm suicide. While half of the suicides in the U.S. are by firearm, 60-70% of service member and veteran suicides are by firearm. Though there is no single explanation or cause for suicide, there are risk factors that military service members and veterans have that do increase the risk for suicide, including access to firearms. Firearm ownership does not necessarily increase suicidal ideation, but access to and familiarity with firearms increases the capability for suicide, which is considered necessary for how suicidal thoughts progress into suicide attempts. Firearms are fundamental to military culture, but they cannot be ignored in addressing suicide.32

For more information, read our report on suicide among service members and veterans and visit our Prevent Firearm Suicide website page on firearm suicide among service members and veterans.

To learn more about firearm suicide and our recommendations, visit our Prevent Firearm Suicide website.

If you or someone you know needs some support now, please contact the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or text “HOME” to 741-741.

For a comprehensive list of available suicide prevention crisis lines, visit our Prevent Firearm Suicide website.

Recommendations

Enact and implement policies, programs, and practices that create time and space between individuals who may be at risk of suicide and firearms.

Firearm suicide is a uniquely American problem. Policies and practices that temporarily reduce access to firearms by individuals when they are at an elevated risk for suicide can save lives. We recommend:

  • Safer storage: Safely storing and thereby reducing access to firearms is a suicide prevention strategy supported by researchers, healthcare professionals, and gun owners alike. For at-home firearm storage, firearms should be stored locked and unloaded, ammunition should be stored and locked separately from firearms, and the key or lock combination should be inaccessible to the person at risk of suicide, whether that is the gun owner or another person in the home. Storing firearms outside of the home is the safest option when a person is at increased risk of suicide.
  • Avoid alcohol when accessing guns: Just like driving a car, alcohol and other substances increase risk of violence and injury. Firearm access should be limited after consuming alcohol and other substances.
  • Lethal means safety counseling: Lethal means safety counseling is an evidence-based healthcare intervention that is effective in preventing firearm injury and can be used to help prevent suicides. Lethal means safety counseling helps healthcare providers work collaboratively with at-risk patients and their families to temporarily reduce access to firearms until the elevated risk subsides. Healthcare professionals should be trained on lethal means safety counseling as a suicide prevention intervention. All patients should be asked about firearm access and provided safer storage information. Patients with suicidal thoughts or behaviors should receive more in-depth lethal means safety counseling. See Lethal Means Safety Counseling for more information.
  • Gun shop projects: Gun shop projects provide local retailers, instructors, and customers with firearm suicide prevention educational materials. These materials include education on the elevated risk of suicide to the gun-owning community and strategies for prevention that allow gun owners to take an active role in suicide prevention among their peers. Gun shop projects should be expanded across the country.
  • Extreme risk laws: Extreme risk laws empower law enforcement and the people closest to an individual at elevated risk of harm to self or others to intervene to help prevent gun tragedies before they occur. These state laws allow law enforcement, and in some states family and household members, among others, to petition a judge to temporarily limit an individual’s access to firearms if they are at elevated risk of suicide. Research shows that extreme risk laws are effective in suicide prevention. Every state should have its own extreme risk law and continuously monitor and evaluate the law to ensure equitable implementation and ongoing effectiveness. See Extreme Risk Laws for more information.
  • Voluntary self-prohibition: Voluntary self-prohibition laws allow individuals to place themselves on a do-not-buy list that enters their name into the National Instant Criminal Background Check System, thus prohibiting them from purchasing firearms. States should pass voluntary self-prohibition laws.
  • Mandatory waiting periods: Mandatory waiting periods require firearm purchasers to wait, generally 3-14 days, after passing a background check before they may take home their newly bought firearms. Suicidal thoughts can be transient or short-lived. As such, putting time and space between a person and a firearm through mandatory waiting periods means a suicidal crisis may pass or suicidal thoughts may subside before the person has access to a firearm. Congress should create a mandatory waiting period for all gun sales. In the absence of federal action, states should continue passing mandatory waiting period laws.
  • Licensing: Licensing laws, also called permit-to-purchase laws, require individuals to obtain a license or permit before purchasing a firearm. These laws vary from state to state, but in addition to a background check, may require an in-person application, safety training, fingerprints, and a waiting period. Research has found that these laws are effective at reducing suicides. States should enact licensing laws and continuously monitor and evaluate the law to ensure equitable implementation.
  • Universal background checks: Universal background checks are the foundation upon which all other gun violence prevention policies are built, but exemptions are necessary for temporary transfers to prevent suicide. Background checks should be required on every gun sale and transfer in America, including private and online sales, with certain exceptions, such as for temporary transfers to prevent imminent death or self-harm. See Universal Background Checks for more information.

Language matters when talking about suicidality. The suicide prevention community recommends the following language choices. To learn more, visit https://reportingonsuicide.org/.

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Last updated July 2020