Naomi Judd, guns, and suicide: Public health and the 2nd Amendment

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America loves its guns, even though that love affair is killing us.

If you own a gun, don’t worry. I’m not coming after them. I know of many nonreligious folks, like Seth Andrews, the popular Thinking Atheist podcaster, who own firearms.

But as a secular humanist, don’t you want to live a life guided by empirical data, rather than by unassailable belief in our Second Amendment right? We walk by sight, not by faith.

And this gun issue is a public health issue.

Thursday’s disclosure that country singer Naomi Judd ended her life with a firearm makes this conversation timely. But sadly, this issue stays evergreen in America (and I’m not even addressing the two major shootings over the weekend: at a Buffalo grocery store and a California church).

We need to talk statistics to demonstrate why this is the case. The CDC reports that in 2020, the last year for which they have data, there were 45,979 suicides in the United States. A firearm was used in more than half of these deaths (24,292). This exceeds the number of firearm homicides by nearly 5,000.

We also know that 85-90% of those employing a firearm to attempt suicide are “successful” in ending their lives.* My own experience as a psychiatrist backs up this statistic. I’ve lost track of the patients I’ve treated whose attempts with prescribed medication, illegal drugs, or sliced blood vessels thankfully failed. In 28 years, I have only seen one person whose firearm discharge didn’t take her life, and a tiny handful of survivors whose weapon misfired or whose game of Russian roulette came up empty.

There are commonly mixed feelings in a desperate person’s effort to end their life. A firearm renders moot any such ambivalence. Those using less lethal methods will often reconsider their deadly intent and live to tell about it.

If we break the numbers down further, states with more guns have higher suicide rates. And if a home contains a firearm, a suicide is three times more likely to occur within its four walls.

Inevitably, this information is met with a rebuttal about the firearm’s place in one’s home for protection of self and family. I’ll respond with this quote from an article in the Journal of Trauma:

For every time a gun in the home was used in a self-defense or legally justifiable shooting, there were four unintentional shootings, seven criminal assaults or homicides, and 11 attempted or completed suicides.

If I were a betting man, I wouldn’t care for those 22-to-1 odds.

Perceptive eyes will note this article dates from 1998. In the medical publishing world, that’s ancient history. But here’s the rub. In 1996, our US Congress—reacting to heavy lobbying from the NRA—placed a gag on gun safety research that remained in place until the fiscal year 2020.

How effective was that gag? According to a 2017 study from the Journal of the American Medical Association, from 2004 to 2015, gun violence was the least researched among the 30 leading causes of death in America. Firearms cause as many deaths yearly as sepsis (systemic blood infection), but gun violence studies only received 0.4% of the funding.

The Second Amendment looks like it’s here to stay, and 40% of American adults live in a home with a firearm. In this milieu, what steps can we take toward better suicide prevention?

First, if you’re a healthcare professional, talk to your mentally ill patients and their families about firearm safety. Too many of us skirt around this issue or avoid it altogether. But individuals who receive such counsel are three times more likely to enact better safety practices.

If you love someone with mental illness who owns firearms, please talk with them about removing guns from their home. If they suffer from psychiatric problems chronically, this is best construed as a long-term solution. If they’re in an acute crisis, urge them to allow this at least till the storm has receded far into the distance. Some gun stores or shooting ranges will house weapons temporarily. Out-of-home storage is preferable, but keeping them in an at-home gun safe to which they lack the combination is better than no intervention.

If you possess firearms and share a roof with someone battling psychiatric illness—or if you struggle with a condition like depression, severe anxiety, or bipolar disorder—please implement these steps for yourself. Human lives are infinitely more valuable than gun ownership or loyalty to the Second Amendment.

*Statistics without a link came from a lecture delivered at the 2021 Psych Congress, courtesy of the Suicide Prevention 360 initiative. This is a collaborative effort between Psych Congress and the American Foundation for Suicide Prevention.