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New study on firearm related suicide can't prove what we all know

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A recent research letter concerning suicide by firearm highlights something that most gun owners already know. The short form of what was reported is that gun owners are not going to tell health care providers that they own firearms. Okay, that’s at least the conjecture that the authors of the paper were not willing outright say. The study involved looking at death due to suicide Between January 1, 2016, and December 31, 2019 in Washington State. The paper, Patient-Reported Firearm Access Prior to Suicide Death, does put a good deal of effort in extracting information from the Washington State death records and electronic health record data they had available. Some of this data was not considered “sensitive” enough to require consent from patients.

The Kaiser Permanente institutional review board approved this study and waived the need for patient informed consent, because use of this protected health information involved no more than a minimal risk to the privacy of individuals. This study followed the reporting guideline for case series.

What did their study uncover? A good deal of statistics that seem to be consistent regardless of who’s doing the study and for the most part where. With males (86%) and whites (85%) ranking in the highest numbers of persons to die by suicide. The other statistic which brings this topic to the pages of Bearing Arms, and will continue to, 48% of completed suicides were done via firearm, and 52% via all “other means”.

In a recent conversation I had with Cam, he noted that he’s more interested in putting an end to all suicides, regardless of methods. I tend to agree with Cam on the overall goal, however I understand that this emphasis on “the gun” has to do with the lethality of potential methods. Depending on which study one is looking at, approximately 85-95% of suicide attempts with a firearm result in death. “Other” means that might be attempted result in death approximately 20% of instances. Further, the majority of people that survive a death by suicide attempt don’t go on to try again.

My big question’s always a quality of life question. Why do so many people want to end their lives in the United States? What about our society, pressures, needs, etc. cause so many people to want to end their lives? If 2/3rds of the approximate 40K deaths due to firearms are suicides, it should pull into sharp focus that in this country an individual is more than likely to use a firearm on themselves 66% of the time over another individual. All the “gun crime” reporting tends to ignore this fact.

Where does this leave us with the study? Some of their conclusions paint a picture that I don’t suspect to change anytime soon. The data the study pulled from utilized a questionnaire that asked patients if they were firearm owners or not.

Our findings have important implications for health care systems that are considering firearm access screening to support suicide prevention. First, this study underscored the potential reach of standardized firearm access questions in primary care clinics, which implemented routine use of this question during the study and where the highest proportion of firearm suicide decedents were seen prior to death. Second, the decision to only ask primary care patients with a MH or SUD diagnosis about firearm access likely resulted in missed opportunities, as many firearm suicide decedents did not have these diagnoses.

It’s those “missed opportunities” that’re going to lose many of the firearm owners. The amount of work that needs to be done for the medical field to be trusted by gun owners is beyond monumental. With so many positions and stances being made over the years from the “medical industry” embracing an abstinence only approach to firearms, why on Earth would anyone want their primary care physicians asking about this sensitive topic? We can’t have medical doctors pushing for red flag laws, asking people to volunteer information about owning guns, telling them they need to keep their guns separate from the ammo and unloaded, and have many of them speak down to us gun owners as if we’re subhuman, then expect us to trust them.

The study does tap dance a little around this topic in a more or less eloquent way.

This study also highlighted the need to improve how health care systems ask standardized questions. Most patients who died by firearm suicide answered the firearm access question when they received it, confirming our prior finding that patients will answer this standardized firearm access question.5 However, more than half of those who answered the question and who subsequently died by firearm suicide reported no firearm access. A study limitation is that we cannot determine whether these individuals acquired access after answering the question or answered no despite having access. Nevertheless, prior qualitative findings suggest that transparency about how firearm access information will be used and building clinician competency and clinician–patient trust may encourage honest reporting, open dialogue, and improved patient-centeredness of this practice.6 Assessing patients’ plans to acquire firearms may also be useful. Future work is needed to test language and strategies designed to encourage patient-reported firearm access.

I think we’d all be kidding ourselves if we actually thought that firearm owners responded truthfully to this question. With more than half saying they had no firearm access. Okay, definitively we can’t say that any of them lied, but we can guess at it in our heads.

The final sentence does more than punctuate that paragraph, it punctuates the issue at large on this subject. More than language testing and strategies need to be designed. The most authentic language we can get from the medical community would be akin to “We screwed up big time with how we’ve acted for decades. We really only want to help. Can you give us another chance?” And then after a suitable time of good behavior I can see gun owners becoming more trusting of the medical industry on the gun subject. Let’s remember the CDC has on more than one occasion dabbled in and around restricting gun ownership. What does need to change?

The way it stands now, I personally adopt a mentality put forth by one of the members of Doctors For Responsible Gun Ownership, Dr. John Edeen. If a doctor that I’m not actually going to go shooting with or isn’t asking me a question about firearms because they’re interested in them, Dr. John’s way of thinking is agreeable to me and how I might handle the situation. With the way medical records are handled today?

There’s several things that you can do. First of all just you can just refuse to answer or just lie. It’s not his…it’s not his business. That’s right it’s a none of your business. It’s is really a lot of these people have been brainwashed by establishment medicine to think that they’re actually helping. Um and they’re not. You know? I mean the American Academy of Pediatrics you know, tells you to store your gun separately from your ammunition. Well that works really good for, you know preventing accidental childhood you know gun [accidents] but it doesn’t do much when somebody’s breaking in your house. And so it goes to one of the things to say…basically you can ask the doctor “So does your insurance company know that you’re practicing outside of your scope of medicine?” You ask them “What organization are you certified by uh to give this kind of advice?” and then also “If I’m harmed by following your advice, are you going to be covered by malpractice insurance?” And that usually gets their attention…that’ll usually get their attention and that, and that’s perfectly you know, a legitimate thing to do. Yeah. Also you know if…if you know pretty much make it clear to the doctor that that they’re out of bounds and they continue to press you can say “Doctor this is a boundary violation. You understand what that is doctor? Because I’m going to report you to the state medical board and you’re going to have to defend this, and you could lose your license to practice medicine or get sanctioned by the state.”

Do I believe the medical industry has a role to play in dealing with this topic? Sure. But not until they’ve regained the respect of gun owners. This is not just about phrasing questions the right way and “strategies designed to encourage” people to volunteer their personal information. Do I think there are physicians that are working towards trying to break these barriers and re-write the book when it comes to this subject? You bet ya. Doctors like Dr. John that are willing to stand up and say the things that he says are good starts to rekindling the relationship.

More physicians need to stand up and put health before politics. If they’re saying they’re here to help, then they need to prove that there are no strings attached.

I reached out to another such physician, Dr. Emmy Betz, one of the doctors who worked on this paper. Betz has a solid track record of not offering up legislative solutions to any of the firearm related subjects we might encounter in the United States. Betz is more known for coming up with solutions that make people want to be more responsible by offering up programs such as the creation of the Colorado Gun Storage Options Map. Betz had a message for me to share concerning the relationships between doctors, their patients, and firearms.

Doctors and other health professionals are trained to discuss a range of sensitive topics with patients, all towards a goal of promoting health and preventing injury or illness. These topics include things like sexual practices, alcohol or drug use, seatbelt use, and exercise and weight loss. Until recently, though, many of us didn’t get specific training in how to talk about firearms in a way that is respectful, non-judgmental, and likely to help firearm owners prevent unintended harm. I’m glad there are more resources and programs available now, but there’s more work to do. It’s also important that these messages – around preventing suicide and other injuries – come from other trusted, non-medical groups.

Betz’s leadership and roles on this topic needs to be emulated throughout the medical industry. With Drs. and physicians like her,  the members of groups like Doctors For Responsible Gun Ownership and the Walk The Talk America, a strained relationship between medicine and firearms can be repaired.

Can the DC Project be the 2A counter to Moms Demand Action?

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We’ve all become familiar with the gun control lobby’s group of red-shirted women demanding more infringements on our right to bear arms, but Moms Demand Action isn’t the only game in town when it comes to a female-centered movement dealing with gun ownership. Since 2016, the DC Project has been attracting a growing number of women who support the Second Amendment, and at this year’s SHOT Show, the group’s founder Dianna Mueller hosted a press event to help spread the word about the organization and its efforts around the country.

Mueller wants the organization to become a counter to Moms Demand Action, and one of the most visible ways the group is doing so is by adopting the color teal to serve as a visual sign of support for the Second Amendment, just as the red shirts of MDA are an easy way for lawmakers to see gun control activists in attendance at legislative hearings or in statehouse galleries. But Mueller and the other DC Project leaders aren’t just looking for ways to visually signal their pro-2A attitudes. They’re looking to have an impact on legislative policies around the nation. In fact, as Mueller told the audience at the DC Project presser on Tuesday, their goal is nothing less than to “save the country” through activism and education.

One of the things that’s most impressive about what the DC Project has been able to accomplish in just five years of existence is that the women have done this largely on their own. Sure, the group has some corporate and individual sponsors, but there’s no deep-pocketed billionaire bankrolling the organization as we’ve seen with Michael Bloomberg and Moms Demand Action. This is a true grassroots effort, and it’s so great to see how the organization has grown over the past five years.

In 2016, the DC Project’s first goal was to bring 50 women, one from every state, to Washington, D.C. to simply demonstrate to lawmakers that yes, pro-Second Amendment women weren’t mythical creatures. From there, the project has snowballed to the point that there are now more than 40 state-level directors for the DC Project leading the pushback against gun control legislation and pressing legislators to approve pro-2A bills, while DC Project members have been called to testify on Capitol Hill on an increasingly frequent basis.

Mueller pointed to the passage of Missouri’s Second Amendment Preservation Act, as well as the defeat of a bad bill in the Democrat-controlled legislature in Nevada last year as two examples of the state-level work that the DC Project is engaged in, and also discussed the legislative battles over multiple gun control bills that they’ll be engaged in this year in Washington State, where lawmakers are once again looking to ban so-called assault weapons and high capacity magazines while further eroding the state’s firearm preemption law and allowing localities and counties to impose their own restrictions on the right to carry during public meetings, permitted events, and in government-owned buildings.

The DC Project is still a pretty new endeavor, all things considered, but they’re already doing great work and have big plans for the immediate future. I’d encourage every woman who supports the Second Amendment to become a part of this organization and get involved in what the DC Project is doing. As their sign says, gun rights are women’s rights, and it’s critically important for more of us to be politically engaged if we want to see those rights safe and secure.

SHOT Show kicks off with good crowds, new guns

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Covering SHOT Show solo is a daunting task, so I will acknowledge up front that there’s no way on earth I’ll be able to get to every booth or talk to every 2A activist in attendance.

However, I’m thrilled that we’re able to kick off our on-the-ground coverage by spending a few minutes with The Reload’s Stephen Gutowski, who shares his impressions of this year’s Range Day with us, along with a few of his plans for his own coverage of SHOT this week.

The crowds are definitely a little sparser than in normal years, though the NSSF says there are approximately 41,000 attendees who’ve registered, which would only be a decline of about 15,000 folks. Now, a 1/3 attendance decline may not sound like anything to cheer about, but given that the Consumer Electronics Show drew about 45,000 people this year when attendance is normally around 175,000, and all of a sudden the SHOT Show attendance numbers look surprisingly strong given the circumstances.

Those smaller crowds and missing exhibitors were even a factor on Range Day, according to Gutowski, although it did make it a little easier to actually shoot and not just stand in line waiting to take your place on the firing line. The industry-wide ammunition shortage, on the other hand, even impacted those who made it out to Boulder City, Nevada for Range Day. No shooting 30 rounds on full auto this year; instead Gutowski says it was much more common for companies to limit shooters to five rounds or so apiece.

We’ll have a separate VIP piece coming up this afternoon on the state of the ammunition industry as a whole, but suffice it to say that demand is still sky high at the moment, which is still playing hell on the ability of companies to fill orders in a timely manner.

The absence of some major players at this year’s SHOT Show (Sig Sauer and Beretta are a few of the big names without a significant footprint) could provide an opportunity for smaller companies to make inroads with distributors, but Gutowski is also keeping an eye on one company in particular: SmartGunz.

The Kansas-based company recently unveiled its RFID-equipped pistol and says it will be available for purchase in April of this year, which could trigger a New Jersey’s gun control law that requires gun stores to carry “smart guns” once they’re officially on the market. Whether there’s much market demand for a $2,195 9mm pistol that only works if the gun syncs to a wearable (in this case, a ring that must be worn) remains to be seen, but the gun control lobby is certainly excited about the prospect, and Gutowski says more blue states could soon follow New Jersey’s lead or even attempt to ban non-smart guns from the market (as was the case with New Jersey’s original “smart gun” law).

Be sure to check out the entire conversation with Stephen Gutowski in the video window above, and check back for more coverage of the 2022 Shooting, Hunting, Outdoor Trade Show all week long here on Bearing Arms.

Activist says college students too stressed for 2A rights

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The state of Missouri adopted Constitutional Carry five years ago, and has followed up with several other pieces of solid pro-Second Amendment legislation in the years since. There’s still one hugely important measure that hasn’t been turned into law yet, however; campus carry. Currently it’s a criminal offense for a licensed concealed carry holder (or any other legal gun owner) to carry on the campus of a college or university, though Rep. Chuck Basye has introduced a campus carry bill that would restrict campuses from “generally prohibiting the carrying, chambering, or active operation or storage of a concealed firearm on the campus of the institution.”

This would bring Missouri in line with the neighboring state of Kansas, where campus carry has been in effect since 2017. There’ve been no issues with the Kansas law in the five years that it’s been in place, but anti-gun activists are still launching a furious attempt to derail the Missouri legislation by warning that campus carry will lead to a dramatic increase in student suicides.

As a graduate of the University of Missouri-Kansas City, I am well aware of the unique stressors of being on a college campus. I recently completed my adult psychiatry residency training and am currently a first-year child and adolescent psychiatry fellow. I have seen firsthand the devastating impacts of the COVID-19 pandemic on college students’ mental health. I have also published research on the impacts of Missouri’s firearm laws on youth and young adult suicide, and I worry that introducing firearms on college campuses in the state would worsen the risk of completed suicide in this population. Firearm suicide rates in college-age Missourians are already at an all-time high. Missouri experienced a 71% increase in suicides in 10- to 24-year-olds from 2007 to 2018. Data from the Centers for Disease Control and Prevention also shows rates of firearm suicides in 18- to 22-year-old Missourians have tripled recently, going from 5.6 in 2013 to 15.9 per 100,000 of these young people in 2020.

For many who attempt suicide, the time between making a plan and attempting is less than 10 minutes. Once the crisis has passed, most people who survive one attempt do not die by suicide later. Access to lethal means during moments of crisis can greatly increase the risk of suicide completion, and firearms are the most lethal means available. Transition to college and college itself is stressful. Students must balance school, work and sometimes children. Many are under enormous financial pressures. Some struggle to manage social pressures and experience homesickness. Some experiment with alcohol or other substances that can affect their mental health and increase risk for self-harm. It’s not surprising that many first episodes of thoughts about suicide emerge during this period.

Suicide is a real issue, but it’s not a gun control issue, and treating it as such only takes us further away from more productive strategies that focus on the actual problem of mental health. And indeed, as author Apurva Bhatt acknowledges, suicide rates have been increasing among college-age students in Missouri without a campus carry law in place, which suggests that the problem isn’t going to be adequately addressed by simply declaring that adults shouldn’t have access to their Second Amendment rights on college or university campuses.

A much better approach would be to recognize that the Second Amendment rights of adult students and staff don’t disappear once you set foot on a university, scale up the mental health resources available on campus for students who need it, and encourage gun owners who may need to temporarily store their firearms out of their home because of a mental health crisis to voluntarily do so, without any law or legal mandate in effect.

If Bhatt is serious about saving lives, there’s no reason for her to call for keeping the status quo in place when suicide rates are already climbing. Instead of focusing on the tool, we need to be paying better attention to those in crisis and ensuring they get the help and support they need. Not only can we can do that without infringing on the Second Amendment rights of all, but a “solution” based on gun control isn’t going to solve anything at all.

2022 SHOT Show Preview

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My posting has been a little lighter than normal today because I’ve been scrambling to get to the airport amidst the remnants of the winter storm that blew up the East Coast this weekend. As long as my flight isn’t delayed or canceled, I’m headed to Las Vegas, Nevada for the 2022 Shooting, Hunting, Outdoor Trade Show, which kicks off in earnest on Tuesday, and I’ll be reporting from SHOT for much of the week.

SHOT Show is hosted by the National Shooting Sports Foundation, and this year marks a return to an in-person trade show for the first time since 2020 thanks to the COVID pandemic. NSSF’s Mark Oliva joins me on today’s Bearing Arms’ Cam & Co for a preview of this year’s show, which does promise to be a different experience from years past.

Oliva says he does anticipate that attendance will be down this year, though he’s still predicting northwards of 40,000 attendees. That would be a significant decrease from the 55,000 or so attendees in 2020, but not nearly as big a decline as we saw with the recent Consumer Electronics Show in Vegas. CES regularly draws in more than 150,000 attendees, but attendance this year was down by more than 70%, to around 45,000. I don’t expect that SHOT will see a 70% decrease in the number of attendees, but several major manufacturers have pulled out entirely, and Oliva says other exhibitors may be sending fewer employees to the show than they would under normal circumstances.

One brief note about one of those company’s that won’t be at SHOT this year: Froglube announced last week that they were pulling out of SHOT over the mask mandate that’s in effect, and chided NSSF for not suing to strike down the mandate. When I asked Oliva about the company’s decision, Oliva stated that Froglube is a Nevada-based company. In fact, their headquarters are in Burleson, Texas.

As for Froglube’s decision, while I’m no fan of mandates either, I don’t know that a legal challenge to the state’s mandate requiring either proof of vaccination or the wearing of masks in large setting would be successful, but I do know that any challenge wouldn’t necessarily have to come from the NSSF. There’s no reason why individual attendees or exhibitors couldn’t have challenged the mandate on their own, not to mention the corporations that own and manage the convention facilities. To pin the responsibility entirely on NSSF seems a little unfair to me, but YMMV.

Even though some companies won’t be in attendance and will be missed, there’s going to be plenty to see and do, including the annual Range Day that’s taking place today. I’m still annoyed that I wasn’t able to make it out to Vegas in time to participate, because the smaller crowds are likely to mean more time trying out new products for those who can make it, but I was forced to choose between flying out early and leaving my family to deal with the winter storm on their own, or sticking around and making sure everyone was safe and warm before I left. As much as I would have liked to send some rounds downrange today, I like not being in the doghouse with my wife even more, so I’m going to have to live vicariously through my friends and colleagues who were able to spend some quality time with many of the products making their debut at the show.

One event we will be covering firsthand this week is the Governors’ Forum taking place on Wednesday, where eight Republican governors will be getting together to discuss the growth of the firearms industry in their states, as well as the wave of relocations we’ve seen in the past decade; from Beretta’s move out of Maryland in 2013 to Smith & Wesson’s recent decision to relocate its headquarters from Springfield, Massachusetts to Marysville, Tennessee.

And of course we’ll also be hitting the floor of the exhibit halls and catching up with leaders and influencers in the Second Amendment movement, as well as trying to find a few spare minutes to write up and share what we’ve discovered with you over the course of the day. I might even find a couple of minutes to sleep over the next few days, but that’s pretty low on my to-do list, to be honest.

Check out the entire conversation with NSSF’s Mark Oliva in the video window above, and look for our on-the-ground coverage from the 2022 SHOT Show starting tomorrow. I also want to thank our VIP members, because their support makes coverage like this possible. As one of our ways of saying thanks, we’ll be providing some exclusive content for our VIP members this week, and you can sign up here. Use the promo code GUNRIGHTS for a significant savings on your membership, and again, I really do appreciate all of our VIP members and their support for our mission of providing our audience with independent, pro-2A news, views, and interviews they won’t find anywhere else.