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.

[dec2007]

So is it your opinion that Hitler managed to take power, murder millions of Jews, socialists, communists, intellectuals, liberals, gypsies/Romani and other people he deemed undesirable and invade and occupy several European countries, because of confiscation of legally owned weapons? Are you going as far as implying that the Holocaust wouldn't have taken place if the Jewish people in Germany had been better armed?

*Seriously? Are you really asking that question?

I'm not sure if you're simply regurgitating a talking point you've heard or if you've actually taken the time to study European history from the early 1900s to the end of WWII?

*Wow! Just.....Wow!!!

Verbosity and condescension always seem to accompany hysterical political discussions.

As far as confiscation of guns in occupied countries, didn't that come after the occupation?

Actually, no.

[nursej22, MSN, RN]

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

I am not understanding "constitutional God-given right"? Does God really care if you bear arms? And does He/She only give this right to Americans?

As for the label of "anti-gun", you will notice many posters in favor of limiting access to firearms to suicidal folks are actually gun owners.

[rzyzzy]

I am not understanding "constitutional God-given right"? Does God really care if you bear arms? And does He/She only give this right to Americans?

As for the label of "anti-gun", you will notice many posters in favor of limiting access to firearms to suicidal folks are actually gun owners.

a plain reading of the constitution, the bill of rights & the writings of the founders leading up to the constitution does show that certain rights are not "privledges" , nor are they subject to being doled out by the state. The state simply does not have the authority to pick and choose and license those rights to a chosen few. The rights and freedoms are innate -

references to god are simply a manner of speech referring to the limitless nature of those rights. People who don't believe in god still have those rights.

One must also put things in context - I doubt anyone would argue that the limits on state power restrain the state from "catching every criminal ". Clearly, the power of the state to catch criminals is limited by the fact that searches and seizures must have a warrant. That's a feature, not a bug.

There should be no argument that the founders made a rational choice to allow a few criminals to go free rather than to subject every citizen to unwarranted & random searches and seizures by the state to catch just a few more criminals. There's nothing specifically in the constitution saying you can't be beaten with a hose & water boarded until you confess to whatever crime the state would like you to admit to, but there's some case law implying the right to be free of torture overrides the noble goal of catching every criminal.

So to is the right to keep and bear arms. Arms includes guns, knives, tasers & ammunition, not just guns. The founders knew that arms would be misused. The founders knew that the state would want to limit them. Before the constitution was written, the British had tried to "regulate" the "militia" (current meaning of the term "regulate", not the term as it was used in colonial times - there is a difference). The British tried to control the ownership of guns, powder and lead, not unlike the Brady campaign would have us do right now - guns, lead & powder stored in an armory controlled by the government. A citizen could "own" a gun, but could only store it in an armory that wasn't controlled by the citizen.

That scheme was rejected by the founders. People fought and died to preserve access to arms & then they explicitly wrote "shall not be infringed" into the second amendment. There's no ambiguity there. And the first part of the sentence doesn't mean the state is "allowed" to have or control guns of it's own. The state and the government have always had the right to keep arms. It takes some serious linguistic gymnastics to turn the "bill of rights" into a document granting the government rights & that's the crux of the "well regulated militia" argument.

As for why other governments haven't recognized the innate rights to self-preservation of the individual, that's on them.

I know Canada has the scheme where you can "own" certain guns with a license but have to store it at a gun range - good for them - but we actually had that imposed on the colonies before the revolution & that was one of the reasons for the revolution and the bill of rights.

You can argue that the innate rights are "obsolete ", and that's an opinion that you're entitled to have, for which the constitution came with a handy remedy- just amend it. There's a process for that, if the population agrees with you.

If the population doesn't agree with you, then you're stuck trying to limit that right judicially in bits and bites as we've seen the Brady bunch & friends doing for the past forty years..

[cmefford]

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.

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.

I realize that is not the entire 2nd amendment. I was replying to another post: The 2nd amendment was never intended to make it a right to carry any weapon whatsoever for any purpose whatsoever. Personal possession was never the main focus. With that in mind, an unlimited individual right to bear any kind and/or number of weapons can not, and should not, be interpreted from the context of the 2nd amendment.

And no matter if they purchase through an FFL dealer or not it is still against the law to purchase or possess a firearm if you have been adjudicated mentally ill. It is also against the law to sell a firearm to anyone on the prohibited list even in a private seller setting. I am not saying that the purchase could not be made from a private seller, but it is still against the law and is punishable by up to 10 years in prison.

https://www.justice.gov/sites/default/files/usao-ut/legacy/2013/06/03/guncard.pdf

[CelticGoddess, BSN, RN]

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*

Was this really necesary?

BTW: Most of the anti-gun people I know happen to be on the right. Most of my left leaning family own guns. Don't generalize

[macawake, MSN]

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.

I haven't fact-checked your claim but since few, if any, countries have more firearms per capita than you do and there are countries with higher homicide rates than yours, your assessment sounds reasonable. But what do you think it proves?

Estimated number of civilian guns per capita by country - Wikipedia

List of countries by intentional homicide rate - Wikipedia

The ratio between the estimated guns per capita in your country versus mine is... 5.22:1 ...

The ratio of intentional homicides per capita in your country versus mine is... drumroll... 4.99:1 ...

Have I now proven that the cause for you having five times as many homicides is because you also have five times as many guns... ?

If this topic wasn't so serious, I would have found it infinitely amusing that the ratios happened to be so close... I hadn't actually checked before now.

But no. The fact that you have many more homicides and also many more guns isn't enough proof to be able to definitively say that the large amount of guns you have, are the direct cause of your high homicide rates. It's a plausible assumption that it's at least a factor, but the numbers themselves don't constitute proof.

So I ask you again. What significance do you think your claim has when almost all countries that have higher homicide rates than yours are countries in Africa, Central and South America and the European "outliers" Russia and the Ukraine?

Many, or perhaps even the majority, of countries that makes your stats look reasonably good are countries that face either one or several of the following serious challenges; poverty, generally high levels of crime, social unrest, war, high level of corruption and undemocratic governments.

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

God-given? Did God author your Constitution? I thought it was a man-given right... Or does the Bible say that all Americans shall have arms...?

OMG LMAO

If you're going to mock people by laughing your posterior off, it helps if you hit the quote button. That way we know whom you are addressing

*Wow! Just.....Wow!!!

Verbosity and condescension always seem to accompany hysterical political discussions.

I'm not in the least bit hysterical. Regarding the condescension. Yup. Guilty as charged.

*Seriously? Are you really asking that question?

Yes, I am seriously asking that question. OP started a thread about gun violence and talks about firearms-related homicides and suicides. She also offers up suggestions about what she thinks that we as nurses and as private citizens can do in order to keep patients safe.

The very first reply she received to her post, was that well-known Heston quote. OP was probably hoping for a professional discussion regarding how lives can be saved, instead she got... this sad mess.

Your first contribution to the thread was to go all Godwin... Did you believe that everyone was just prepared to let that particular strategy go unchallenged? I'm not.

This was your post (it also included a book reference that I didn't include here).

I hesitate to participate in any political discussion, but I do think history is always relevant. If you study the rise of the Third Reich, and the gradual occupation of other countries by the Nazi regime, you will find confiscation of legally owned and registered weapons belonging to citizens was an initial step in occupation.

What was the point of your post? You say you hesitated to make it, yet you overcame your hesitation, so I gather it was important?

OP's post was never about confiscating legally owned weapons, a fact that you conceded when you were asked about it.

Can you show where the original post suggested confiscating arms?

I don't believe it did.

So now we've established that you agree that confiscation wasn't on the table.

But for some reason you still felt a need to introduce a Nazi regime lead by Hitler into this discussion. A brutal regime that started a war that ultimately lead to the deaths of somewhere between 70 and 85 million human beings.

You know what? I perceived your post as fear-mongering and I don't think you appreciate being asked to justify its relevance to this discussion.

You were obviously trying to imply or say something with your post, or you wouldn't have made it in the first place. It's not at all clear to me what Hitler's Germany has to do with this discussion, so why don't you explain why you thought it had any relevance whatsoever? That way I don't have to guess and you don't have to ask me if I'm seriously asking you what on earth you mean. Because I seriously am.

And the question I was seriously asking was this:

So is it your opinion that Hitler managed to take power, murder millions of Jews, socialists, communists, intellectuals, liberals, gypsies/Romani and other people he deemed undesirable and invade and occupy several European countries, because of confiscation of legally owned weapons? Are you going as far as implying that the Holocaust wouldn't have taken place if the Jewish people in Germany had been better armed?

Since my question appears to have either irked or befuddled you (not sure which), you're free to respond that of course civilians having more handguns, wouldn't have prevented Hitler's regime from committing atrocities.

If you were to acknowledge that, that would bring me right back to.... Why on earth did you inject confiscations of legally owned guns and Hitler and his regime into this thread?

Actually, no.

Your reply is so short and non-illuminating that one has to wonder why you thought it worth making.

You chose to quote only a single sentence from my post, and not the entire "train of thought". Allow me to refresh your memory:

As far as confiscation of guns in occupied countries, didn't that come after the occupation? Of course an invading country will want their continued presence to be met by as little resistance as possible, so that makes sense from their perspective. However confiscations of guns didn't lead to countries being invaded and occupied, the confiscation came after.

I should have finished the last sentence with the words, the invasion. I thought I had, but as my many spelling errors demonstrate, I was too tired to do any serious proof-reading. That was my mistake, but I suspect that it's still pretty clear that what I was saying was that confiscation of guns didn't chronologically occur before Hitler actually started the invasions.

As your reply was clear as mud to me, I am again forced to ask questions in order to figure out what you're trying to say.

You're saying that my claim that confiscations were not what lead to Germany invading and then occupying several European countries?

Is it your position that the invaded countries were made into "softer" targets prior to the invasions? By whom? Did Hitler send civilians in advance to confiscate legally owned guns? (It couldn't really have been military personnel, because that would be the start of an invasion by a foreign power). Or did he recruit the governments in the respective countries that were subsequently invaded, and persuaded them to strip citizens of their guns so that he could successfully invade later on? Do you have any proof that widespread confiscations took place prior to the invasions?

Once again, how is any of this relevant?

What exactly were you warning your fellow posters about when you chose to make your post?

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.

I have noticed that the the first part is most often left out when the Second Amendment is quoted. It's pretty clear why it is.

I'm not a legal scholar, (and they don't even always agree amongst themselves), but my amateurish layman interpretation is that, if the more often quoted part of the amendment, the part with the "non-infringable" right to bear arms, was truly intended to be standalone, there would be nothing in the amendment that says that each and every citizen doesn't have a right to bear any and every type of arms. Tactical nukes for example, would be permissible. Is anyone really arguing that they are or should be?

I'm not sure what "militia" translates to in modern-day terms, but I'm pretty sure that the term "well regulated" allows for some type of rules.

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.

I think you're entirely correct.

~~~~~

To those posters who think it's meaningful to analyze various firearms technical details and educate the "liberals" in the thread, you guys need to understand that they in all likelyhood could not care less. I personally am among those who think that this long-winded and deep-diving explanations of various gun characteristics and performance, is just deflection.

As someone who's spent quite a lot of time around guns, I'm well aware of limiting factors such as heat and magazine capacity, as well as the shooter's skill level. I just don't find it relevant.

When I listen to the audio recording of the Las Vegas shooting, I can only imagine the horror the concertgoers must have felt and the panic they felt as they tried to flee. Thinking about it makes me very ad as well as sick to my stomach. I wonder why there are actually people who think the weapons and accoutrements this perpertrator used, is a necessary thing. Who the **** needs bump stocks? What are they good for? Self-defense? Accuracy? Moose hunting? Hardly. The only thing they're good for in my opinion, is to give a vicious murderer a power high.

[MunoRN, RN]

I realize that is not the entire 2nd amendment. I was replying to another post: The 2nd amendment was never intended to make it a right to carry any weapon whatsoever for any purpose whatsoever. Personal possession was never the main focus. With that in mind, an unlimited individual right to bear any kind and/or number of weapons can not, and should not, be interpreted from the context of the 2nd amendment.

And no matter if they purchase through an FFL dealer or not it is still against the law to purchase or possess a firearm if you have been adjudicated mentally ill. It is also against the law to sell a firearm to anyone on the prohibited list even in a private seller setting. I am not saying that the purchase could not be made from a private seller, but it is still against the law and is punishable by up to 10 years in prison.

https://www.justice.gov/sites/default/files/usao-ut/legacy/2013/06/03/guncard.pdf

As you pointed out earlier, criminals don't voluntarily follow the law, which is why there has to be some mechanism to apply the law to firearm transfers, which is why universal background checks should be required on a comprehensive basis.

[MunoRN, RN]

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.

I think you're wildly misrepresenting the view of the majority of gun owners. I am a gun owner and part of the vast majority of gun owners who support "stricter gun laws", the main law that's been proposed at the federal level is universal background checks, which are supported by 75% to more than 90% of gun owners depending on which poll you prefer. Universal background checks have been shown to reduce the flow of guns to the black market, and as a gun owner I can't imaging selling a gun to someone without going through some sort of reliable process to ensure they are legally allowed to have a gun.

[MunoRN, RN]

....That scheme was rejected by the founders. People fought and died to preserve access to arms & then they explicitly wrote "shall not be infringed" into the second amendment. There's no ambiguity there. And the first part of the sentence doesn't mean the state is "allowed" to have or control guns of it's own. The state and the government have always had the right to keep arms. It takes some serious linguistic gymnastics to turn the "bill of rights" into a document granting the government rights & that's the crux of the "well regulated militia" argument.

There's only two possible interpretations of "well regulated militia", one is the military term of 'regulated' which would then mean the amendment doesn't apply to individual ownership unrelated to an organized militia not under federal control, which today is called the National Guard.

The preferable interpretation for gun rights advocates is that it refers to being 'sufficiently restricted', ie that the right can in fact be restricted, restricted to certain individuals and certain firearms. This is the interpretation currently in place as defined by the Supreme Court, and not by a pro-gun-control majority opinion but by Scalia, the most pro-gun Justice on the court at the time.

[rzyzzy]

There's only two possible interpretations of "well regulated militia", one is the military term of 'regulated' which would then mean the amendment doesn't apply to individual ownership unrelated to an organized militia not under federal control, which today is called the National Guard.

The preferable interpretation for gun rights advocates is that it refers to being 'sufficiently restricted', ie that the right can in fact be restricted, restricted to certain individuals and certain firearms. This is the interpretation currently in place as defined by the Supreme Court, and not by a pro-gun-control majority opinion but by Scalia, the most pro-gun Justice on the court at the time.

This is what we've come down to - a document that clearly intended for all men to have equal rights and protections under the law being re-interpreted by a Supreme Court to try to rationalize 200 years of "common sense" infringements, many of them legislated from the bench.

Again, let's step away from guns & talk about another freedom that has been infringed by artful interpretations- the right to be free of unreasonable searches and seizures. Scalia never met an infringement there he didn't like. Things like admitting that being searched by the nose of a dog is an infringement, but that it's totally cool "if it only takes a few minutes ". So - now in a "free country" , we have government agents searching people on the highway without any probable or reasonable cause to do so.

The founders never envisioned police forces seizing more private property than burglars do.

Scalia wasn't a great apostle of constitutional freedoms, he was right about one issue (for the wrong reasons ) and wrong about just about everything else.

The founders allowed slavery to continue- that was clearly unconstitutional unless you were willing to argue about whether someone who was black was actually a person & the Supreme Court kept arguing about that pretty obvious fact right up until very recently.

So, as far as Scalia saying "the second amendment doesn't mean any weapons you want to own ", history of the time shows different.

The revolutionary (continental) navy had 64 warships & was "supplemented" by nearly 1700 "privateers".

The continental navy had 1200 guns & the privateers had 14000 guns.

Privateers or Merchant Mariners help win the Revolutionary War

So, tell me again how men who lived through a revolution that was made possible by privately owned *warships* would decide that "citizens can't own a warship"?

The supremes have spent a couple hundred years trying to justify lots of infringements on the bill of rights.

The real problem here is a population that has surrendered their own disbelief & allowed them to act like the supremes have some deep understanding that no one else does.

The constitution was printed and distributed widely so that every citizen could see & interpret it themselves. It wasn't meant to be unintelligible unless you had a law degree & it wasn't written to give the government power. It was written to limit government power.

[rzyzzy]

As you pointed out earlier, criminals don't voluntarily follow the law, which is why there has to be some mechanism to apply the law to firearm transfers, which is why universal background checks should be required on a comprehensive basis.

There's no way to regulate "transfers" without registering all 400 million weapons currently in circulation.

Canada tried to require registration of long guns, (a lot less than we have) & they wasted millions of dollars & had ridiculously low compliance rates, so bad even they gave up.

That's a population that is inherently more receptive to the idea than the U.S. Population.

I really doubt the crips and the bloods are going to register anything.

So what's the point of making a list?

Would you like to waste a billion dollars?

Would you like to create millions of new felons?

Please explain the end game?

[Woodenpug, BSN]

If I thought firearms would be an effective threat against a corrupt government or foreign invasion... I would own a few registered firearms. I would dutifully turn them in when big brother asked. I would agree that I felt safer now that I have learned how wrong it is for private citizens to own firearms. I would wait for the perfect time to execute an effective counter strike, all while flying as low as possible under the radar.

If I thought firearms are an effective self defense strategy, I would make sure that anyone capable and willing to use deadly force against me remained at least 21 feet away.

If I felt that brandishing a firearm or the criminals knowledge that I had a firearm would be an effective defense...I would likely think it through and realize that would make me more of a target.

If I enjoyed hunting or target practice, I would advocate for cheap or free storage at a firearms range. It would be less likely to be stolen and the range owner would have to replace my weapon.

I do not own a firearm.

If I were as clever as I should be, I would not have posted here. I should know I am only contributing to a thread that was hijacked in the first reply.