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Bauder CR, Rooney EA, Hay JM, Long CM, Bryan CJ. Associations Between PTSD Features and Firearm Ownership and Storage: Results From the PRImary Care Screening Methods (PRISM) Study. Mil Med 2024:usae342. [PMID: 38970431 DOI: 10.1093/milmed/usae342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Revised: 06/16/2024] [Accepted: 06/24/2024] [Indexed: 07/08/2024] Open
Abstract
INTRODUCTION Veterans and active duty service members are significantly more likely to die by suicide using firearms compared to the general population. Not-secure firearm storage (e.g., keeping guns loaded/in an unlocked location) is associated with greater risk for suicide and a third of veteran firearm owners store at least 1 personal firearm unsecured. Veterans and active duty service members are also significantly more likely to be diagnosed with posttraumatic stress disorder (PTSD) than the general population. Symptoms of PTSD are divided into 4 criteria: reexperiencing, avoidance, negative affect, and hyperarousal. Research has suggested that endorsement of hyperarousal symptoms is positively associated with unsecure firearm storage and that avoidance symptoms might be negatively associated with unsecure storage practices. The present study examined the relationship between self-reported firearm ownership and storage practices among each item from the Primary Care PTSD Screening for DSM-IV-TR (PC-PTSD-IV) to explore associations between PTSD features and firearm ownership and storage. MATERIALS AND METHODS Participants were recruited from primary care clinics across 5 military installations in the United States as part of a larger study (Mage = 45.4, SD = 16.9). Among participants (n = 2,685), most of our sample identified as male (51.3%) and white (67.3%) with 61.6% currently serving in the military, 16.8% retirees, and 21.6% family members. PTSD symptoms were assessed using the PC-PTSD-IV and a quarter met the clinical threshold for PTSD. Binomial and multinomial logistic regression analyses were used. RESULTS Among completed responses, 989 (38.1%) people reported owning guns; among gun owners, 386 (39.0%) reported that they were loaded, and 352 (35.6%) reported they were loaded and unlocked. Endorsement of specific items on the PC-PTSD-IV, including those specific to hyperarousal and avoidance, was not significantly associated with storing firearms loaded and/or in nonsecure locations when controlling for military service. Non-responses to items around firearm storage practices were significantly associated with those individuals meeting the clinical threshold for PTSD according to the PC-PTSD-IV and participants currently serving had higher odds of storing at least 1 personal firearm loaded and both loaded and unlocked. CONCLUSIONS Results from our study highlight similarities and departures from the previous literature on the connection between PTSD and non-secure firearm storage practices. Further research may examine (1) the relation between PTSD symptoms and firearm storage between active duty service members, retirees, and family members and (2) whether non-response to items regarding firearm ownership is systematic.
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Affiliation(s)
| | - Emily A Rooney
- Department of Psychiatry & Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH 43210, USA
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Bond AE, Karnick AT, Capron DW, Anestis MD. Predicting potential underreporting of firearm ownership in a nationally representative sample. Soc Psychiatry Psychiatr Epidemiol 2024; 59:715-723. [PMID: 37351596 DOI: 10.1007/s00127-023-02515-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/24/2023]
Abstract
PURPOSE This study utilized demographic and intrapersonal variables to identify individuals who may have falsely denied firearm ownership and determined if individuals can be divided into meaningful subgroups. METHODS Participants were United States residents (N = 3500) recruited from January to June 2020. matched to the 2010 census data for age, race, sex, income, and education level. A Zero-Inflated Negative Binomial (ZINB) regression was utilized to determine potential underreporting of firearm ownership, and a latent class analysis was utilized to determine unique subgroups of those who were identified as underreporting firearm ownership in the ZINB. RESULTS Participants (N = 1306) were identified as underreporting firearm ownership (excess zeros) based on a model that included demographic and intrapersonal variables. A latent class analysis indicated that among excess zeros, three unique subgroups exist. CONCLUSIONS Determining who may be underreporting firearm ownership will allow for a more comprehensive understanding of firearm ownership in the US and more targeted safe storage messages that may reach those who own firearms and are at risk for firearm-related injury and death.
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Affiliation(s)
- Allison E Bond
- The New Jersey Gun Violence Research Center, Rutgers University, Newark, USA.
- The Department of Psychology, Rutgers University, Newark, USA.
| | - Aleksandr T Karnick
- The School of Psychology, The University of Southern Mississippi, Hattiesburg, USA
| | - Daniel W Capron
- The School of Psychology, The University of Southern Mississippi, Hattiesburg, USA
| | - Michael D Anestis
- The New Jersey Gun Violence Research Center, Rutgers University, Newark, USA
- The School of Public Health, Rutgers University, Newark, USA
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3
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Docherty M, Kubik J, Drawve G. Examining predictors of suicide by firearm in young, middle, and late adulthood. Suicide Life Threat Behav 2024; 54:221-232. [PMID: 38124679 DOI: 10.1111/sltb.13035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 11/18/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023]
Abstract
INTRODUCTION Suicide remains a leading cause of death in the U.S., and firearms are one of the most lethal methods of suicide. This study examines personal and contextual factors that predict suicide with a firearm compared to other methods across stages of adulthood. METHODS Data on adult suicide decedents from 2009 to 2019 were obtained from Colorado's National Violent Death Reporting System (NVDRS) data (N = 11,512). The dataset includes incident and person characteristics collected by law enforcement and coroners. Zip code level data were integrated from the American Community Survey. RESULTS Age, sex, race, marital status, military service, substance use, suicide attempt history, mental health, and location characteristics (population density, as well as age, education, veteran status, and household status of population) predicted suicide by firearm. Risk was particularly high for males in older adulthood. We further explored age-specific models (young, middle-aged, and older adults) to determine salient risk factors for each group. CONCLUSION This study highlights the need for comprehensive suicide prevention approaches that consider both individual and contextual risk factors, as well as unique risks in each stage of adulthood.
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Affiliation(s)
- Meagan Docherty
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio, USA
| | - Joanna Kubik
- Department of Sociology, Rider University, Lawrenceville, New Jersey, USA
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Bond AE, Stanley I, Bandel SL, Anestis M. Law enforcement and firearms: understanding firearm ownership and storage habits. Inj Prev 2024; 30:132-137. [PMID: 37875335 DOI: 10.1136/ip-2023-044919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 10/08/2023] [Indexed: 10/26/2023]
Abstract
OBJECTIVE This study seeks to better understand firearm ownership among law enforcement officers (LEO), with the goal of informing future firearm injury and suicide prevention efforts. We describe the frequency and sociodemographic correlates of firearm ownership and storage practices among, and examine the association between suicidal ideation and current firearm storage practices. METHODS The present study used data from a large online study (n=6410) and included data from individuals who were currently or previously being employed as an LEO (n=369; M (SD) age=39.2 y (15.8 y), 75.2% male, 66.7% white). Self-report measures were used to assess for firearm ownership, storage habits and suicidal ideation. Descriptive statistics were used to describe the frequency of firearm ownership and logistic regressions were used to examine the extent to which demographic characteristics and suicidal ideation were associated with firearm ownership. RESULTS Overall, 70.5% (n=261) of the sample reported firearm ownership. LEO who were older had significantly lower odds of reporting firearm ownership. Those who were married and those who reported lifetime suicidal ideation had significantly greater odds of reporting firearm ownership. Whereas firearm-owning LEO who reporting storing a firearm locked had significantly lower odds of reporting lifetime suicidal ideation, those who reported storing a firearm unloaded had significantly greater odds of reporting lifetime suicidal ideation. CONCLUSION Findings have important public health implications and can be used to increase adherence with secure storage recommendations. Increasing secure storage may help reduce suicide risk among LEO, a sample at heightened risk for suicide.
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Affiliation(s)
- Allison E Bond
- Psychology, Rutgers University, Piscataway, New Jersey, USA
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
| | - Ian Stanley
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
| | - Shelby L Bandel
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
- Department of Psychology, The State University of NJ, Piscataway, New Jersey, USA
| | - Michael Anestis
- New Jersey Gun Violence Research Center, Rutgers University, New Brunswick, New Jersey, USA
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5
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Thulin EJ, French A, Messman E, Masi R, Heinze JE. Firearm-Related Tips in a Statewide School Anonymous Reporting System. Pediatrics 2024; 153:e2023063861. [PMID: 38229535 DOI: 10.1542/peds.2023-063861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/01/2023] [Indexed: 01/18/2024] Open
Affiliation(s)
- Elyse J Thulin
- Addiction Center, Psychiatry, Michigan Medicine, Ann Arbor, Michigan
- The Michigan Institute for Data Science
- Prevention Research Center
- Sandy Hook Promise Foundation, Newtown, Connecticut
- Institute for Firearm Injury Prevention, University of Michigan, Ann Arbor, Michigan
| | - Alex French
- Sandy Hook Promise Foundation, Newtown, Connecticut
| | - Elizabeth Messman
- Health Behavior Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
| | - Rachel Masi
- Sandy Hook Promise Foundation, Newtown, Connecticut
- Rachel A. Masi, Ph.D. PLLC Clinical Psychology Practice, New York, New York
| | - Justin E Heinze
- Prevention Research Center
- Health Behavior Health Education, School of Public Health, University of Michigan, Ann Arbor, Michigan
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6
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Miller AB, Oppenheimer CW, Chew RF, Weitzel KJ, D'Arcangelo B, Barnes A, Lowe A, Yaros AC. Exploring whether mental health crisis text conversations that include discussion of firearms differ from those without firearms. Prev Med 2023; 177:107783. [PMID: 37980956 PMCID: PMC10783174 DOI: 10.1016/j.ypmed.2023.107783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 10/10/2023] [Accepted: 11/13/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Firearm violence represents a public health crisis in the United States. Yet, there is limited knowledge about how firearms are discussed in the context of mental health emergencies representing a major gap in the current research literature. This study addresses this gap by examining whether the content of mental health crisis text conversations that mention firearms differ from those that do not mention firearms in a large, unique dataset from a national crisis text line. METHODS We examined data from over 3.2 million conversations between texters to Crisis Text Line and volunteer crisis counselors between September 2018 and July 2022. We used a study developed text classification machine learning algorithm that builds on natural language processing to identify and label whether crisis conversations mentioned firearms. We compared the frequency of psychosocial factors between conversations that mention firearms with those that did not. RESULTS Results from a generalized linear mixed-effects model demonstrated that. conversations mentioning firearms more frequently were associated with suicide, racism, physical, sexual, emotional, and unspecified abuse, grief, concerns about a third party, substance use, bullying, gender and sexual identity, relationships, depression, and loneliness. Further, conversations mentioning firearms were less likely to be related to self-harm and eating/body image. CONCLUSIONS These results offer an initial glimpse of how firearms are mentioned in the context of acute mental health emergencies, which has been completely absent in prior literature. Our results are preliminary and help sharpen our understanding of contextual factors surrounding mental health emergencies where a firearm is mentioned.
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Affiliation(s)
| | | | | | | | | | | | - Ashley Lowe
- RTI International, Research Triangle Park, NC, USA
| | - Anna C Yaros
- RTI International, Research Triangle Park, NC, USA
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Houtsma C, Raines AM. When safe firearm storage isn't enough: Examining risk profiles among firearm suicide decedents. Suicide Life Threat Behav 2023; 53:655-665. [PMID: 37417720 DOI: 10.1111/sltb.12971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/01/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023]
Abstract
INTRODUCTION Suicide is a leading cause of death in the United States, and firearms are the most frequently used suicide method. Research suggests risk for firearm suicide increases with greater access to firearms (e.g., storing loaded or unlocked). Although safe firearm storage is promoted as a means of risk reduction, no studies have explored factors differentiating firearm suicide decedents who stored firearms safely vs. those who stored unsafely prior to death. METHODS Utilizing data from the National Violent Death Reporting System, the current study aimed to determine which factors distinguish firearm suicide decedents who stored firearms safely vs. those who stored unsafely. The current sample included decedents for whom data were available on whether the firearm used in the suicide was stored loaded or unloaded (n = 4269) and unlocked or locked (n = 6273) prior to their death. RESULTS Results revealed using a long gun in the suicide (as opposed to a handgun) was associated with five times greater odds of storing unloaded prior to death, suggesting this safe firearm storage practice alone does not mitigate risk among all long gun owners. CONCLUSION These findings indicate a need to increase suicide prevention efforts within the long gun owning community.
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Affiliation(s)
- Claire Houtsma
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Amanda M Raines
- Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana, USA
- South Central Mental Illness Research, Education and Clinical Center, New Orleans, Louisiana, USA
- Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
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Anestis MD, Bandel SL, Bond AE, Bryan CJ. Threat sensitivity, intolerance of uncertainty, and firearm purchasing during a firearm purchasing surge. J Psychiatr Res 2023; 162:200-206. [PMID: 37172510 DOI: 10.1016/j.jpsychires.2023.05.038] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/24/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
The firearm purchasing surge that began in 2020 has seen an unprecedented number of firearms purchased within the United States. The present study examined if those who purchased during the surge differed in their levels of threat sensitivity and intolerance of uncertainty from firearm owners who did not purchase during the surge and from non-firearm owners. A sample of 6,404 participants from New Jersey, Minnesota, and Mississippi were recruited through Qualtrics Panels. Results indicated that surge purchasers have higher levels of intolerance of uncertainty and threat sensitivity relative to firearm owners who did not purchase during the surge and non-firearm owners. Additionally, first time purchasers reported greater threat sensitivity and intolerance of uncertainty relative to established firearm owners who purchased additional firearms during the purchasing surge. Findings from the present study increase our understanding of how sensitivity to threats and the ability to tolerate uncertainty differs among firearm owners purchasing at this time. The results help us determine what programs will increase safety among firearm owners (e.g., buy back options, safe storage maps, firearm safety trainings).
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Affiliation(s)
- Michael D Anestis
- New Jersey Gun Violence Research Center, USA; Rutgers, the State University of New Jersey, USA.
| | | | | | - Craig J Bryan
- The Ohio State University Wexner Medical Center, USA
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9
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Daruwala SE, Bandel SL, Anestis MD. Conformity to masculine role norms, firearm storage behaviors, and openness to means safety among two samples of firearm owners. J Psychiatr Res 2023; 158:365-372. [PMID: 36641973 DOI: 10.1016/j.jpsychires.2023.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 12/06/2022] [Accepted: 01/09/2023] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Understanding the sociocultural characteristics that are associated with US firearm owners' current storage practices and openness to means safety can inform suicide prevention initiatives. Masculinity, which is dominant within the US gun culture, may be a particularly salient factor that influences firearm ownership, storage practices, and openness to means safety. A recent study by McDermott et al. (2021) found that firearm ownership was associated with a combination of being White, male, politically conservative, and endorsing higher conformity to the masculine norms of violence, risk taking, and power over women. The current study builds upon McDermott and colleagues' (2021) research by examining the unique contribution of conformity to nine masculine norms as predictors of current firearm storage practices and openness to firearms means safety. METHODS Two samples of US firearm owners were recruited on Amazon's Mechanical Turk in 2019 (Sample 1; n = 200) and 2020 (Sample 2; n = 297). RESULTS Higher adherence to the norms of emotional control, violence, and power over women were associated with less secure storage practices, but only in Sample 2. The hypothesis that self-reliance, emotional control, and risk taking would be associated with openness to means safety was largely unsupported. Adherence to the violence norm was observed to have the greatest association with both current storage practices and openness to changing storage practices. CONCLUSIONS While several masculine norms were not consistently associated with our outcomes, the norm of violence may play a small role in firearm storage practices and openness to means safety for suicide prevention.
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Affiliation(s)
- Samantha E Daruwala
- The Ohio State University Wexner Medical Center, Columbus, OH, USA; VA Center of Excellence for Suicide Prevention, VA Finger Lakes Healthcare System, Canandaigua, NY, USA.
| | - Shelby L Bandel
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; New Jersey Gun Violence Research Center, Piscataway, NJ, USA
| | - Michael D Anestis
- Rutgers, The State University of New Jersey, New Brunswick, NJ, USA; New Jersey Gun Violence Research Center, Piscataway, NJ, USA
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Anestis MD, Bond AE, Capron DW, Bryan AO, Bryan CJ. Differences in firearm storage practices among United States military servicemembers who have and have not disclosed suicidal thoughts or attended behavioral health sessions. Suicide Life Threat Behav 2023; 53:262-269. [PMID: 36622136 DOI: 10.1111/sltb.12940] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/24/2022] [Accepted: 12/09/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Two-thirds of military suicides are by firearm, and unsafe storage increases the risk of suicide. Understanding who is at risk for suicide, their interactions with behavioral healthcare, and their firearm storage habits have implications for suicide prevention. METHOD Probability-based sampling was used. Inclusion criteria were current military service and firearm ownership. Analyses focused on those who endorsed past year (n = 180) or past month suicidal ideation (n = 85). RESULTS Servicemembers with undisclosed past year ideation stored firearms at home more often and with a locking device less often. Servicemembers with past year ideation who did not attend recent behavioral health sessions stored firearms with a locking device and loaded less often. Servicemembers with undisclosed suicidal ideation in the past month stored firearms with a locking device less often. Servicemembers with past month ideation who have not attended recent behavioral health sessions stored firearms with a locking device and loaded less often. CONCLUSIONS Servicemembers experiencing undisclosed suicidal ideation and who are not receiving treatment generally have more ready access to firearms. Safe firearm storage messaging needs to be disseminated in a manner that shifts social norms around firearm storage, whether or not suicide risk is known.
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Affiliation(s)
- Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, USA.,Rutgers, The State University of New Jersey, Piscataway, USA
| | - Allison E Bond
- New Jersey Gun Violence Research Center, Piscataway, USA.,Rutgers, The State University of New Jersey, Piscataway, USA
| | | | | | - Craig J Bryan
- The Ohio State University College of Medicine, Columbus, USA
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11
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Bond AE, Karnick AT, Bandel SL, Capron DW, Anestis MD. Demographic differences in the type of firearm and location of bodily injury in firearm suicide decedents. DEATH STUDIES 2022; 47:948-956. [PMID: 36382498 DOI: 10.1080/07481187.2022.2144547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study describes the type of firearm used and location of bodily injury among demographic subgroups of suicide decedents. Data on those who died by suicide via firearm from the National Violent Death Reporting System (N = 117,126) between the years 2003-2018 was utilized. A series of five logistic regression analyses examining the age of decedent, type of firearm, location of wound site, loaded vs. unloaded firearms, and locked vs. unlocked storage, using predictors including gender, race, who owns the firearm and age were performed. Findings have important public health implications. Increasing safe storage or removing the specific types of firearms one is likely to use in their death from the home during a time of crisis may decrease risk of suicide.
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Affiliation(s)
- Allison E Bond
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Aleksandr T Karnick
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Shelby L Bandel
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- Department of Psychology, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - Daniel W Capron
- Department of Psychology, The University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Michael D Anestis
- The New Jersey Gun Violence Research Center, Piscataway, New Jersey, USA
- School of Public Health, Rutgers University, The State University of New Jersey, New Brunswick, New Jersey, USA
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Monteith LL, Holliday R, Miller CN, Schneider AL, Brenner LA, Hoffmire CA. Prevalence and Correlates of Firearm Access Among Post-9/11 US Women Veterans Using Reproductive Healthcare: a Cross-Sectional Survey. J Gen Intern Med 2022; 37:714-723. [PMID: 36042091 PMCID: PMC9481791 DOI: 10.1007/s11606-022-07587-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide rates have increased among women Veterans, with increased use of firearms as the method. Addressing suicide risk in this population requires understanding the prevalence and correlates of firearm access in healthcare settings frequented by women Veterans. OBJECTIVES Characterize the prevalence and correlates of firearm ownership and storage practices among women Veterans using Department of Veterans Affairs (VA) reproductive healthcare (RHC) services. DESIGN Cross-sectional national survey conducted in 2018-2019 (17.9% response rate). PARTICIPANTS Post-9/11 women Veterans using RHC (n=350). MAIN MEASURES VA Military Sexual Trauma Screen, PTSD Checklist for DSM-5, Hurt/Insult/Threaten/Scream, Columbia-Suicide Severity Rating Scale screener, self-reported firearm access. KEY RESULTS 38.0% (95% confidence interval [95% CI]: 32.9, 43.3) of participants reported personally owning firearms, and 38.9% (95% CI: 33.7, 44.2) reported other household members owned firearms. Among those with firearms in or around their homes, 17.8% (95% CI: 12.3, 24.4) and 21.9% (95% CI: 15.9, 28.9) reported all were unsafely stored (loaded or unlocked, respectively). Women who experienced recent intimate partner violence were less likely to report personally owning firearms (adjusted prevalence ratio [APR]=0.75; 95% CI: 0.57, 0.996). Those who experienced military sexual harassment (APR=1.46; 95% CI=1.09, 1.96), were married (APR=1.74; 95% CI: 1.33, 2.27), or lived with other adult(s) (APR=6.26; 95% CI: 2.87, 13.63) were more likely to report having household firearms owned by someone else. Storing firearms loaded was more prevalent among women with lifetime (APR=1.47; 95% CI=1.03, 2.08) or past-month (APR=1.69; 95% CI=1.15, 2.48) suicidal ideation and less likely among those with other adult(s) in the home (unadjusted PR=0.62; 95% CI=0.43, 0.91). Those with parenting responsibilities (APR=0.61; 95% CI=0.38, 0.97) were less likely to store firearms unlocked. CONCLUSIONS Firearm access is prevalent among post-9/11 women Veterans using VA RHC. Interpersonal factors may be important determinants of firearm access in this population. Safe firearm storage initiatives are needed among women Veterans using RHC, particularly for those with suicidal ideation.
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Affiliation(s)
- Lindsey L Monteith
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA. .,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Ryan Holliday
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christin N Miller
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA
| | - Alexandra L Schneider
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Claire A Hoffmire
- VA Rocky Mountain Mental Illness, Research, Education and Clinical Center (MIRECC) for Suicide Prevention, Rocky Mountain Regional VAMC, 1700 N. Wheeling Street, Aurora, CO, 80045, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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13
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Baiden P, Eugene DR, Nicholas JK, Spoor S, Brown FA, LaBrenz CA. Misuse of Prescription Opioids and Suicidal Behaviors Among Black Adolescents: Findings from the 2017 and 2019 Youth Risk Behavior Survey. J Racial Ethn Health Disparities 2022:10.1007/s40615-022-01369-5. [PMID: 35861928 DOI: 10.1007/s40615-022-01369-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 12/28/2022]
Abstract
PURPOSE Although some studies have examined the association between prescription opioid misuse and mental health outcomes, few have investigated the effects of prescription opioid misuse on suicidal behaviors among Black adolescents. The objective of this study was to investigate the cross-sectional association between prescription opioid misuse and suicidal ideation, suicide plan, and suicide attempt among Black adolescents. METHODS Data for this study came from the 2017 and 2019 Youth Risk Behavior Survey. An analytic sample of 4798 Black adolescents aged 14-18 years (51.2% female) was analyzed using binary logistic regression. The outcome variables investigated were suicidal ideation, suicide plan, and suicide attempt, and the main explanatory variable was prescription opioid misuse. RESULTS Of the 4798 Black adolescents, 15% reported ever misusing prescription opioids; 16.2% experienced suicidal ideation; 14% made a suicide plan; and 11.3% attempted suicide during the past 12 months. In the multivariate logistic regression models, Black adolescents who misused prescription opioids had 1.39 times higher odds of making a suicide plan and 1.65 times higher odds of making a suicide attempt during the past 12 months when compared to their counterparts who did not misuse prescription opioids. Other significant factors associated with suicidal behaviors include female sex, school bullying, cyberbullying, depressive symptoms, and illicit drug use. In addition, physical activity had a protective effect on suicide attempt. CONCLUSION The findings of the present study demonstrate the effects of prescription opioid misuse and its association with suicidal behaviors among Black adolescents.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA.
| | - Danielle R Eugene
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA
| | - Julia K Nicholas
- Department of Psychological and Brain Sciences, University of Louisville, Room 317 Life Sciences Building, Louisville, KY, 40292, USA
| | - Samantha Spoor
- Department of Psychology, University of Wyoming, 1000 E. University Ave, Laramie, WY, 82071, USA
| | - Fawn A Brown
- Department of Psychology, The University of Texas at Arlington, 501 Nedderman Dr, Box 19528, Arlington, TX, 76019, USA
| | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, 211 S. Cooper St, Box 19129, Arlington, TX, 76019, USA
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14
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Bond AE, Anestis MD. Firearm Type and Number: Examining Differences among Firearm Owning Suicide Decedents. Arch Suicide Res 2022; 26:1624-1631. [PMID: 33570007 DOI: 10.1080/13811118.2021.1885536] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The present study sought to determine if among a sample of firearm owning suicide decedents, the type and number of firearms owned was associated with dying by suicide using a firearm compared to another method. METHOD Data were collected as part of a larger online study that gathered information on suicide decedents and the context surrounding their death from family members and friends. The present study used data from those who owned at least one firearm (n = 121). Participants in the present study were mostly male and white. RESULTS Among firearm owners, handgun ownership was significantly associated with dying by suicide using a firearm compared to using another method. The number of firearms owned was inversely associated with using a firearm compared to another method in a suicide death. The average number of firearms owned was higher among those who owned shotguns compared to handguns. CONCLUSIONS Handgun ownership, not shotgun ownership, was associated with having died from a self-inflicted gunshot wound. The finding regarding number of firearms should be interpreted with caution. Overall, findings provide insight into what differentiates firearm owners who die by suicide using a firearm compared to another method.
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15
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Bond AE, Bandel SL, Rodriguez TR, Anestis JC, Anestis MD. Mental Health Treatment Seeking and History of Suicidal Thoughts Among Suicide Decedents by Mechanism, 2003-2018. JAMA Netw Open 2022; 5:e222101. [PMID: 35285919 PMCID: PMC9907334 DOI: 10.1001/jamanetworkopen.2022.2101] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Understanding mental health and substance use treatment seeking and suicidality among suicide decedents is important to determine prevention efforts. OBJECTIVE To evaluate differences in treatment seeking and suicidality between suicide decedents who died by firearms and those who died by other methods. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional data were collected on 234 652 suicide decedents from 2003 to 2018. Participant information was reported by their state of residence to the National Violent Death Reporting System. Statistical analysis was performed from July 1, 2021, to January 21, 2022. MAIN OUTCOMES AND MEASURES Main outcomes were treatment for mental health and substance use at time of death, previous treatment for mental health and substance use, history of suicidal ideation or plans, history of suicide attempts, and disclosure of suicidal ideation or plans. RESULTS A total of 234 652 participants (182 520 male [77.8%]; 205 966 White [87.8%]; mean [SD] age, 46.3 [18.2] years [range, 3-112 years]) were included in this study. Compared with suicide decedents who died by another method (n = 117 526 [50.1%]), those who died by firearm (n = 117 126 [49.9%]) were more likely to have disclosed thoughts or plans of suicide within the month prior to death (odds ratio [OR], 1.16 [95% CI, 1.13-1.18]) and were less likely to have previously attempted suicide (OR, 0.44 [95% CI, 0.43-0.46]). Compared with those who died by poisoning, those who used a firearm were more likely to have had a history of suicidal thoughts or plans (OR, 1.19 [95% CI, 1.15-1.23]) and to have disclosed their thoughts or plans of suicide within the month prior to death (OR, 1.06 [95% CI, 1.03-1.10]). Compared with those who died by hanging, those who used a firearm were more likely to have disclosed their thoughts or plans of suicide to another person within the month prior to their death (OR, 1.14 [95% CI, 1.11-1.17]). CONCLUSIONS AND RELEVANCE These findings provide information that suggests who is at risk to die by firearm suicide. Community-based interventions in suicide prevention could help reduce access to firearms during a time of crisis. The finding that firearm suicide decedents were more likely to disclose their suicidal thoughts or plans provides an important avenue for prevention.
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Affiliation(s)
- Allison E. Bond
- The New Jersey Gun Violence Research Center, Piscataway
- Department of Psychology, Rutgers University, The State University of New Jersey, New Brunswick
| | - Shelby L. Bandel
- The New Jersey Gun Violence Research Center, Piscataway
- Department of Psychology, Rutgers University, The State University of New Jersey, New Brunswick
| | - Taylor R. Rodriguez
- The New Jersey Gun Violence Research Center, Piscataway
- Department of Psychology, Rutgers University, The State University of New Jersey, New Brunswick
| | - Joye C. Anestis
- School of Public Health, Rutgers University, The State University of New Jersey, New Brunswick
| | - Michael D. Anestis
- The New Jersey Gun Violence Research Center, Piscataway
- School of Public Health, Rutgers University, The State University of New Jersey, New Brunswick
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16
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Bond AE, Bandel SL, Wagler K, Daruwala SE, Anestis MD. Differentiating suicide decedents who died by firearm verse hanging. Int Rev Psychiatry 2021; 33:631-637. [PMID: 34218727 DOI: 10.1080/09540261.2021.1910498] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This present study sought to examine how demographics and the availability of means for suicide converge to impact method selection between firearms and hanging, which are the two most lethal and commonly used methods for suicide in the United States. Data were collected as part of a larger online study that gathered information about suicide decedents and the circumstances around their death from family members and friends; the most common sources being parents, friends, and other family members. This study used data from those who died by suicide by firearm or hanging (n = 149); and was restricted to those who identified as male and white. The study examined if age, education, marital status, military affiliation, and firearm ownership impacted method selection. Results indicated that age and owning a firearm were associated with using a firearm in a suicide death. Additionally, those who used a firearm were significantly younger and more likely to own a firearm than those who used another method; and those who died by hanging were significantly younger than those who used another method. Findings from this study can be leveraged to improve the effectiveness of means safety efforts and create more personalised public health messages on firearm safe storage.
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Affiliation(s)
- Allison E Bond
- College of Education and Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Shelby L Bandel
- College of Education and Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Kayla Wagler
- College of Education and Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Samantha E Daruwala
- College of Education and Psychology, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael D Anestis
- New Jersey Gun Violence Research Center, Piscataway, NJ, USA.,School of Public Health, Rutgers University, The State University of New Jersey, New Brunswick, NJ, USA
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17
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Anestis MD, Bandel SL, Bond AE. The Association of Suicidal Ideation With Firearm Purchasing During a Firearm Purchasing Surge. JAMA Netw Open 2021; 4:e2132111. [PMID: 34714337 PMCID: PMC8556615 DOI: 10.1001/jamanetworkopen.2021.32111] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
IMPORTANCE Firearm access is associated with risk for suicide, and, since early 2020, the US has experienced an unprecedented surge in firearm sales. OBJECTIVE To assess frequency of suicidal ideation among individuals who purchased firearms during the surge period (surge purchasers), other firearm owners, and non-firearm owners. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional online survey data were collected from January to June 2021. Participants were recruited via quota sampling through Qualtrics Panels. Within Minnesota, zip codes from Minneapolis and St Paul were oversampled. Participants included 6404 US adults recruited from 3 states: New Jersey (n = 3197), Minnesota (n = 1789), and Mississippi (n = 1418). Participants identified as becoming a first-time firearm owner during the surge period, being an established firearm owner who purchased a firearm during the surge period, being a firearm owner who did not buy firearms during the surge period, and not owning firearms. MAIN OUTCOMES AND MEASURES The primary outcomes were lifetime, past year, and past month suicidal ideation as measured by the Self-injurious Thoughts and Behaviors Interview-Revised. RESULTS The mean (SD) age within the full sample was 44.81 (18.45) years, with 3132 males (48.8%), 4706 White adults (73.4%), 2674 reporting annual household income less than $50 000 (41.7%), and 1546 (24.1%) reporting current firearm ownership. In the full sample, individuals who purchased firearms during the surge period were more likely than were non-firearm owners to report lifetime suicidal ideation (odds ratio [OR], 2.21; 95% CI, 1.82-2.68), past-year suicidal ideation (OR, 2.10; 95% CI, 1.72-2.55), and past-month suicidal ideation (OR, 1.80; 95% CI, 1.41-2.29). In addition, among individuals who purchased firearms during the surge period, first-time owners were more likely than established firearm owners to report lifetime suicidal ideation (OR, 2.12; 95% CI, 1.43-3.14) and past-year suicidal ideation (OR, 2.37; 95% CI, 1.59-3.53). Results were largely consistent across states. CONCLUSIONS AND RELEVANCE In this survey study, results highlighted that individuals who acquired firearms during the purchasing surge were more likely than other firearm owners and non-firearm owners to have experienced suicidal thoughts. This is particularly true for individuals who purchased a firearm for the first time during the surge period. This illustrates the need to implement policies and interventions that increase safety among firearm purchasers (eg, safe firearm storage) as well as those that promote the acquisition of alternative forms of protection (eg, home alarm systems).
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Affiliation(s)
- Michael D. Anestis
- New Jersey Gun Violence Research Center, Piscataway
- Rutgers, the State University of New Jersey, New Brunswick
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18
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Anestis MD, Bond AE, Daruwala SE, Bandel SL, Bryan CJ. Suicidal Ideation Among Individuals Who Have Purchased Firearms During COVID-19. Am J Prev Med 2021; 60:311-317. [PMID: 33358551 DOI: 10.1016/j.amepre.2020.10.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 10/07/2020] [Accepted: 10/12/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Given the increase in firearm purchases during the COVID-19 pandemic, this study seeks to determine the extent to which COVID-19 firearm purchasers differ in terms of suicide risk from nonfirearm owners and firearm owners who did not make a purchase during COVID-19. METHODS Participants (N=3,500) were recruited through Qualtrics Panels to participate in an online survey examining methods for self-protection. ANCOVAs were utilized to assess suicidal ideation. Multivariate ANCOVAs were used to examine firearm storage practices and storage changes during COVID-19. Data were collected in late June and early July 2020, and analyses were conducted in July 2020. RESULTS Individuals who purchased a firearm during COVID-19 more frequently reported lifetime, past-year, and past-month suicidal ideation than nonfirearm owners and firearm owners who did not make a purchase during COVID-19. COVID-19 purchasers with lifetime ideation were less likely to hide loaded firearms in a closet than those without lifetime ideation. COVID-19 purchasers with past-year or past-month ideation were more likely to use locking devices than COVID-19 purchasers without past-month ideation. CONCLUSIONS In contrast to firearm owners more generally, COVID-19 firearm purchasers appear far more likely to have experienced suicidal ideation and appear less likely to use certain unsafe firearm storage methods but also report a greater number of storage changes during COVID-19 that made firearms less secure. Future research should seek to further understand those who purchased a firearm during COVID-19 and determine ways to increase secure storage among firearm owners.
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Affiliation(s)
- Michael D Anestis
- New Jersey Gun Violence Research Center, Rutgers School of Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey; Department of Urban-Global Public Health, Rutgers, The State University of New Jersey, Piscataway, New Jersey.
| | - Allison E Bond
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi
| | - Samantha E Daruwala
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi
| | - Shelby L Bandel
- School of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi
| | - Craig J Bryan
- Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, Ohio
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19
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Goldman-Mellor S, Hall C, Cerdá M, Bhat H. Firearm suicide mortality among emergency department patients with physical health problems. Ann Epidemiol 2020; 54:38-44.e3. [PMID: 32950655 DOI: 10.1016/j.annepidem.2020.09.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/30/2020] [Accepted: 09/10/2020] [Indexed: 01/09/2023]
Abstract
PURPOSE Individuals with poor physical and mental health may face elevated risk for suicide, particularly suicide by firearm. METHODS This retrospective cohort study used statewide, longitudinally linked emergency department (ED) patient record and mortality data to examine 12-month incidence of firearm suicide among ED patients presenting with a range of physical health problems. Participants included all residents presenting to a California ED in 2009-2013 with nonfatal visits for somatic diagnoses hypothesized to increase suicide risk, including myocardial infarction, congestive heart failure, cerebrovascular disease, chronic obstructive pulmonary disease, diabetes, cancer, back pain, headache, joint disorder, and injuries. For each patient diagnostic group, we calculated rates of firearm suicide per 100,000 person-years and standardized mortality ratios (SMRs) relative to the demographically matched California population. RESULTS Firearm suicide rates per 100,000 person-years ranged from 9.6 (among patients presenting with unintentional injury) to 55.1 (patients with cancer diagnoses), with SMRs from 1.48 to 7.45 (all p < 0.05). SMRs for patients with cardiovascular conditions ranged from 2.45 to 5.10. Men and older individuals had higher firearm suicide rates, and there was substantial between-group variability in the proportion of suicide decedents who used a firearm. CONCLUSIONS ED patients presenting with deliberate self-harm injuries, substance use, and cancer were especially at risk for firearm suicide. To avoid missed suicide prevention opportunities, EDs should implement evidence-based suicide interventions as a best practice for their patients.
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Affiliation(s)
- Sidra Goldman-Mellor
- Department of Public Health; School of Social Sciences, Humanities, and Arts; University of California, Merced CA.
| | - Carlisha Hall
- Department of Public Health; School of Social Sciences, Humanities, and Arts; University of California, Merced CA
| | - Magdalena Cerdá
- Department of Population Health at NYU Grossman School of Medicine, New York, NY
| | - Harish Bhat
- Department of Applied Mathematics, School of Natural Sciences; University of California, Merced CA
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20
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Olfson M, Cosgrove CM, Wall MM, Blanco C. Sociodemographic Factors Associated With High Risk for Firearm Suicide Among US Adults. JAMA Intern Med 2020; 180:1014-1019. [PMID: 32421141 PMCID: PMC7235913 DOI: 10.1001/jamainternmed.2020.1334] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
This cohort study assesses the association of firearm suicide risk with sociodemographic characteristics among US adults.
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Affiliation(s)
- Mark Olfson
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York
| | | | - Melanie M Wall
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, New York State Psychiatric Institute, Columbia University, New York
| | - Carlos Blanco
- Division of Epidemiology, Services, and Prevention Research, National Institute on Drug Abuse, Rockville, Maryland
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21
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Monteith LL, Wendleton L, Bahraini NH, Matarazzo BB, Brimner G, Mohatt NV. Together With Veterans: VA National Strategy Alignment and Lessons Learned from Community-Based Suicide Prevention for Rural Veterans. Suicide Life Threat Behav 2020; 50:588-600. [PMID: 31950557 DOI: 10.1111/sltb.12613] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 10/28/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Rural veterans are at increased risk for dying by suicide compared with urban veterans, yet interventions for preventing suicide among rural veterans have been limited. OBJECTIVES (1) Describe how Together With Veterans (TWV), a community-based intervention to prevent suicide among veterans in rural communities, aligns with the VA National Strategy for Preventing Veteran Suicide; (2) share lessons learned while beginning to implement TWV in rural communities. METHODS Together With Veterans is being implemented in four rural communities and comprises six suicide prevention best practices: (1) reducing stigma and promoting help-seeking; (2) lethal means safety, with an emphasis on firearms; (3) gatekeeper training; (4) training primary care providers; (5) improving access to crisis services; and (6) enhancing support for high-risk veterans. RESULTS Together With Veterans best practices align with most, but not all, of the strategies in the VA National Strategy for Preventing Veteran Suicide. Community veteran partners have shown a willingness to collaborate and provide local leadership, enthusiasm, and a sense of duty. CONCLUSIONS By supporting and facilitating local veteran leaders and their community partners in increasing suicide prevention knowledge, public awareness, and resources, we propose that TWV offers an acceptable and feasible approach that builds on the strengths of rural communities. Systematic evaluation is warranted.
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Affiliation(s)
- Lindsey L Monteith
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Leah Wendleton
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA
| | - Nazanin H Bahraini
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bridget B Matarazzo
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA.,Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Gina Brimner
- Western Interstate Commission for Higher Education Behavioral Health Program, Boulder, Colorado, USA
| | - Nathaniel V Mohatt
- Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA.,Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, USA
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22
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Ammerman BA, Reger MA. Evaluation of Prevention Efforts and Risk Factors Among Veteran Suicide Decedents Who Died by Firearm. Suicide Life Threat Behav 2020; 50:679-687. [PMID: 32017233 DOI: 10.1111/sltb.12618] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 11/08/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Veterans die by suicide at a higher rate than the U.S. population, and veterans more frequently use a firearm as the suicide method. Consequently, firearm accessibility and storage represent important prevention considerations. This project aimed to explore the implementation of suicide prevention efforts among veterans who went on to die by suicide, with and without the use of a firearm, and to identify factors that differentiated veteran suicide decedents to help inform suicide prevention efforts. METHODS Data from the Veteran Health Administration Behavior Health Autopsy Program was analyzed for 97 veteran suicide decedents. RESULTS Results demonstrated that veterans who used a firearm for suicide were less likely to have engaged in suicide prevention efforts overall and were less likely to have received lethal means safety counseling / safety planning. Veterans who died by firearm had lower levels of notable risk factors (e.g., prior suicide attempt, no-shows for appointments), however were more likely to have a documented unsecured firearm in their home. CONCLUSION These findings support the benefit of broadening the reach of suicide prevention efforts, especially for high-risk veterans with access to firearms.
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Affiliation(s)
| | - Mark A Reger
- VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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23
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Goldberg SB, Tucker RP, Abbas M, Schultz ME, Hiserodt M, Thomas KA, Anestis MD, Wyman MF. Firearm Ownership and Capability for Suicide in Post-Deployment National Guard Service Members. Suicide Life Threat Behav 2019; 49:1668-1679. [PMID: 31002425 DOI: 10.1111/sltb.12551] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 01/25/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE National Guard service members demonstrate increased suicide risk relative to the civilian population. One potential mechanism for this increased risk may be familiarity with and access to firearms following deployment. This study examined the association between firearm ownership, reasons for ownership, and firearm familiarity with a widely studied suicide risk factor-capability for suicide-among National Guard service members. METHOD Data were drawn from a cross-sectional survey of National Guard service members conducted immediately post-deployment in 2010. Service members (n = 2,292) completed measures of firearm ownership, firearm familiarity, and capability for suicide. RESULTS Firearm ownership and increased firearm familiarity were associated with capability for suicide (d = 0.47 and r = .25, for firearm ownership and familiarity, respectively). When examined separately based on reason for ownership, owning a firearm for self-protection (d = 0.33) or owning a military weapon (d = 0.27) remained significantly associated with capability for suicide. In contrast, owning a firearm for hobby purposes did not (d = -0.07). CONCLUSION Our findings support theories emphasizing practical aspects of suicide (e.g., three-step theory) and suggest that owning firearms, in particular for self-protection, along with familiarity using firearms may be associated with greater capability for suicide.
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Affiliation(s)
- Simon B Goldberg
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA
| | - Raymond P Tucker
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Maleeha Abbas
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA.,VA Puget Sound Health Care System, Seattle, WA, USA
| | - Megan E Schultz
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Michele Hiserodt
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Kathryn A Thomas
- Department of Counseling Psychology, University of Wisconsin - Madison, Madison, WI, USA.,William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | | | - Mary F Wyman
- William S. Middleton Memorial Veterans Hospital, Madison, WI, USA.,School of Medicine & Public Health, University of Wisconsin - Madison, Madison, WI, USA
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24
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Katz C, Bhaskaran J, Bolton JM. Access to Firearms Among People Assessed by Psychiatric Services in the Emergency Department. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2019; 64:770-776. [PMID: 31615276 PMCID: PMC6882073 DOI: 10.1177/0706743719882200] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE In Canada, 80% of firearm-related deaths are suicides. Access to firearms is associated with increased suicide rates. This study examines the frequency and factors that influence assessment of firearm access in an emergency setting. METHODS A total of 15,847 consecutive adults seen for psychiatric consultation in two tertiary emergency departments (EDs) in Winnipeg, Manitoba were interviewed. Data captured whether access to firearms was assessed, and whether respondents endorsed access or not. Comparisons were done to determine group differences among those with and without and with known and unknown firearm access. RESULTS Access to firearms was unknown in 47% (n = 7,363) of psychiatric ED consultations, including 43% (n = 998) of individuals who presented with a suicide attempt. Female sex was associated with decreased odds of firearm access (odds ratio [OR] 0.28; 95% CI, 0.22 to 0.35). Being single was associated with lower odds of known firearm access (OR 0.83; 95% CI, 0.77 to 0.89) yet higher likelihood of firearm access (OR 1.36; 95% CI, 1.11 to 1.68). Presenting with a suicide attempt (OR 2.45; 95% CI, 1.80 to 3.34), preparatory acts (OR 6.40; 95% CI, 4.38 to 9.36) and suicidal ideation (OR 2.45; 95% CI, 1.87 to 3.21) were associated with increased odds of reporting access. When clinicians felt there was a high likelihood of future suicide, firearm access remained unknown in half of cases. CONCLUSION Firearm ownership and access is an essential component of a suicide risk assessment and remains unknown in half of individuals seen by psychiatry in this tertiary care ED sample. People presenting with suicidal ideation and attempts were more likely to report access to firearms.
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Affiliation(s)
- Cara Katz
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Joanna Bhaskaran
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James M. Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
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25
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Butterworth SE, Anestis MD. Political Beliefs, Region of Residence, and Openness to Firearm Means Safety Measures to Prevent Suicide. Arch Suicide Res 2019; 23:616-633. [PMID: 29952717 DOI: 10.1080/13811118.2018.1486250] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Firearms account for approximately half of all suicides in the United States and are highly lethal, widely available, and popular; thus, are an ideal candidate for targeted means safety interventions. However, despite their value as a suicide prevention tool, firearm means safety strategies are not widely utilized, possibly due to factors which impede openness to their use. This study examines the relationship between region, political beliefs, and openness to firearm means safety in a sample of 300 American firearm owners. Overall, firearm owners were more willing to engage in means safety for others than for themselves and to store firearms safely than temporarily remove them from the home. Social policy views and region were significantly associated with openness to firearm means safety measures, however, economic policy views were not. This study provides further context for the development and implementation of efficacious means safety measures capable of overcoming potential barriers to their use.
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26
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Ulrich MR. A Public Health Approach to Gun Violence, Legally Speaking. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2019; 47:112-115. [PMID: 31298120 DOI: 10.1177/1073110519857332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The call for a public health approach to gun violence has largely ignored what role the nascent Second Amendment jurisprudence will play in hindering change. Given the state interest for infringing on Second Amendment rights is nearly always public safety, public health law doctrine provides an apt framework for analysis.
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Affiliation(s)
- Michael R Ulrich
- Michael R. Ulrich, J.D., M.P.H., is an Assistant Professor of Health Law, Ethics, & Human Rights at the Boston University School of Public Health. His scholarship focuses on the intersection between public health, constitutional law, bioethics, and social justice, with an emphasis on the role of law in the health outcomes of vulnerable and underserved populations
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Knopov A, Sherman RJ, Raifman JR, Larson E, Siegel MB. Household Gun Ownership and Youth Suicide Rates at the State Level, 2005-2015. Am J Prev Med 2019; 56:335-342. [PMID: 30661885 PMCID: PMC6380939 DOI: 10.1016/j.amepre.2018.10.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/01/2022]
Abstract
INTRODUCTION Determining whether the prevalence of gun ownership is associated with youth suicide is critical to inform policy to address this problem. The objective of this study is to investigate the relationship between the prevalence of household gun ownership in a state and that state's rate of youth suicide. METHODS This study, conducted in 2018, involved a secondary analysis of state-level data for the U.S. using multivariable linear regression. The relationship between the prevalence of household gun ownership and youth (aged 10-19 years) suicide rates was examined in a time-lagged analysis of state-level household gun ownership in 2004 and youth suicide rates in the subsequent decade (2005-2015), while controlling for the prevalence of youth suicide attempts and other risk factors. RESULTS Household gun ownership was positively associated with the overall youth suicide rate. For each 10 percentage-point increase in household gun ownership, the youth suicide rate increased by 26.9% (95% CI=14.0%, 39.8%). CONCLUSIONS Because states with high levels of household gun ownership are likely to experience higher youth suicide rates, these states should be especially concerned about implementing programs and policies to ameliorate this risk.
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Affiliation(s)
- Anita Knopov
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Rebecca J Sherman
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts
| | - Julia R Raifman
- Department of Health Law, Policy, and Management, Boston University School of Public Health, Boston, Massachusetts
| | - Elysia Larson
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Michael B Siegel
- Department of Community Health Sciences, Boston University School of Public Health, Boston, Massachusetts.
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Daruwala SE, Butterworth SE, Anestis MD. Openness to firearm storage safety as a suicide prevention tool among those exposed to suicide: The role of perceived closeness to the suicide decedent. Psychiatry Res 2018; 269:437-443. [PMID: 30195232 DOI: 10.1016/j.psychres.2018.08.050] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/25/2018] [Accepted: 08/13/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Exposure to suicide and closeness to a suicide decedent may be relevant to means safety, especially in firearm owners. This study examines how such factors are associated with firearm owners' current firearm storage methods and openness to changing storage methods. METHOD 300 firearm owners completed a survey on Amazon's Mechanical Turk program; 176 participants reported being exposed to suicide. Perceived closeness was rated as Not at all close, Close, or Extremely Close. RESULTS Those exposed to suicide were more open to secure storage and temporarily storing the firearm with a trusted individual to prevent someone else's suicide. Those close to the suicide decedent were more likely to use secure storage practices, more open to using secure storage methods to prevent their own and someone else's suicide, and had a higher degree of storage methods in place compared to those not close to the decedent. LIMITATIONS The sample may not be representative of all American firearm owners exposed to suicide. CONCLUSIONS Being close to a suicide decedent may influence firearm owners' current storage practices and openness to changing storage methods. Such individuals may better relate to the suicide decedent and realize the significance of using secure storage methods to prevent suicide.
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Butterworth SE, Houtsma C, Anestis JC, Anestis MD. Investigating the Relationship Between Social and Economic Policy Views, Firearm Ownership, and Death by Firearm in a Sample of Suicide Decedents. Arch Suicide Res 2018; 22:420-431. [PMID: 28727925 DOI: 10.1080/13811118.2017.1355287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Extant literature provides evidence for the frequent use and lethality of firearms in suicide and the ability of means safety measures to prevent suicides; however, little evidence exists to provide an understanding of the characteristics that differentiate suicide decedents who die by firearm from those who die by other methods. In this study, we build on prior findings regarding the characteristics of those who die by firearms by examining the relationship between social and economic policy views and both firearm ownership and death by firearm in a sample of 160 American suicide decedents. We hypothesized that individuals with more conservative social and economic policy views would have higher rates of firearm ownership and would be more likely to die by firearm than would individuals with more liberal social and economic policy views. Furthermore, we hypothesized that differences in the likelihood of dying by a firearm would be accounted for by firearm ownership, providing preliminary evidence for a specific mechanism through which risk for death by firearm is conferred. As expected, suicide decedents with conservative social and economic policy views owned firearms at higher rates than did decedents with moderate or liberal views. The use of a firearm, the most common method across all decedents, was higher in individuals with conservative policy views. These results represent a novel angle from which to consider the importance of means safety efforts focused on firearm ownership and storage and limit concerns that firearm specific suicide research has relied too heavily on samples that are not representative of typical American suicide decedents.
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Anestis JC, Anestis MD, Preston OC. Psychopathic personality traits as a form of dispositional capability for suicide. Psychiatry Res 2018; 262:193-202. [PMID: 29453038 DOI: 10.1016/j.psychres.2018.02.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 02/01/2018] [Accepted: 02/01/2018] [Indexed: 02/04/2023]
Abstract
The capability to enact lethal self-harm has recently been highlighted as a critical risk factor for suicidal behavior. Klonsky and May's (2015) three step theory of suicide (3ST) expanded upon the construct of the capability for suicide by dividing it into categories: dispositional, acquired, and practical. The current study examined constructs of Patrick and colleagues' (2009) triarchic model of psychopathy as indicators of dispositional capability in gun owners, a sample at heightened risk for death by suicide (Anestis and Houtsma, 2017). We anticipated that specific psychopathic traits would exhibit robust associations with other components of the capability for suicide. In a sample of 300 gun-owning adults, Boldness was uniquely related to all indicators of practical capability in both male and female gun owners, and a Boldness*Meanness interaction predicted the highest levels of some capability components. These results are consistent with theoretical conceptualizations of the triarchic model. Our findings indicate that, among US gun owners, dispositional factors may impact comfort with and aptitude with guns, which may enhance our understanding of which gun owners are at the greatest risk of gun suicide should they develop suicidal thoughts.
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Affiliation(s)
- Joye C Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Olivia C Preston
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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Anestis MD, Butterworth SE, Houtsma C. Perceptions of firearms and suicide: The role of misinformation in storage practices and openness to means safety measures. J Affect Disord 2018; 227:530-535. [PMID: 29169121 DOI: 10.1016/j.jad.2017.11.057] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 10/12/2017] [Accepted: 11/12/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND Firearm ownership and unsafe storage increase risk for suicide. Little is known regarding factors that influence storage practices and willingness to engage in means safety. METHODS Utilizing Amazon's Mechanical Turk program, we recruited an online sample of 300 adults living in the US who own at least one firearm. Firearm storage practices and openness to means safety measures were assessed using items designed for this study. Data were collected and analyzed in 2017. RESULTS Firearms stored in non-secure locations and without a locking device were associated with lower beliefs in the relationship between firearm storage and suicide risk. Fearlessness about death moderated the association between current secure versus non-secure storage and beliefs regarding firearm storage and suicide risk, in that storage practices and beliefs were more strongly related at higher levels of fearlessness about death. For both secure and locked storage of a firearm, there was a significant indirect effect of current storage practices on willingness to engage in means safety in the future through current beliefs regarding the relationship between firearm storage and suicide risk. Unsafe storage practices were largely associated with an unwillingness to store firearms more safely or to allow a trusted peer to temporarily store the firearm outside the home in order to prevent their own or someone else's suicide. LIMITATIONS Self-report and cross-sectional data were used. Results may not generalize to non-firearm owners. CONCLUSIONS Firearm owners are prone to inaccurate beliefs about the relationship between firearms and suicide. These beliefs may influence both current firearm storage practices and the willingness to engage in means safety.
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Houtsma C, Butterworth SE, Anestis MD. Firearm suicide: pathways to risk and methods of prevention. Curr Opin Psychol 2017; 22:7-11. [PMID: 30122279 DOI: 10.1016/j.copsyc.2017.07.002] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Accepted: 07/10/2017] [Indexed: 11/17/2022]
Abstract
Firearms are utilized in approximately half of all US suicides, making them a serious public health concern and a target of suicide prevention efforts. Practical capability influences the transition from suicidal ideation to action and is particularly relevant to firearm suicide. Firearm ownership, experience using firearms, unsafe firearm storage, and high cultural acceptability of firearms increase risk for death by firearm suicide. Means safety strategies, which emphasize the reduction of practical capability for suicide through the limitation of access to and safe storage of firearms, are effective in preventing suicide and include interventions such as lethal means counseling, firearm legislation, and promoting safe storage practices. Public health interventions aimed at reducing firearm suicide are critical topics for continued research.
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Affiliation(s)
- Claire Houtsma
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA.
| | - Sarah E Butterworth
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS, USA
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