The DOI matches its Crossref record; 64 of the 66 references it cites were found in a registry or an index.
Reducing a Suicidal Person’s Access to Lethal Means of Suicide
Open accessAbstract
Reducing the availability of highly lethal and commonly used suicide methods has been associated with declines in suicide rates of as much as 30%-50% in other countries. The theory and evidence underlying means restriction is outlined. Most evidence of its efficacy comes from population-level interventions and natural experiments. In the U.S., where 51% of suicides are completed with firearms and household firearm ownership is common and likely to remain so, reducing a suicidal person's access to firearms will usually be accomplished not by fiat or other legislative initiative but rather by appealing to individual decision, for example, by counseling at-risk people and their families to temporarily store household firearms away from home or otherwise making household firearms inaccessible to the at-risk person until they have recovered. Providers, gatekeepers, and gun owner groups are important partners in this work. Research is needed in a number of areas: communications research to identify effective messages and messengers for "lethal means counseling," clinical trials to identify effective interventions, translational research to ensure broad uptake of these interventions across clinical and community settings, and foundational research to better understand method choice and substitution. Approaches to suicide methods other than firearms are discussed. Means restriction is one of the few empirically based strategies to substantially reduce the number of suicide deaths.
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Cites
Fatal and non-fatal repetition of self-harm: Systematic review
Owens, D., Horrocks, J., & House, A. (2002) · British Journal of Psychiatry · doi:10.1192/bjp.181.3.193 · Cited by 1,241
Suicide in the Home in Relation to Gun Ownership
Kellermann, A. L., Rivara, F. P., Somes, G. W., Reay, D. T., Francisco, J. T., Banton, J. G., Prodzinski, J., Fligner, C. L., & Hackman, B. B. (1992) · New England Journal of Medicine · doi:10.1056/nejm199208133270705 · Cited by 809
Role of media reports in completed and prevented suicide: Werther v. Papageno effects
Niederkrotenthaler, T., Voracek, M., Herberth, A., Till, B., Strauss, M., Etzersdorfer, E., Eisenwort, B., & Sonneck, G. (2010) · British Journal of Psychiatry · doi:10.1192/bjp.bp.109.074633 · Cited by 719
Gun Storage Practices and Risk of Youth Suicide and Unintentional Firearm Injuries
Grossman, D. C. (2005) · JAMA · doi:10.1001/jama.293.6.707 · Cited by 684
Means restriction for suicide prevention
Yip, P. S., Caine, E., Yousuf, S., Chang, S.-S., Wu, K. C.-C., & Chen, Y.-Y. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60521-2 · Cited by 551
Characteristics of Impulsive Suicide Attempts and Attempters
Simon, T. R., Swann, A. C., Powell, K. E., Potter, L. B., Kresnow, M., & O'Carroll, P. W. (2002) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.32.1.5.49.24212 · Cited by 548
New data on the nature of suicidal crises in college students: Shifting the paradigm.
Drum, D. J., Brownson, C. B., Denmark, A. B., & Smith, S. E. (2009) · Professional Psychology Research and Practice · doi:10.1037/a0014465 · Cited by 532
Suicide acts in 8 states: incidence and case fatality rates by demographics and method
Spicer, R. S., & Miller, T. R. (2000) · American Journal of Public Health · doi:10.2105/ajph.90.12.1885 · Cited by 491
The Presence and Accessibility of Firearms in the Homes of Adolescent Suicides
Brent, D. A. (1991) · JAMA · doi:10.1001/jama.266.21.2989 · Cited by 456
The coal gas story. United Kingdom suicide rates, 1960-71.
Kreitman, N. (1976) · Journal of Epidemiology & Community Health · doi:10.1136/jech.30.2.86 · Cited by 451
The impact of pesticide regulations on suicide in Sri Lanka
Gunnell, D., Fernando, R., Hewagama, M., Priyangika, W. D. D., Konradsen, F., & Eddleston, M. (2007) · International Journal of Epidemiology · doi:10.1093/ije/dym164 · Cited by 378
The epidemiology and prevention of suicide by hanging: a systematic review
Gunnell, D., Bennewith, O., Hawton, K. E., Simkin, S., & Kapur, N. (2005) · International Journal of Epidemiology · doi:10.1093/ije/dyh398 · Cited by 353
Deisenhammer, E. A., Ing, C.-M., Strauss, R., Kemmler, G., Hinterhuber, H., & Weiss, E. M. (2009) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.07m03904 · Cited by 315
Suicide prevention by limiting access to methods: A review of theory and practice
Florentine, J. B., & Crane, C. (2010) · Social Science & Medicine · doi:10.1016/j.socscimed.2010.01.029 · Cited by 285
Hawton, K., Bergen, H., Simkin, S., Dodd, S., Pocock, P., Bernal, W., Gunnell, D., & Kapur, N. (2013) · BMJ · doi:10.1136/bmj.f403 · Cited by 273
Surveillance for Fatal and Nonfatal Injuries--United States, 2001
Vyrostek, S. B., Annest, J. L., & Ryan, G. W. (2004) · PsycEXTRA Dataset · doi:10.1037/e307172005-001 · Cited by 265
Miller, M., Azrael, D., & Barber, C. (2012) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-031811-124636 · Cited by 265
Self-citationSuicide prevention through means restriction: Assessing the risk of substitution
Daigle, M. S. (2005) · Accident Analysis & Prevention · doi:10.1016/j.aap.2005.03.004 · Cited by 263
Access to Firearms and Risk for Suicide in Middle-Aged and Older Adults
Conwell, Y., Duberstein, P. R., L.Connor, K., Eberly, S. W., Cox, C., & Caine, E. D. (2002) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200207000-00007 · Cited by 263
Household Firearm Ownership and Rates of Suicide Across the 50 United States
Miller, M., Lippmann, S., Azrael, D. R., & Hemenway, D. (2007) · The Journal of Trauma: Injury, Infection, and Critical Care · doi:10.1097/01.ta.0000198214.24056.40 · Cited by 259
Suicide and violence prevention: Parent education in the emergency department
Kruesi, M. J. P., Grossman, J., Pennington, J. M., Woodward, P. J., Duda, D., & Hirsch, J. G. (1999) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199903000-00010 · Cited by 251 · cited 1×
“A small body of literature on parents of youth with psychiatric problems suggests that families who were counseled to reduce access to firearms andmedications at home were more likely to do so than those not receiving such counseling.(55,58,59) This is encouraging, but more intervention research is needed in three bro…”
BackgroundGuns in the Home and Risk of a Violent Death in the Home: Findings from a National Study
Dahlberg, L. L. (2004) · American Journal of Epidemiology · doi:10.1093/aje/kwh309 · Cited by 250
Deisenhammer, E., Ing, C.-M., Strauss, R., Kemmler, G., Hinterhuber, H., & Weiss, E. M. (2009) · PubMed · Cited by 237
Mortality among Recent Purchasers of Handguns
Wintemute, G. J., Parham, C. A., Beaumont, J. J., Wright, M. A., & Drake, C. (1999) · New England Journal of Medicine · doi:10.1056/nejm199911183412106 · Cited by 215
Hawton, K. (2007) · Crisis · doi:10.1027/0227-5910.28.s1.4 · Cited by 162
Lubin, G., Werbeloff, N., Halperin, D., Shmushkevitch, M., Weiser, M., & Knobler, H. Y. (2010) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2010.40.5.421 · Cited by 159
Miller, M., Azrael, D. R., Hepburn, L. H., Hemenway, D., & Lippmann, S. (2006) · Injury Prevention · doi:10.1136/ip.2005.010850 · Cited by 154
Reisch, T., Steffen, T., Habenstein, A., & Tschacher, W. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.12091256 · Cited by 141
Choice of Poison for Intentional Self-Poisoning in Rural Sri Lanka
Eddleston, M., Karunaratne, A., Weerakoon, M., Kumarasinghe, S., Rajapakshe, M., Sheriff, M. H. R., Buckley, N. A., & Gunnell, D. (2006) · Clinical Toxicology · doi:10.1080/15563650600584444 · Cited by 129
Brent, D. A., BAUGHER, M., Birmaher, B. B., Kolko, D. J., & Bridge, J. A. (2000) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-200010000-00007 · Cited by 126
Risk factors for male and female suicide decedents ages 15–64 in the United States
Kung, H.-C., Pearson, J. L., & Liu, X. (2003) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s00127-003-0656-x · Cited by 125
Brent, D. A. (2001) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.2001.tb05808.x · Cited by 122
The effectiveness of structural interventions at suicide hotspots: a meta-analysis
Pirkis, J., Spittal, M. J., Cox, G., Robinson, J., Cheung, Y. T. D., & Studdert, D. (2013) · International Journal of Epidemiology · doi:10.1093/ije/dyt021 · Cited by 114
Who are the Owners of Firearms Used in Adolescent Suicides?
Johnson, R. M., Barber, C. W., Azrael, D. R., Clark, D. E., & Hemenway, D. (2010) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2010.40.6.609 · Cited by 109
Gunnell, D., Middleton, N., & Frankel, S. (2000) · Social Psychiatry and Psychiatric Epidemiology · doi:10.1007/s001270050261 · Cited by 107
Mental Illness, Previous Suicidality, and Access to Guns in the United States
Ilgen, M. A., Zivin, K., McCammon, R. J., & Valenstein, M. M. (2008) · Psychiatric Services · doi:10.1176/ps.2008.59.2.198 · Cited by 97
Betz, M. E., Miller, M., Barber, C. W., Miller, I., Sullivan, A. F., Camargo, C. A., Boudreaux, E. D., & on behalf of the ED-SAFE Investigators (2013) · Depression and Anxiety · doi:10.1002/da.22075 · Cited by 97
Miller, M., Barber, C., Azrael, D. R., Hemenway, D., & Molnar, B. E. (2009) · Injury Prevention · doi:10.1136/ip.2008.021352 · Cited by 96
McManus, B. L., Kruesi, M. J. P., Dontes, A., DeFazio, C. R., Piotrowski, J. T., & Woodward, P. J. (1997) · The American Journal of Emergency Medicine · doi:10.1016/s0735-6757(97)90124-8 · Cited by 91
Okoro, C. A., Nelson, D. E., Mercy, J. A., Balluz, L. S., Crosby, A. E., & Mokdad, A. H. (2005) · PEDIATRICS · doi:10.1542/peds.2005-0300 · Cited by 90
Changes in rates of suicide by car exhaust asphyxiation in England and Wales
Amos, T., Appleby, L., & Kiernan, K. (2001) · Psychological Medicine · doi:10.1017/s0033291701003920 · Cited by 90
Suicidal Behavior and Firearm Access: Results from the Second Injury Control and Risk Survey
Betz, M. E., Barber, C. W., & Miller, M. (2011) · Suicide and Life-Threatening Behavior · doi:10.1111/j.1943-278x.2011.00036.x · Cited by 85
Hawton, K. E., Bergen, H. A., Simkin, S., Wells, C., Kapur, N., & Gunnell, D. (2012) · PLoS Medicine · doi:10.1371/journal.pmed.1001213 · Cited by 82
Johnson, R. M., Frank, E. M., Ciocca, M., & Barber, C. W. (2011) · Archives of Suicide Research · doi:10.1080/13811118.2011.589727 · Cited by 75
A Suicide Prevention Campaign for Firearm Dealers in N ew H ampshire
Vriniotis, M. G., Barber, C. W., Frank, E., Demicco, R., & Coalition, T. N. H. F. S. (2014) · Suicide and Life-Threatening Behavior · doi:10.1111/sltb.12123 · Cited by 65
Restrictions in Means for Suicide: An Effective Tool in Preventing Suicide: The Danish Experience
Nordentoft, M., Qin, P., Helweg‐Larsen, K., & Juel, K. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.6.688 · Cited by 64
Feasibility and acceptability of interventions to delay gun access in VA mental health settings.
Walters, H. M., Kulkarni, M. R., Forman, J., Roeder, K. M., Travis, J., & Valenstein, M. (2012) · General Hospital Psychiatry · doi:10.1016/j.genhosppsych.2012.07.012 · Cited by 62
Effect of a barrier at Bloor Street Viaduct on suicide rates in Toronto: natural experiment
Sinyor, M., & Levitt, A. J. (2010) · BMJ · doi:10.1136/bmj.c2884 · Cited by 60
Preventive Strategies on Suicide
(1995) · BRILL eBooks · doi:10.1163/9789004665088 · Cited by 48
Limiting paracetamol pack size: has it worked in the UK?
Bateman, D. N. (2009) · Clinical Toxicology · doi:10.1080/15563650903093192 · Cited by 48
The effects of detoxification of domestic gas on suicide in the United States.
Lester, D. (1990) · American Journal of Public Health · doi:10.2105/ajph.80.1.80 · Cited by 47
A follow-up study of attempted railway suicides
O’Donnell, I., Arthur, A. J., & Farmer, R. D. J. (1994) · Social Science & Medicine · doi:10.1016/0277-9536(94)90444-8 · Cited by 44
The effect of the detoxification of domestic gas in Switzerland on the suicide rate
Lester, D. S. (1990) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1990.tb01406.x · Cited by 42
Mental Health and Firearms in Community-Based Surveys
Sorenson, S. B., & Vittes, K. A. (2008) · Evaluation Review · doi:10.1177/0193841x08315871 · Cited by 40
Deliberate Exposure to Motor Vehicle Exhaust Gas: The Psychosocial Profile of Attempted Suicide
Skopek, M., & Perkins, R. (1998) · Australian & New Zealand Journal of Psychiatry · doi:10.3109/00048679809073873 · Cited by 39
Giggie, M. A., Olvera, R. L., & JOSHI, M. N. (2007) · Journal of Psychiatric Practice · doi:10.1097/01.pra.0000281485.96698.6d · Cited by 39
Lester, D., & Abe, K. (1989) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1989.tb01324.x · Cited by 36
Studdert, D. M., Gurrin, L. C., Jatkar, U., & Pirkis, J. (2010) · PLoS Medicine · doi:10.1371/journal.pmed.1000210 · Cited by 30
Gunnell, D., & Miller, M. (2010) · BMJ · doi:10.1136/bmj.c3054 · Cited by 25
A truly national National Violent Death Reporting System
Barber, C. W., Azrael, D. R., & Hemenway, D. (2013) · Injury Prevention · doi:10.1136/injuryprev-2013-040817 · Cited by 21
Effects of Detoxification of Domestic Gas on Suicide in the Netherlands
Lester, D. (1991) · Psychological Reports · doi:10.2466/pr0.1991.68.1.202 · Cited by 18
Mokdad, A. H., Okoro, C. A., Nelson, D. E., Mercy, J. A., Balluz, L. S., & Eigenstetter, A. (2005) · Cited by 18
Messer, S. B., & Meinster, M. O. (1980) · Journal of Clinical Psychology · doi:10.1002/1097-4679(198001)36:1 · Cited by 16
Trends in the methods used for suicide in Northern Ireland.
Curran, P. S., & Lester, D. (1991) · PubMed · Cited by 13
Research works printed but not linked: 1
- Vyrostek, 2004, Surveillance for fatal and nonfatal injuries–U.S., 2001, MMWR Surveill Summ, 53, 1
Cited by
Sorted by citations
Naghavi, M. (2019) · BMJ · doi:10.1136/bmj.l94 · Cited by 1,043
The global burden of fatal self-poisoning with pesticides 2006-15: Systematic review
Mew, E. J., Padmanathan, P., Konradsen, F., Eddleston, M., Chang, S.-S., Phillips, M. R., & Gunnell, D. (2017) · Journal of Affective Disorders · doi:10.1016/j.jad.2017.05.002 · Cited by 530
Trends in Suicide Among Youth Aged 10 to 19 Years in the United States, 1975 to 2016
Ruch, D. A., Sheftall, A. H., Schlagbaum, P., Rausch, J., Campo, J. V., & Bridge, J. A. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.3886 · Cited by 303
Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study
Conner, A., Azrael, D., & Miller, M. (2019) · Annals of Internal Medicine · doi:10.7326/m19-1324 · Cited by 286
Self-citationThe three-step theory of suicide: Description, evidence, and some useful points of clarification
Klonsky, E. D., Pachkowski, M. C., Shahnaz, A., & May, A. M. (2021) · Preventive Medicine · doi:10.1016/j.ypmed.2021.106549 · Cited by 256
Metadata
- Authors
- Barber, C. W., & Miller, M. J.
- Affiliations
- Harvard University (US)
- Corresponding author
- Barber, Catherine W.
- ORCID
- Barber, Catherine W.
- Venue
- American Journal of Preventive Medicine
- Publisher
- Elsevier BV
- Published
- 2014-09
- Volume
- 47
- Issue
- 3
- Pages
- S264-S272
- ISSN
- 0749-3797 (ISSN-L)
- OpenAlex
- W2121004493
- Cited by
- 329
- References
- 66
- Citations by year
- 2026: 21 · 2025: 26 · 2024: 40 · 2023: 24 · 2022: 32 · 2021: 42 · 2020: 34 · 2019: 29 · 2018: 24 · 2017: 24 · 2016: 21 · 2015: 10 · 2014: 1
- FWCI
- 22.43
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Preventive Medicine (publishedVersion)
- PubMed (publishedVersion)
- Americanae (AECID Library) (publishedVersion, other-oa)
- UCL Discovery (University College London) (submittedVersion)
- LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, cc-by-nc-sa)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Health › Gun Ownership and Violence Research
- Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
- Keywords
- suicide prevention, means restriction, firearm access, household firearms, suicide methods, gatekeepers, at-risk individuals, suicide rates
- MeSH terms
- Suicide Prevention, Clinical Trials as Topic, Firearms, Humans, Ownership, Research, Risk Factors, Suicide, Suicide, Attempted, United States, Information Dissemination, Translational Research, Biomedical
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