Understanding the Risk of Firearms: Suicide vs. Homicide

[Melissa Mills]

If you watch the news or TV shows, you might be led to believe that there is a high risk of firearm homicide. Researchers from Northeastern University, University of Washington, and Harvard University conducted a study into the perceptions of gun violence and the leading cause of death in the United States. They found that the presence of a firearm in a home increases the risk for suicide, which is more common than firearm homicide.

So, what's behind our misconception about gun violence and how do you educate the community about the real dangers?

Looking at the Numbers

According to the Brady Campaign, the oldest organization in the gun violence prevention movement, 96 people die every day in the United States from gun violence. Of these 96, 34 are murdered, and 59 die from suicide. That means nearly twice as many people die from firearm suicide compared to firearm homicide. There are also 246 people shot daily who survive - 183 are injured in an attack, 49 are shot unintentionally, 4 are shot in a legal intervention, and 11 survive a suicide attempt.

A 2014 study published in the Annals of Internal Medicine reported that access to firearms in the home increases your risk of violent death by suicide, homicide, or unintentional injury. There was a direct correlation to the risk of suicide among people who had access to firearms compared to those without access. The study also reported that the US has one of the highest rates of access to firearms in the world.

Could impulsivity and the ease of access to a gun place some people at a higher risk of committing suicide or homicide? The study suggests that it's possible. Yet, there are no hard data to support the claim. States with the highest rates of firearms, also have a higher percentage of firearm violence compared to non-firearm violence.

Is it a Public Health Issue?

According to the American Public Health Association (APHA), gun violence is an issue that is deeply rooted in our culture and must be addressed through a public health approach. Violence research should be conducted to ensure that guns don't fall into the wrong hands. APHA also believes that access to mental health services must be expanded to those who need it most to decrease the number of suicides by firearms.

Do Nurses Have a Role In the Firearms Debate?

Every day nurses in Emergency Rooms across the country come face-to-face with the gun violence issue. They might deal with victims of homicide, suicide, and unintentional shootings.

Nurses who work in schools have become far too familiar with the issue over the past few years. The National Association of School Nurses released a Position Brief in which they state that school shootings in the US are an urgent public health crisis. The NASN advocates for safe school environments for all children and recognizes the emotional and physical effects that gun violence has on our students. This doesn't account for nurses in the ICU, rehabilitation units, and many other settings that might care for gunshot victims.

Unfortunately, healthcare workers can fall victim to gun violence, too. Recent research has highlighted the prevalence of suicide among nurses. And, gun violence in hospitals and other healthcare facilities seems to happen at an alarming rate. In fact, just a few weeks ago, a young doctor was killed in the parking lot of Mercy Hospital in Chicago at the hands of her former fiancee.

What Can You Do To Help?

Gun violence is a hot political debate these days. No matter which side of the aisle you stand on, as a nurse there are a few things you can do to help keep patients safe:

1. Educate patients about the risks inherent in having a gun in their home. It's particularly important to speak to parents of young children about safe storage of all firearms.
2. Connect patients with mental health concerns to services as quickly as possible. Many patients have mental health needs that if left unattended can quickly lead to violence towards themselves or others.
3. Participate in violence prevention and intervention programs at your hospital or facility. None of us want to discuss or consider that a shooting could happen at our workplace, but unfortunately, the risk is real.
4. Write to your elected officials to make your viewpoints on the issues known.
5. Advocate for more research to be done to increase our understanding of homicide, suicide, and those who commit both.

What are your thoughts on the firearm statistics? Do you feel that nurses have a place in the firearm debate? Let us know your thoughts in the comments below.

[cmefford]

I think there is a point being missed here.

With Adam Lanza, there was an entire *dynamic* going on there. He didn't merely steal guns; his mother purchased these types of guns for him. So many, many factors came into play with Sandy Hook that ultimately failed those 26 people who lost their lives. This was a kid who was on the radar briefly, whose mom all but gave up, whose dad and brother hadn't spoken with him in about 3 years. He was anorexic. So many things failed.

Mental illness played a role with this kid. But the shear amount of weapons in this household, the high number of rounds he was able to unload in such a short amount of time, also played a role.

Relative to other countries, we do not have a disproportionately high number of mentally ill people. We do not have a disproportionately high number of extremists. What separates us from every other developed nation in the world is the sheer number of guns that exist in this country and the ease with which they can be acquired. We have 120.5 guns for every 100 people; that's more guns than people.

A March 2016 study in the American Journal of Medicine found that Americans are 25 times more likely to die from gun homicide than people in other wealthy countries. Why?

Women in the U.S. are 16 times more likely to be killed with a gun than women in other high-income countries. Why?

And in case we begin to lose sight ... Firearms are the second leading cause of death for American children and teens and the first leading cause of death for Black children and teens. Black children and teens are 15 times more likely than white children and teens of the same age to die by gun homicide. A very real public health issue, indeed.

So what do we do?

We focus on mass shootings and wring our hands, blasting lack of mental health services. But that ain't the whole of it. Then give our thoughts and prayers and wait for the next one.

We focus on those darn inner cities and thank our lucky stars "we don't live there and WE'RE safe, gosh darn it ... I'M responsible, it's those hooligans in the cities." And then we forget about it the next moment, forgetting that "hey, this is actually a public HEALTH concern too ..."

Slippery slope or not, if the government decides to go all rogue, the peashooters don't stand a chance. We don't have years, decades, to wait for what's protected. There needs to be a change; it won't happen and people will keep dying.

Anyone with a mental illness, by law is ineligible to possess or purchase a firearm. Doesn't mean that they will not steal them to get them, just like a criminal will use a firearm to murder someone, again which is against the law and they do not care.

Products - Data Briefs - Number 37 - May 2

[akulahawkRN, ADN, RN, EMT-P]

Actually that is exactly what the 2nd amendment meant. The right to bear arms shall not be infringed.

Also, if you want to be taken serious by individuals that truly believe in the 2nd amendment, you need to do your research on firearms before you spew out false "main stream media talking points".

Can you show me a firearm that is legal to own in any state that can fire 400 rounds/minute?

Legal in all states or just the ones where it's legal to personally own/possess machine guns? If it's the latter, there's about 180k machine guns that are legal to personally own/possess. It's technically LEGAL to own them in California too but you must have the right permit to do so. Without the specific permit, personal possession of a machine gun is illegal in California. There are 3 people that have such a permit. I know one, he knows the other two. Now then, it's legal for me to own a machine gun but I just can't possess it here in California because of the permit issue.

Now if you're referring to a firearm that's legal in all states that has a cyclic rate of 400 rounds per minute that is not a machine gun, there are millions that can... using the right technique. There are devices that can facilitate the use of the technique but those aren't necessary and they don't alter the actual function. Sustained fire at that rate is almost impossible with them and accuracy is terrible at best.

This gun issue is a very deep rabbit hole and I've been down a lot of it, but I defer to those that have reached the bottom of it. Those guys are the subject matter experts on this...

[cmefford]

Legal in all states or just the ones where it's legal to personally own/possess machine guns? If it's the latter, there's about 180k machine guns that are legal to personally own/possess. It's technically LEGAL to own them in California too but you must have the right permit to do so. Without the specific permit, personal possession of a machine gun is illegal in California. There are 3 people that have such a permit. I know one, he knows the other two. Now then, it's legal for me to own a machine gun but I just can't possess it here in California because of the permit issue.

Now if you're referring to a firearm that's legal in all states that has a cyclic rate of 400 rounds per minute that is not a machine gun, there are millions that can... using the right technique. There are devices that can facilitate the use of the technique but those aren't necessary and they don't alter the actual function. Sustained fire at that rate is almost impossible with them and accuracy is terrible at best.

This gun issue is a very deep rabbit hole and I've been down a lot of it, but I defer to those that have reached the bottom of it. Those guys are the subject matter experts on this...

There is alot more to owning an automatic weapon than just obtaining a permit!

How to Purchase a Machine Gun as an Individual:

Confirm that they are lawful to possess in your state

Find a currently registered machine gun made before 1986 either at a gun shop or a private individual. You can search locally or online (but out-of-state online sales of all firearms must go to your local gunshop).

Purchase the machine gun as an individual or through a trust (you are looking at spending upwards of $25,000 or more for an automatic machine gun) - but, no, you can't take it home yet! Trusts were popular to avoid certain requirements (fingerprints, law enforcement approval, etc.) but ATF changed the rules last year. Previously, your local Chief Law Enforcement Officer (CLEO) approval was required but the ATF changed the rules last year to only require notification. Also, members of a trust could obtain new NFA firearms without fingerprints/photos but now every lawful possessor is required to submit them each time. These rule changes removed much of the reason to get a trust.

Fill out an ATF Form 4 application to transfer an NFA firearm. This application will include a $200 check for your tax, your fingerprints, a passport-style photograph, and information about you and the firearm.

Wait 9-12 months for the ATF to approve and return your paperwork.

Abide by local, state, and federal gun regulations: Assuming one has the record and the patience to pass the background check along with the actual cash to purchase the firearm, that person now finds themselves subject to a host of new regulations.

The ATF registers the new fully-automatic gun owner. They notify local law enforcement of the name and address of the person who owns the firearm. And they strictly regulate the transportation of these weapons. If a civilian wants to cross state lines with their new purchase (say to attend the Big Sandy machine gun shoot in Arizona), they'll have to apply for permission.

More legislation regarding machine guns exist at the state level and can impose long prison sentences.

In fact, fines of up to $250,000 and prison sentences up to 10 years can be instituted to those in possession of an unregistered machine gun.

Sam Paredes, executive director at Gun Owners of California said that machine gun owners are already under enough scrutiny.

"The federal government knows exactly how many [machine guns] are out there and everybody who owns them," he told ABC News, adding that the background checks are extensive. "It takes anywhere from six months to two years to have the privilege granted to you to buy one."

And procuring a machine gun can be difficult.

"It's not like buying a .410 shotgun if you're going to go squirrel hunting," said Jim Wallace, executive of the Massachusetts Gun Owners Action League. "The license for a machine gun, let alone the weapon, is not easy to acquire."

The average middle class citizen more than likely will not own one. It is extremely costly to obtain one.

Firing any firearm generates a very high temperature in the firearm's barrel and elevated temperature throughout much of its structure. If fired too fast, the components of the firearm will suffer a structural failure. This means that all firearms, regardless of whether they are semi-automatic, fully automatic, or burst mode in their firing methods, will overheat and fail if fired too often. This is especially a problem with fully automatic fire. In actual use (for example the MG34), a gun might be able to fire at 1200 rounds per minute, but in one minute it may also overheat and fail. So guns used in a repeated firing mode must not be fired too often. The MG34 is fired manually in bursts of 5 to 7 rounds (no automatic disconnector mode in this gun). It can fire at an effective rate of 150 rounds per minute.[3]

Similarly semi-automatic firearms will also overheat if not allowed to cool. A semi-automatic rifle typically has an effective firing rate of 40 rounds per minute.[citation needed] A large part of the reason that this is so low, is that the recoil of firing a round pushes the gun's aim off target. The time it takes to "reacquire" the target slows the effective firing rate.[4] The Army Study Guide lists the sustained rate of fire for an M4 Rifle at 12 to 15 rounds per minute.[5]

Anyone that is not looking to use their firearm for illegal uses, would never use a "bump-stock" for their firearm. They are not accurate and completely a waste of ammunition.

So, yes, I guess technically you are correct, but it would destroy the firearm to shoot it at 400 rounds per min. And yes fully auto are still legal to own, but as stated, not for a normal average citizen. I know a lot of people that own a lot of firearms in Missouri and not one of the everyday average citizens owns one. I know firearms dealers that own them.

It is a deep rabbit hole! There are millions of opinions on this, not one is "right".

I think it also has a lot to do with where you live, the experiences that you have had with firearms or lack thereof.

I personally know someone that used a firearm on her ex that was trying to harm her and her children, they survived, he didn't. He made a poor choice and she saved her children from harm. I also have been in that situation with my ex trying to break into my house, I did not fire my firearm, but the sight of it was enough for him to stop and leave. We live in the country and law enforcement is a minimum of 15 mins away, we would be dead before they could get there of we did not have a way to protect ourselves.

[dec2007]

There is alot more to owning an automatic weapon than just obtaining a permit!

How to Purchase a Machine Gun as an Individual:

Confirm that they are lawful to possess in your state

Find a currently registered machine gun made before 1986 either at a gun shop or a private individual. You can search locally or online (but out-of-state online sales of all firearms must go to your local gunshop).

Purchase the machine gun as an individual or through a trust (you are looking at spending upwards of $25,000 or more for an automatic machine gun) - but, no, you can't take it home yet! Trusts were popular to avoid certain requirements (fingerprints, law enforcement approval, etc.) but ATF changed the rules last year. Previously, your local Chief Law Enforcement Officer (CLEO) approval was required but the ATF changed the rules last year to only require notification. Also, members of a trust could obtain new NFA firearms without fingerprints/photos but now every lawful possessor is required to submit them each time. These rule changes removed much of the reason to get a trust.

Fill out an ATF Form 4 application to transfer an NFA firearm. This application will include a $200 check for your tax, your fingerprints, a passport-style photograph, and information about you and the firearm.

Wait 9-12 months for the ATF to approve and return your paperwork.

Abide by local, state, and federal gun regulations: Assuming one has the record and the patience to pass the background check along with the actual cash to purchase the firearm, that person now finds themselves subject to a host of new regulations.

The ATF registers the new fully-automatic gun owner. They notify local law enforcement of the name and address of the person who owns the firearm. And they strictly regulate the transportation of these weapons. If a civilian wants to cross state lines with their new purchase (say to attend the Big Sandy machine gun shoot in Arizona), they'll have to apply for permission.

More legislation regarding machine guns exist at the state level and can impose long prison sentences.

In fact, fines of up to $250,000 and prison sentences up to 10 years can be instituted to those in possession of an unregistered machine gun.

Sam Paredes, executive director at Gun Owners of California said that machine gun owners are already under enough scrutiny.

"The federal government knows exactly how many [machine guns] are out there and everybody who owns them," he told ABC News, adding that the background checks are extensive. "It takes anywhere from six months to two years to have the privilege granted to you to buy one."

And procuring a machine gun can be difficult.

"It's not like buying a .410 shotgun if you're going to go squirrel hunting," said Jim Wallace, executive of the Massachusetts Gun Owners Action League. "The license for a machine gun, let alone the weapon, is not easy to acquire."

The average middle class citizen more than likely will not own one. It is extremely costly to obtain one.

Firing any firearm generates a very high temperature in the firearm's barrel and elevated temperature throughout much of its structure. If fired too fast, the components of the firearm will suffer a structural failure. This means that all firearms, regardless of whether they are semi-automatic, fully automatic, or burst mode in their firing methods, will overheat and fail if fired too often. This is especially a problem with fully automatic fire. In actual use (for example the MG34), a gun might be able to fire at 1200 rounds per minute, but in one minute it may also overheat and fail. So guns used in a repeated firing mode must not be fired too often. The MG34 is fired manually in bursts of 5 to 7 rounds (no automatic disconnector mode in this gun). It can fire at an effective rate of 150 rounds per minute.[3]

Similarly semi-automatic firearms will also overheat if not allowed to cool. A semi-automatic rifle typically has an effective firing rate of 40 rounds per minute.[citation needed] A large part of the reason that this is so low, is that the recoil of firing a round pushes the gun's aim off target. The time it takes to "reacquire" the target slows the effective firing rate.[4] The Army Study Guide lists the sustained rate of fire for an M4 Rifle at 12 to 15 rounds per minute.[5]

Anyone that is not looking to use their firearm for illegal uses, would never use a "bump-stock" for their firearm. They are not accurate and completely a waste of ammunition.

So, yes, I guess technically you are correct, but it would destroy the firearm to shoot it at 400 rounds per min. And yes fully auto are still legal to own, but as stated, not for a normal average citizen. I know a lot of people that own a lot of firearms in Missouri and not one of the everyday average citizens owns one. I know firearms dealers that own them.

It is a deep rabbit hole! There are millions of opinions on this, not one is "right".

I think it also has a lot to do with where you live, the experiences that you have had with firearms or lack thereof.

I personally know someone that used a firearm on her ex that was trying to harm her and her children, they survived, he didn't. He made a poor choice and she saved her children from harm. I also have been in that situation with my ex trying to break into my house, I did not fire my firearm, but the sight of it was enough for him to stop and leave. We live in the country and law enforcement is a minimum of 15 mins away, we would be dead before they could get there of we did not have a way to protect ourselves.

Thank you for this information! It's good to understand how the process really works.

[BCgradnurse, MSN, RN, NP]

A mandatory waiting period may have saved this man if it was in place.

Parents of suicide victim push for gun waiting period in son's obituary | Boston.com

[MunoRN, RN]

Actually that is exactly what the 2nd amendment meant. The right to bear arms shall not be infringed.

Also, if you want to be taken serious by individuals that truly believe in the 2nd amendment, you need to do your research on firearms before you spew out false "main stream media talking points".

Can you show me a firearm that is legal to own in any state that can fire 400 rounds/minute?

To clarify, that's not the second amendment, or at least not all of it, the second amendment is "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." You can't just ignore the first part, which can be interpreted in at least a couple of different ways, and currently is interpreted by the SC to mean that there should be sufficient restrictions on the right, including that who can own firearms can be restricted and the types of firearms can be restricted, specifically that only firearms for a primarily lawful purpose are protected.

As a supporter of the second amendment, it's overstating or misrepresenting the second amendment that I would argue it the biggest risk to the second amendment.

And yes, a semi-auto rifle with a bump stock can fire at or well above 400 rounds per minute.

Anyone with a mental illness, by law is ineligible to possess or purchase a firearm. Doesn't mean that they will not steal them to get them, just like a criminal will use a firearm to murder someone, again which is against the law and they do not care.

Products - Data Briefs - Number 37 - May 21

The problem is that currently they don't even have to go through the effort of stealing them, they are only prevented from purchasing firearms when going through an FFL in most states, and it's not hard at all anymore to purchase a firearm outside of an FFL.

[AbbyLane]

I would like to point out that America is the SAFEST country in regards to gun violence in ratio to the amount of firearms in our country.

With that being said, the second amendment isn't going anywhere

[AbbyLane]

We call them "ammosexuals"

Woah people actually support a constitutional God-given right? AMMOSEXUALS!!!

[AbbyLane]

I'm angry and frustrated, too. I don't have guns, so I don't shoot anyone. Easy as pie.

I mean I could say "i don't own a car so I don't run over anyone :-)" but that would sound dumb.

[AbbyLane]

OMG LMAO

[AbbyLane]

libs are always sarcastic when you debate them.

He's pointing that out because many people on the left, people who are anti-gun and CNN literally do not know the difference half the time.

*sigh*

[AbbyLane]

And this is LITTERALLY what the vast majority of pro-gun people feel yet we are constantly being described as "ignorant" and "non-caring" in mainsteam media. The VAST majority of us are everyday, normal people who are unbelievably responsible and respectable in regards to firearms and satistics SHOW that. So us pro-gun people are scratching our heads wondering why are left leaners so mad at us? we agree with you guys! we are devastated by every mass shooting after shooting. But what we are trying to say its not GUNS its PEOPLE. statistics prove over and over that this is not a "law" issue, it's a case-by-case issue because why should the VAST majority suffer when these extremely small percentage of people are not responsibly using their weapons?

Some facts on the matter -

A lot of these "mass" shooters are not licensed LEGAL gun owners.

America is THE SAFEST country with gun violence in ratio to the sheer amount of guns here

Areas in the country with the strictest gun laws often have HIGHER rates of violence, just look at Chicago!!!

So I'm sorry anti-gun peeps, I totally respect your opinion, but us pro gun people just sit here and scratch our head when you guys act like we are the problem or that the fact we aren't willing to budge on guns laws makes US the issue, when time and time again statistics supports our side of the argument and our points more.

we ALL want a solution to mass shootings, suicides, etc but implementing stricter gun laws are not going to change anything as I stated before, statistics back that up 100% and that's what we are trying to get you guys to understand.