|
Abstract
|
Suicide in the United States has increased by more than 30% in the past 20 years.1 While available data indicate that the rate of suicide has stabilized and even decreased among some groups during the COVID-19 pandemic,2 in 2020, a recorded 45,855 people in the US died by suicide. Before 2020, increases occurred across every age and major demographic group, including youth.3 Suicide is preventable, and most suicidal crises are temporary and treatable.4,5 Urgent efforts towards prevention are scaling up, including a new national number for mental health support (#9-8-8).
In the United States, approximately half of suicide deaths are by firearm, and the proportion of suicides by firearm has remained relatively static.4 Firearms are a highly lethal means of intentional self-harm, and a firearm in the home is a strong risk factor for suicide death.6,7 During a suicidal crisis, reducing access to lethal means is critical, especially given the evidence that most people who survive a suicide attempt do not re-attempt.4
Given the public health burden of suicide in the United States and the central contribution of firearms to intentional self-harm, restricting access to guns among those at high risk of suicide is a key public health strategy. The analysis by Swanson et al. demonstrates that legal owners of a single handgun in California are at more than four times higher risk of suicide than the general adult population of California, and it evaluates whether voluntarily divesting from ownership reduces suicide risk.8 While the public health and policy implications of this analysis are clear and compelling, we are concerned that the assumptions necessary for causal identification are untenable. That said, the authors' pursuit of causal identification may be unnecessary for the practical purpose of informing firearm suicide prevention efforts...
Language: en |