I recently testified in Annapolis in favor of a bill that would close an unfortunate loophole in the law by requiring background checks on all long gun (rifle and shotgun) sales, including from unlicensed sellers. While dramatic mass killings in Maryland, including the slaughter of children and members of the press, have led to this proposed legislation, the law would also reduce firearm suicides, which constitute two-thirds of all gun deaths.
Approximately 2,500 Marylanders have died due to firearm suicide in the past decade, mostly in rural areas where long guns are the weapon of choice.
Suicide is the third leading cause of death for young Marylanders aged 15-34. It is the 10th leading cause of death in the country overall, and it has been estimated to cost Maryland $586,391,000 in medical and work loss expenses each year.
Guns are by far the most lethal, common means of attempting suicide, and because of their high fatality rate, they are by far the most common way by which suicides occur.
While suicidal thoughts arise frequently in many patients with depression, suicide itself is an impulsive act; 71 percent of people who attempt suicide make that decision within the hour; 24 percent make the decision within just 5 minutes. The majority of suicide deaths happen on the first attempt. Most people who survive the attempt never go on to die by suicide — they get treatment, and they live. The lethality of method available when the impulse strikes is critically important. If there are pills in the house for overdose, your chance of death is only 2 percent. If there is a rifle at home, you will likely not survive to receive help.
Because the majority of suicides occur in people suffering mental illness, background checks prevent firearm purchases for those who have been involuntarily hospitalized for a mental illness in the past. Background checks are an effective strategy for preventing suicides, but mostly in areas where the gun of choice is a handgun, since these policies currently do not apply to long guns.
In Maryland, firearm suicide rates in rural counties are more than double that of our cities. Last year, my colleagues and I published data demonstrating how the suicide rates are higher in Maryland’s rural areas compared to urban areas due largely to firearms. While in the cities we have handguns, in rural areas, the firearms available are long guns, which are currently very easy to attain for any purpose. Long guns are most prevalent in rural areas because they are the firearms of choice for hunters, as they were for Ernest Hemingway, who used one in his own suicide. He had just begun treatment for his depression, which was never completed because when the suicidal impulse struck, Hemingway had easy access to his shotgun.
In my clinical work, I often find myself in the emergency room performing psychiatric evaluations on patients who have made non-fatal suicide attempts. Because they have survived, I am able to get them into treatment.
Despite the fact that most completed suicides are a result of firearm use, I never see these patients in my ER. They go straight to the medical examiner’s office for autopsy.
Instead, in my clinical practice, I see their families and loved ones, in mourning, wishing that the deceased did not have such easy access to a gun. Wishing that when the suicidal impulse flared, they were not armed with such a lethal method, and instead they were found still clinging to life and brought to the ER, where problem solving and psychiatric care can begin.
Stricter common sense gun laws have been found again and again to decrease suicide rates, simply by virtue of delaying access, especially to people at risk.
Suicide rates in this country have increased almost 30 percent over the past 20 years. If our legislators pass this bill, it could play an important role in reversing this sad trend in Maryland.
Dr. Paul Nestadt (email@example.com; Twitter: @paulnestadt) is a psychiatrist and epidemiologist on faculty at Johns Hopkins and a researcher focusing on suicide and gun violence.