Citation

Goldstein EV, Prater LC, Wickizer TM. Health Aff. (Hope) 2019; 38(10): 1711-1718.

Affiliation

Thomas M. Wickizer ( twickizer@cph. osu. edu ) is the Stephen F. Loebs Distinguished Professor and chair of the Division of Health Services Management and Policy, College of Public Health, Ohio State University; and an affiliate professor in the Department of Health Services, School of Public Health, University of Washington, in Seattle.

Copyright

(Copyright © 2019, Project HOPE - The People-to-People Health Foundation)

DOI

10.1377/hlthaff.2019.00753

PMID

31589526

Abstract

Firearms account for most self-harm deaths, and many more Americans kill themselves with a firearm each year than are murdered with one. Mental illness is an important risk factor for firearm suicide. While the literature focuses on firearm safety, little is understood about how the supply of behavioral health treatment services can reduce firearm suicide. We evaluated whether states with greater behavioral health treatment capacity have lower firearm suicide rates, examining variation across the United States and over time. The mean adjusted firearm suicide rate rose from 6.74 per 100,000 people in 2005 to 7.89 per 100,000 in 2015-a 17.1 percent increase. We found a significant independent inverse relationship between greater behavioral health treatment capacity and the firearm suicide rate. We show that across all states, on average, a 10.0 percent relative increase in behavioral health workers per state was associated with a modest 1.2 percent relative reduction in the adjusted firearm suicide rate. Given this finding, we discuss whether firearm control initiatives might offer a greater protective effect for reducing firearm suicide, compared to the protective effect of increasing behavioral health treatment capacity.

Language: en

Keywords

Behavioral health care; Drug use; Firearms; Gun violence; Health policy; Mental health; Public Health; Substance use; Suicide; Violence