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Mental Health Assessments Need to Ask the Right Questions to Identify Suicidal Ideation with Gun Owners

Jim Windell

             The number of suicides in the U.S. has increased by more than 30% since 2000. The most likely method of suicide is a firearm.

            Studies show that gun ownership is associated with elevated suicide rates. However, the varied ways in which suicidal ideation and suicidal behavior co-occur remain poorly understood. For example, many people who attempt suicide deny experiencing suicidal ideation and suicidal planning in advance. There may, though, be differences in suicidal ideation and suicide planning between gun owners and non-gun owners.

           A recent study had the goal of addresses these gaps in our understanding by assessing a broad range of suicidal ideation and behaviors among U.S. adults who either own or do not own firearms.

           Cross-sectional online survey data were collected from March to April, 2020 from U.S. adults recruited via Qualtrics Panels. Quota sampling was used to approximate U.S. census demographics. Of the 65,079 adults invited to participate, 10,625 (16.3%) completed the survey; 9153 responded “yes” or “no” to the firearm ownership item and were included in the analysis. Of these 9153 respondents, 51.3% were male with a mean age of 46.7. Just over 30 % (30.3%) reported owning a gun and 6380 (69.7%) reported not owning a gun. Gun owners were more likely to be male, White and to have served in the military.

           The results were published in the journal JAMA Network Open. It was found that gun owners with a recent suicide attempt are less likely than non-gun owners to report experiencing suicidal ideation – even though firearms are the most common method of suicide. Researchers from The Ohio State University Wexner Medical Center and College of Medicine concluded that gun owners and non-gun owners experience thoughts about suicide in different ways, which may explain why the standard questions to identify those at risk of suicide often fall short.

           According to Craig Bryan, a clinical psychologist and director of the Division of Recovery and Resilience at Ohio State’s Department of Psychiatry and Behavioral Health, “Not everyone experiences suicidal ideation in the same way. So, maybe our traditional ways of asking about suicidal thoughts are incomplete.”

           Bryan says that perhaps a simple shift in questioning – adding one more different perspective or a different angle to ask about suicidal thoughts – could potentially help us to identify people who are in a vulnerable state.

           Bryan, who is the author of the book Rethinking Suicide: Why Prevention Fails, and How We Can Do Better, says this includes amending assessments to go beyond asking someone if they’ve thought about suicide by asking if they’ve considered a method of suicide, which gun owners are more likely to have an answer to. He says combining more comprehensive questions with simple barriers to immediate gun access, such as locking firearms in a safe or asking someone they trust to store them, can save lives.

           “Suicidal crises tend to come on suddenly, but don't last very long,” Bryan says, “so, if we limit access to lethal methods during that short window of time, that could potentially prevent a suicide.”

           To read the original article, find it with this reference:

Bryan, C.J.,  Bryan, A.O., Wastler, H.M., Khazem, L.R., Ammendola, E., Baker, J.C., Szeto, E., Tabares, J., & Bauder, C.R.. (2022). Assessment of Latent Subgroups With Suicidal Ideation and Suicidal Behavior Among Gun Owners and Non–Gun Owners in the US. JAMA Network Open, e2211510. doi:10.1001/jamanetworkopen.2022.11510