Without Means: The role of guns in suicide deaths

April 10, 2013

(Photo courtesy of Lindsay Van Sickle)
Lindsay Van Sickle with her father. Prior to his suicide, Van Sickle says her father was outgoing and the life of the party.

Lindsay Van Sickle’s dad loved to shoot. He lived on a farm and hunted as a little boy. As an adult, he spent time at the shooting range. He collected what she calls “cowboy guns” and loved the history behind some of his WWII firearms.

Van Sickle describes her dad as the life of the party. But he also struggled emotionally.  In July of 2011, he took one of his guns, locked the rest of them up, left his house and shot himself at a park. He was 54. The year he died, of the 30,867 gun deaths in the U.S., 19,766 were suicides.

Van Sickle says her dad was a model of responsibility with guns.

“At the house they were locked up in the basement. I didn’t even know where the keys were,” she said. “Even a few of my dad’s cousin’s who grew up kind of like my dad, were shocked that he would take something he loved so much and use it to end his life.”

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As Van Sickle watches the news, and sees all these debates about guns, she’s found herself wondering, what role these suicides play in the debate.

“When something like this happens, you can’t help but wonder about the what if. If laws were different, if rules were different, if the outcome would be the same,” said Van Sickle.

I posed that question, about laws and suicide, to Dr. Cathy Barber at the Harvard School of Public Health.

She says first, it’s important to note why the method of suicide matters.

A number of years ago, Barber was helping develop a new system for the federal government called the National Violent Death Reporting system.

“In the process of doing that, I would read through thousands of suicides, little thumbnail sketches of suicides,” Barber recalled.

Barber was surprised at how many of the suicides seemed impulsive. Barber, like many others, assumed that suicide is something people plan. In another study, people who almost died in a suicide were asked how long after they decided to attempt suicide did they actually try it. Twenty-four percent said under 5 min. Two-thirds said under an hour. Only 16 percent said a day or more. 

“You’d think this is such a huge decision, you’d think it would be a more deliberative one,” said Barber.

This matters because even though people may have long battles with depression, the window of time in which they actually want to attempt suicide is small. And many people who survived suicide attempts, never go on to try again.

So Barber, came to a simple conclusion. What mattered in that tiny window was the instrument available to the person wanting to commit suicide.

“There is a huge difference across methods of suicide in how likely they are to actually kill. Firearms are actually at the top of the heap.”


Suicide attempts with a gun, result in death 85 percent of the time. Poisoning, for example, only results in death 2 percent of the time.

State suicide statistics illustrate this as well.  Eastern states, like Massachusetts have a much lower rate of suicide death than Western states like Wyoming. They don’t vary much in depression rates or even suicide attempts.The biggest difference is the number of guns in each state.

This has gotten some public health workers thinking about a method called “means restriction.”

The term comes from the U.K., where gas—sticking your head in the oven—was once a leading means of suicide.

“Back in the 1960s, they started replacing the source of gas with a non-toxic source, and suddenly suicides in Great Britain went down by a third,” Barber said. “And so that’s when we started realizing means restriction actually can save lives.”

But of course, “means restriction” with guns in the U.S. is not as simple.

Gun control usually focuses on homicide. Even laws like waiting periods, or background checks, haven’t really been shown to help. That’s because people usually don’t go out and buy a gun for a suicide.

What matters is having a gun around. And no one is proposing laws that would get guns out of homes all together. 

“I don’t see it as being in line what the courts have decided about second amendment rights,” said Barber.  “I mean people can have their opinions about this, but personally, my interest is looking at this and saying ‘how do we save lives right now.’”

So Barber’s approach is a public health one. Her project based at Harvard School of Public Health is called Means Matters. She encourages programs that work with, not against gun owners. For example, a New Hampshire project trains gun shop owners in suicide prevention.  In addition to learning about how to lock up and store a gun, gun purchasers learn about how to keep guns away from suicidal individuals. They also receive resources for mental health support.

But the politicized debates over gun laws sometimes spill over to these public health approaches too. Dr.  Joseph O'Neil used to work as a family doctor. At appointments, he asked about general safety concerns.

“When I was talking about car seats, when I was talking about seatbelt use, I often asked families if there was a firearm in the house. And I had several families take exception to that.”

Some patients were so upset, that he would ask what they considered a personal, non-medical question, that they switched doctors.

But O'Neill didn’t stop. In fact, he expanded his efforts. He became part of the Indiana Violent Death Prevention Project. One of the organizations projects was training clergy in suicide intervention.

Over a third of clergy members, said they had actually lost someone in their congregation to suicide. The training helped them counsel potentially suicidal individuals.

“Clergy felt more empowered to say by the way I know you feel this way. Is there a gun in the home, would you be willing to get it out of the house,” said O’Neill.

But they never got to see how well it worked. Their funding, from the Joyce Foundation, the same private foundation that supports this series, ran out. Other funding for firearm injury research is scarce.

The Center for Disease Control funds research on causes of death and injury. But since 1996, most of their research on firearms was restricted by congress, who was pressured by the NRA.

Another problem: The Consumer Product Safety Commision, which regulates household products like toys or cars, doesn’t oversee firearms.

O'Neil said there just isn’t the same oversight or information on guns. “Since 1975, we’ve reduced the number of infants killed in motor vehicle accidents by 75%. For toddlers, 50%. I wish we could do that for firearm injuries.”

But without the research dollars and oversight, he thinks they won’t. “It’s sort of like going without a compass. We don’t know where we’ve been and we don’t know where we are going unless we have the data.”

Both Dr. O'neill and Dr. Barber say that the current political battles over guns are a catch 22. It brings more attention to their issue.  But it makes any mention of guns so contentious their work becomes political. And it’s hard to talk to gun owners-- the very people most at risk of gun suicides-- without coming across as anti-gun.

As for Lindsay Van Sickle, the experience of actually losing someone to a firearms suicide has changed the way she feels.

“If you have a gun, even if it’s for hunting or protection, there may come a time in your life that you may be depressed. And that may be a means to take your life. So I am definitely more nervous and scared about guns now based on what my dad did to himself.”

She doesn't’ know if any policies or programs could have changed what happened to her father. But she does think, at the very least, it’s worth us asking the question.

Shannon Heffernan is a WBEZ reporter. Follow her @shannon_h.