Objective: To examine the risk factors and precipitating circumstances associated with firearm suicide.
Methods: Data from the restricted National Violent Death Reporting System (2003–6) for 25 491 male and female suicide decedents aged 18 and older were analysed by multiple logistic regression to estimate the relative odds of firearm use with 95% CIs.
Results: Firearms were often used in male (58.1%) and female (31.2%) suicides. Among male decedents, older age, veteran status, residing in areas with higher rates of firearm availability, raised blood alcohol concentration, acute crisis and relationship problems were all associated with firearm use. Conversely, men with a diagnosis of a mental health problem, a history of suicide attempts or alcohol problems had lower odds of firearm use. Among female decedents, factors with a significant effect on firearm use included: being older, married, white and a veteran; residing in areas with higher rates of firearm availability; having an acute crisis; having experienced the death of a relative or friend; being depressed; and having relationship problems. Of note, women who had a treated DSM-IV-diagnosed problem, previous suicide attempts and physical health problems were less likely to use firearms.
Conclusions: These findings challenge the conventional view that those who are severely depressed and suicidal are prone to highly lethal methods, such as firearms. Rather, firearms users may be reacting to acute situations.
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Funding The Joyce Foundation and the American Foundation for Suicide Prevention supported this research. All analyses, interpretations and conclusions based on these data are solely the responsibility of the authors.
Competing interests None.
Contributorship: Study concept and design and critical revision of the manuscript for important intellectual content: MSK, BHM. Acquisition of data: MSK, NH. Analysis and interpretation of data and drafting of the manuscript: MSK, BHM and NH. Statistical expertise: BHM.
Provenance and Peer review Not commissioned; externally peer reviewed.
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