The Problem

The September 27, 2022 issue of the Journal of the American Medical Association (V. 328, No. 12) devoted almost half of its pages to “Firearms and Violence,” in the form of well documented opinion pieces. The effort is chockfull of arresting data.

The first article pointed out that mass shootings get the major portion of publicity on gun violence, but that “only” three percent of deaths from guns are attributable to automatic rifles. The real problem lies with hand guns, especially in regard to suicides.

In the period from 2010 to 2020 in the US, of all firearm deaths (45,222 in 2020, for instance), 60 percent were due to suicides. Looked at a different way, among all suicides, over 50 percent were carried out with firearms. In youth aged 10 to 19 who died by suicide, 42 percent used a firearm, almost always one that a family member owned.

71 percent of people who attempt suicide do so within an hour after deciding to do so. Two thirds of survivors of attempted suicide never try again.

Approaches to the problem

One editorialist in the above cited JAMA issue stated that any serious approach to gun regulation must address firearm suicide. There has been a scattering of somewhat modest attempts to legislate gun control, but these vary significantly by state. Legislation called “Red flag” laws is one initiative, but only 19 states have passed such laws.

These laws allow almost anyone (usually a family member, a friend, a therapist, etc.) to petition a court for an order to prevent someone from accessing a gun. Only nine states have such legislation, but such laws are problematic anyway. They generally require burdensome paper work by the concerned individual who fears for the safety of an individual perceived to be at risk for suicide, and a court appearance is part of the petition. Most importantly, initiating such an action can compromise an important relationship with the person thought to be at risk for suicide.

Child access prevention laws (“CAP”s) require gun owners to secure guns in their homes and not provide a minor with a gun. Laws like these have been linked to a decrease in youth suicides, but most are weak and poorly written.

Given the impulsiveness attending many suicide attempts, I have thought that legislating “cooling off” periods make sense. These measures require a time period between purchase of a firearm and possession. States with waiting periods for handgun purchase have experienced a decrease in suicides overall from 11 to 27 percent compared to states without them. Only nine percent of states have such laws on the books, however, and Oklahoma, in the name of protecting Second Amendment rights, has proscribed them.

In general, there is evidence that states with the fewest laws that regulate guns experience the greatest suicide rates, but studies that support this are weak. This is true of most gun control measures. You can’t randomize people to bestowing guns on their children versus no guns.

Implications

Legislation that meaningfully regulates automatic rifles is important, but it is not where the real money is. In fact, I fear that if our society were, for instance, to outlaw ARs, we might erroneously think that the work on gun control is done. But regulating handguns is where the low hanging fruit lies, and commonsense approaches could save thousands of lives each year.

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