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.

[cec0007]

All of akulahawkRN's post is excellent, but I'd especially like to quote this part of it:

,,,

More research does need to be done, in a non-biased, non-political way to increase our understanding of violence toward others and our understanding of suicide. The tool used is of less consequence... fix the underlying problem and it won't matter what tools are available.

Seriously, remember that the gun isn't the problem. It's an inanimate object that some people have come to focus upon as the cause of violence. In other countries where guns are highly restricted, knives are now the focus. Neither are actually the cause of violence towards others. Reduction of violence itself is where we need to focus. Reduction of suicide is also an area to focus on. We do that and we won't have to worry about the "how" because we'll have limited the "why" something happens.

This is the crux; the problem is not the gun, and there is no reason to try to take guns away from those who are doing nothing illegal with them. That is not the solution to gun violence of any type.

In countries where a gun is seldom used for suicide, jumping off bridges is a favored way. Some bridges are famous for it. People also seem to like to step in front of trains, even in the US. I'm not sure how that is any better.

The reality in the USA is that literally hundreds of millions of guns are already owned by its citizens; so many that getting rid of them (even if that were desirable and constitutional, which it is not) is impossible and will never happen. (Ever heard of Prohibition?) The anti-Second Amendment people can wish forever, but realistically it's not happening, especially for criminals who would get them regardless. And it wouldn't solve the problem of violence even if it could be done.

(I just asked Alexa; she said 359,081,400 guns in the US, that she knows of, of course. I'll take her word for it.)

In fact, it's notable, considering the sheer number of guns in the US, that many more deaths involving their use DON'T occur. That's because it's not the guns, folks.

There have been several instances recently of using cargo trucks to mow down innocent people in Europe. Obviously trucks aren't the problem. Now some countries are working hard to eliminate knives, even kitchen knives. News flash: Knives aren't the problem, either, and it's.not.going.to.work.

In any society there will always be some risk from the criminal element. It's unavoidable. A few years ago a German pilot decided to commit suicide and take the commercial airliner down with him, killing all on board. That was not the first time a commercial pilot has chosen to crash a plane. The disappearance of the Malaysian airliner is believed by many experts to have been intentionally done by one of the pilots, with the loss of all on board. Sadly, tragic as they all are, I don't know how we eliminate such things. Outlaw airline travel? No. Many more people, including children, die on our highways, often because someone acted illegally, than are murdered by all methods combined. Should we try to reduce the death toll? Of course, but not by making driving or owning vehicles illegal. Punish only those who have broken the laws.

Which brings me to the rest of macawake's post, parts of which have surprised me. Apparently he or she greatly misunderstands US gun laws. We're actually in agreement on these things:

,,,

How many people actually support gun control laws that completely deny a law abiding citizen the right to own a gun?

Can you pass a background check and are you otherwise emotionally and physically equipped to handle a firearm in a safe manner?

If you can and are, I personally don't see a problem for you or anyone else who meets those criteria, to own a gun.

The question isn't whether you should be allowed to drive a car despite the fact that other people get DUIs. The question is if a person who's been convicted of his or her third DUI has a sacred right to keep their driver's license and keep on driving.

,,,

Apparently a certain number actually support that very thing, which is what we legal gun owners can't understand. I'm glad to hear that you're not one of the supporters.

Yes, I have and yes, I can. I'm glad you don't see a problem with those like me owning guns. Those are the same people that I--and others--don't have a problem with, either! We do meet your criteria. Practically no one advocates that non-law-abiding people be allowed to own guns.

Where did you ever get such a strange misconception?

You may be happy to learn that passing a federal background check is required before purchasing any new gun in every state. It's federal law. "Straw purchases" (purchasing for another person) are illegal. When purchasing a used gun from anyone, it is illegal to sell to a prohibited person and it is illegal for a prohibited person to buy a gun. Some states have additional requirements and hoops to jump through. Many states have additional requirements before one can carry a gun outside the home. Some states or cities are ridiculously prohibitive. Chicago is one of the most restrictive. Compare their murder rate.

Again, no one wants convicted criminals, even those convicted one time, much less three times, to have a "sacred right" to own guns. Where did you get that notion?

We are in agreement on these things!

What remains is how to eliminate the desire and determination to commit violence or suicide. There is no simple answer.

[Guest219794]

i. Will. Not. Give. Up. My. Guns. Any of them to anyone.

That? Wasn't? My? Question?

When Charlton Heston made that quote famous, he was an actor playing the part of a zealot willing to die for what he finds sacred- his guns. There is no reason to think he was sincere- much like the person who played The Wicked Witch wasn't really a witch.

So, in your scenario, where you get to be the martyr for the noble cause, you die in a firefight. Presumably with the police. So, you are ready to die to keep your gattling gun or armor piercing bullets or whatever. Are you willing to kill a police officer over it? Or, in this scenario do you just go down in a hail of bullets, lovingly clutching your weapon- kind of a suicide by cop deal. You do realize that is what that particular meme means, right?

This is just rhetorical- I realize the character you play on line isn't going To. Give. A. Straight. Answer.

That whole punctuation thing really works for emphasis- thanks.

[OldDude]

The logical failure here is quoting "studies" done by biased, rabidly anti-gun organizations. The Brady center was initially organized as "handgun control inc".

You're never going to find middle-ground by quoting anti-gun zealots as reliable sources, then vilifying those that quote the NRA.

The 2nd amendment is way more important now than at any time in our country's previous history. We have at both the state and federal level- government that doesn't want to follow the law. Presidents, governors & legislators who actively subvert the will of the people by gerrymandering, over-ruling voters & trying to kneecap their successors when they lose elections.

You have for-profit prisons holding a higher percentage of the population in prison than Russia under Stalin, and for-profit policing that takes more property from citizens via seizure than criminals do via theft or robbery. Think about that.

Further, without a frank discussion about what happens when you try to separate the 400 million firearms from the 100 million Americans who lawfully own them, you're engaging in the silliest form of mental masturbation. The cat doesn't go back in the bag without leaving claw marks on the country.

If you think 10,000 intentional deaths a year by firearms is bad, think about what happens to an unarmed population under a totalitarian government.

Quite thought provoking.

[klone, MSN, RN]

As a European I really don't understand why so many Americans seem so infatuated with their firearms and the right to carry one whenever/wherever.

We call them "ammosexuals"

[OldDude]

We call them "ammosexuals"

I don't care what your view of the subject is...this is funny!!

[Kyrshamarks, BSN, RN]

What could be more straight than I won't give up my guns ever. Not to you, not to the the police or even the government. When they start to try confiscations by police, then we have become a totalitiarian society and it is our duty to stand up to it. I would fight and die for my rights and yours. I spent many years in the military doing just that. Oh wait...according to some in power that makes me onenof the largest group of terrorists. A white, ex military male gun owner...

[Jedrnurse, BSN, RN]

i. Will. Not. Give. Up. My. Guns. Any of them to anyone.

Very nuanced.

By the way, did anyone ask you for them?

[Farawyn]

What could be more straight than I won't give up my guns ever. Not to you, not to the the police or even the government. When they start to try confiscations by police, then we have become a totalitiarian society and it is our duty to stand up to it. I would fight and die for my rights and yours. I spent many years in the military doing just that. Oh wait...according to some in power that makes me onenof the largest group of terrorists. A white, ex military male gun owner...

You forgot the Zombies.

[Emergent, RN]

I have a concealed pistol permit and also own a shotgun for home protection. I rarely carry, mainly while camping and hiking.

Frankly, I believe mass media has fueled the modern attention seeking spree killings. The internet fosters and feeds the ideological fanaticism behind such things as the killings of the elderly Jews in the synagogue, the attack on the Republican legislators playing baseball, Islamic terrorism, etc. It also has exposed young people to all kinds of sexual deviancy and sadism. Should we consider banning it as well?

I, personally, don't see the purpose for individuals to own automatic weapons. Even if for the stated purpose in the constitution of raising a militia to oppose a government gone bad, you'd need more than guns to oppose the US armed forces. Are we going to allow the public to own rocket launchers and hand grenades? Under the principles cited by the NRA, we should.

I'm always for the middle, rational ground. Common sense tells me that there is more behind the explosion of gun violence than just guns, and that includes those who want to harm themselves.

[Farawyn]

I have a concealed pistol permit and also own a shotgun for home protection. I rarely carry, mainly while camping and hiking.

Frankly, I believe mass media has fueled the modern attention seeking spree killings. The internet fosters and feeds the ideological fanaticism behind such things as the killings of the elderly Jews in the synagogue, the attack on the Republican legislators playing baseball, Islamic terrorism, etc. It also had exposed young people to all kinds of sexual deviancy and sadism. Should we consider banning it as well?

I, personally, don't see the purpose for individuals to own automatic weapons. Even if for the stated purpose in the constitution of raising a militia to oppose a government gone bad, you'd need more than guns to oppose the US armed forces. Are we going to allow the public to own rocket launchers and hand grenades? Under the principles cited by the NRA, we should.

I'm always for the middle, rational ground. Common sense tells me that there is more behind the explosion of gun violence than just guns, and that includes those who want to harm themselves.

Well, with no money in federal mental health and social services, we may never know what those are.

It's much easier to blame the media.

[Emergent, RN]

Well, with no money in federal mental health and social services, we may never know what those are.

It's much easier to blame the media.

I think the poorly run welfare state is one negative factor in society. It has rewarded the breakdown of the family structure, and allowed a generation to sit on their butts, smoking pot, playing video games, consuming hot cheetos and soda pop on the pubic dime.

It had done very little to incentivize more wholesome lifestyles like marriage, family values, healthy eating and physical activity, all of which would improve mental and physical health.

[Farawyn]

I think the poorly run welfare state is one negative factor in society. It has rewarded the breakdown of the family structure, and allowed a generation to sit on their butts, smoking pot, playing video games, consuming hot cheetos and soda pop on the pubic dime.

It had done very little to incentivize more wholesome lifestyles like marriage, family values, healthy eating and physical activity, all of which would improve mental and physical health.

...And this has what to do with guns? Or getting accessible mental health help?

Does it matter to you that most of the mass shooters were middle class?

I also object to you listing marriage as a "wholesome family value" when over 1/2 of all marriages end in divorce.