The DOI matches its Crossref record; 17 of the 17 references it cites were found in a registry or an index.
Clinical strategies for reducing firearm suicide
Abstract
Suicide is complex, with psychiatric, cultural, and socioeconomic roots. Though mental illnesses like depression contribute to risk for suicide, access to lethal means such as firearms is considered a key risk factor for suicide, and half of suicides in the USA are by firearm. When a person at risk of suicide has access to firearms, clinicians have a range of options for intervention. Depending on the patient, the situation, and the access to firearms, counseling on storage practices, temporary transfer of firearms, or further intervention may be appropriate. In the USA, ownership of and access to firearms are common and discussing added risk of access to firearms for those at risk of suicide is not universally practiced. Given the burden of suicide (particularly by firearm) in the USA, the prevalence of firearm access, and the lethality of suicide attempts with firearms, we present the existing evidence on the burden of firearm suicide and what clinicians can do to reduce their patients’ risk. Specifically, we review firearm ownership in the USA, firearm injury epidemiology, risk factors for firearm-related harm, and available interventions to reduce patients’ risk of firearm injury and death.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Nearly 70% of those who died by violent suicide methods had never been treated for a mental health or substance use disorder.”
From A Moving Target: Firearm Deaths, Mental Health, and the Role of Physicians (2024) · cites this paper as [5]
In the citing paper
“Alarmingly, firearm suicides have increased by 24% over the past twenty years [5].”
From A Moving Target: Firearm Deaths, Mental Health, and the Role of Physicians (2024) · cites this paper as [5]
In the citing paper
“The rate of firearm suicides has continued to grow in the United States, even as firearm homicides have slightly declined.”
From A Moving Target: Firearm Deaths, Mental Health, and the Role of Physicians (2024) · cites this paper as [5]
In the citing paper
“In 2021, data from the NVDRS showed that among 45.5% of decedents with recorded blood alcohol concentration (BAC), 65% had a BAC greater than 0.08 g/dL.”
From A Moving Target: Firearm Deaths, Mental Health, and the Role of Physicians (2024) · cites this paper as [5]
In the citing paper
“suicide screening and clinical judgement should also target other high-risk populations, including heavy alcohol users and those with firearm access.”
From A Moving Target: Firearm Deaths, Mental Health, and the Role of Physicians (2024) · cites this paper as [5]
6 more claims about this paper
Create a free account to see every claim other papers make about this one.
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Suicide as an outcome for mental disorders: A meta-analysis
Harris, E. C., & Barraclough, B. (1997) · British Journal of Psychiatry · doi:10.1192/bjp.170.3.205 · Cited by 2,589
Psychological autopsy studies of suicide: a systematic review.
CAVANAGH, J. T. O., CARSON, A. J., SHARPE, M., & LAWRIE, S. M. (2003) · Psychological Medicine · doi:10.1017/s0033291702006943 · Cited by 2,207
Risk Factors for Femicide in Abusive Relationships: Results From a Multisite Case Control Study
Campbell, J. C., Webster, D., Koziol-McLain, J., Block, C., Campbell, D., Curry, M. A., Gary, F., Glass, N., McFarlane, J., Sachs, C., et al. (2003) · American Journal of Public Health · doi:10.2105/ajph.93.7.1089 · Cited by 1,550
Suicide risk and prevention during the COVID-19 pandemic
Gunnell, D., Appleby, L., Arensman, E., Hawton, K., John, A., Kapur, N., Khan, M., O'Connor, R. C., Pirkis, J., Appleby, L., et al. (2020) · The Lancet Psychiatry · doi:10.1016/s2215-0366(20)30171-1 · Cited by 1,513
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
The Lifetime Risk of Suicide in Schizophrenia: A Reexamination
Palmer, B. A., Pankratz, V. S., & Bostwick, J. M. (2005) · Archives of General Psychiatry · doi:10.1001/archpsyc.62.3.247 · Cited by 1,026
Anglemyer, A., Horvath, T., & Rutherford, G. (2014) · Annals of Internal Medicine · doi:10.7326/m13-1301 · Cited by 623
Suicidal behavior and alcohol abuse.
Pompili, M., Serafini, G., Innamorati, M., Dominici, G., Ferracuti, S., Kotzalidis, G. D., Serra, G., Girardi, P., Janiri, L., Tatarelli, R., et al. (2010) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph7041392 · Cited by 477
Reducing a Suicidal Person’s Access to Lethal Means of Suicide
Barber, C. W., & Miller, M. J. (2014) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2014.05.028 · Cited by 329
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
Research works printed but not linked: 66
- Anestis MD, Bond AE, Bryan AO, Bryan CJ. An examination of preferred messengers on firearm safety for suicide prevention. Prev Med. 2021;145:106452. · DOI
- Azrael D, Hepburn L, Hemenway D, Miller M. The stock and flow of US Firearms: results from the 2015 National Firearms Survey. RSF. 2017;3(5):38–57. · DOI
- Azrael D, Cohen J, Salhi C, Miller M. Firearm storage in gun-owning households with children: results of a 2015 national survey. J Urban Health. 2018;95(3):295–304. · DOI · Paper page
- Barber C, Frank E, Demicco R. Reducing suicides through partnerships between health professionals and gun owner groups—beyond Docs vs Glocks. JAMA Intern Med. 2017;177(1):5. · DOI
- Barber C, Goralnick E, Miller M. The problem with ICD -Coded firearm injuries. JAMA Intern Med. 2021;181(8):1132. · DOI
- Beidas RS, Rivara F, Rowhani-Rahbar A. Safe firearm storage: a call for research informed by firearm stakeholders. Pediatrics. 2020;146(5):e20200716. · DOI
- Berrigan J, Azrael D, Hemenway D, Miller M. Firearms training and storage practices among US gun owners: a nationally representative study. Inj Prev. 2019;25(Suppl 1):i31–8. · DOI
- Betz ME, Azrael D, Barber C, Miller M. Public opinion regarding whether speaking with patients about firearms is appropriate: results of a national survey. Ann Intern Med. 2016;165(8):543–50. · DOI
- Betz ME, McCourt AD, Vernick JS, Ranney ML, Maust DT, Wintemute GJ. Firearms and dementia: clinical considerations. Ann Intern Med. 2018;169(1):47. · DOI
- Betz ME, Azrael D, Johnson RL, Knoepke CE, Ranney ML, Wintemute GJ, et al. Views on firearm safety among caregivers of people with alzheimer disease and related dementias. JAMA Netw Open. 2020;3(7):e207756. · DOI
- Blair-West GW, Cantor CH, Mellsop GW, Eyeson-Annan ML. Lifetime suicide risk in major depression: sex and age determinants. J Affect Disord. 1999;55(2–3):171–8. · DOI
- Bongiorno DM, Kramer EN, Booty MD, Crifasi CK. Development of an online map of safe gun storage sites in Maryland for suicide prevention. Int Rev Psychiatry. 2020;1–5. · DOI
- Caine ED. Forging an agenda for suicide prevention in the United States. Am J Public Health. 2013;103(5):822–9. · DOI
- Carroll D, Kearney LK, Miller MA. Addressing suicide in the veteran population: engaging a public health approach. Front Psychiatry. 2020;11:569069. · DOI
- Cleveland EC, Azrael D, Simonetti JA, Miller M. Firearm ownership among American veterans: findings from the 2015 National Firearm Survey. Inj Epidemiol. 2017;4(1):33. · DOI
- Conner KR, Huguet N, Caetano R, Giesbrecht N, McFarland BH, Nolte KB, et al. Acute use of alcohol and methods of suicide in a US national sample. Am J Public Health. 2014;104(1):171–8. · DOI
- Conner A, Azrael D, Miller M. Firearm safety discussions between clinicians and U.S. adults living in households with firearms: results from a 2019 national survey. Ann Intern Med. 2020;M20-6314 · DOI
- Conwell Y, Duberstein PR, Connor K, Eberly S, Cox C, Caine ED. Access to firearms and risk for suicide in middle-aged and older adults. Am J Geriatr Psychiatry. 2002;10(4):407–16. · DOI · Paper page
- Crifasi CK, Doucette ML, McGinty EE, Webster DW, Barry CL. Storage practices of US gun owners in 2016. Am J Public Health. 2018;108(4):532–7. · DOI
- Dahlberg LL, Ikeda RM, Kresnow MJ. Guns in the home and risk of a violent death in the home: findings from a national study. Am J Epidemiol. 2004;160(10):929–36. · DOI
- for the FACTS Consortium, Ranney M, Karb R, Ehrlich P, Bromwich K, Cunningham R, et al. What are the long-term consequences of youth exposure to firearm injury, and how do we prevent them? A scoping review. J Behav Med. 2019;42(4):724–40. · DOI
- Frattaroli S, Sharfstein JM. Extreme risk protection orders—a tool for clinicians to prevent gun violence. JAMA Health Forum. 2021;2(4):e210948. · DOI
- Gibbons MJ, Fan MD, Rowhani-Rahbar A, Rivara FP. Legal liability for returning firearms to suicidal persons who voluntarily surrender them in 50 US states. Am J Public Health. 2020;e1–4. · DOI
- Goodwin FK. Suicide risk in bipolar disorder during treatment with lithium and divalproex. JAMA. 2003;290(11):1467. · DOI · Paper page
- Grinshteyn E, Hemenway D. Violent death rates: the US compared with other high-income OECD countries, 2010. Am J Med. 2016;129(3):266–73. · DOI · Paper page
- Grossman DC, Mueller BA, Riedy C, Dowd MD, Villaveces A, Prodzinski J, et al. Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293(6):707–14. · DOI · Paper page
- Günak MM, Barnes DE, Yaffe K, Li Y, Byers AL. Risk of suicide attempt in patients with recent diagnosis of mild cognitive impairment or dementia. JAMA Psychiat. 2021;78(6):659. · DOI
- Hawk M, Coulter RWS, Egan JE, Fisk S, Reuel Friedman M, Tula M, et al. Harm reduction principles for healthcare settings. Harm Reduct J. 2017;14(1):70. · DOI · Paper page
- Hedman LC, Petrila J, Fisher WH, Swanson JW, Dingman DA, Burris S. State laws on emergency holds for mental health stabilization. PS. 2016;67(5):529–35. · DOI
- Hemenway D, Nelson E. The scope of the problem: gun violence in the USA. Curr Trauma Rep. 2020;6(1):29–35. · DOI
- Hooley JM, Franklin JC, Nock MK. Chronic pain and suicide: understanding the association. Curr Pain Headache Rep. 2014;18(8):435. · DOI
- Johnson RM, Barber C, Azrael D, Clark DE, Hemenway D. Who are the owners of firearms used in adolescent suicides? Suicide Life Threat Behav. 2010;40(6):609–11. · DOI
- Kaplan MS, McFarland BH, Huguet N, Conner K, Caetano R, Giesbrecht N, et al. Acute alcohol intoxication and suicide: a gender-stratified analysis of the National Violent Death Reporting System. Inj Prev. 2013;19(1):38–43. · DOI
- Kivisto AJ, Phalen PL. Effects of risk-based firearm seizure laws in Connecticut and Indiana on suicide rates, 1981–2015. Psychiatr Serv. 2018;appips201700250. · DOI
- Lindsey MA, Sheftall AH, Xiao Y, Joe S. Trends of suicidal behaviors among high school students in the United States: 1991–2017. Pediatrics. 2019;144(5):e20191187. · DOI · Paper page
- Marino E, Wolsko C, Keys SG, Pennavaria L. A culture gap in the United States: implications for policy on limiting access to firearms for suicidal persons. J Public Health Policy. 2016;37(Suppl 1):110–21. · DOI
- Marino E, Wolsko C, Keys S, Wilcox H. Addressing the cultural challenges of firearm restriction in suicide prevention: a test of public health messaging to protect those at risk. Arch Suicide Res. 2018;22(3):394–404. · DOI
- Mauri AI, Wolfson JA, Azrael D, Miller M. Firearm storage practices and risk perceptions. Am J Prev Med. 2019;57(6):830–5. · DOI
- Mertens B, Sorenson SB. Current considerations about the elderly and firearms. Am J Public Health. 2012;102(3):396–400. · DOI
- Miller M, Barber C, White RA, Azrael D. Firearms and suicide in the United States: is risk independent of underlying suicidal behavior? Am J Epidemiol. 2013;178(6):946–55. · DOI · Paper page
- Pallin R, Spitzer SA, Ranney ML, Betz ME, Wintemute GJ. Preventing firearm-related death and injury. Ann Intern Med. 2019a;170(11):ITC81. · DOI
- Pallin R, Siry B, Azrael D, Knoepke CE, Matlock DD, Clement A, et al. “Hey, let me hold your guns for a while”: a qualitative study of messaging for firearm suicide prevention. Behav Sci Law. 2019b;37(3):259–69. · DOI
- Pallin R, Charbonneau A, Wintemute GJ, Kravitz-Wirtz N. California public opinion on health professionals talking with patients about firearms. Health Aff. 2019c;38(10):1744–51. · DOI
- Polzer ER, Nearing K, Knoepke CE, Matlock DD, Azrael D, Siry BJ, et al. “Safety in dementia”: development of an online caregiver tool for firearm, driving, and home safety. J Am Geriatr Soc. 2020;68(9):2137–9. · DOI
- Polzer E, Nearing K, Knoepke CE, Matlock DD, McCourt A, Betz ME. Firearm access in dementia: legal and logistic challenges for caregivers. Int Rev Psychiatry. 2021;1–9. · DOI
- Rowhani-Rahbar A, Simonetti JA, Rivara FP. Effectiveness of interventions to promote safe firearm storage. Epidemiol Rev. 2016;38(1):111–24.
- Schleimer JP, Kravitz-Wirtz N, Pallin R, Charbonneau AK, Buggs SA, Wintemute GJ. Firearm ownership in California: a latent class analysis. Inj Prev. 2019;injuryprev–2019–043412. · DOI
- Schleimer JP, McCort CD, Pear VA, Shev A, Tomsich E, Asif-Sattar R, et al. Firearm purchasing and firearm violence in the first months of the coronavirus pandemic in the United States [Internet]. Epidemiology; 2020 Jul [cited 2020 Jul 21]. Available from: https://doi.org/10.1101/2020.07.02.20145508 · DOI
- Serafini G, Calcagno P, Lester D, Girardi P, Amore M, Pompili M. Suicide risk in Alzheimer’s disease: a systematic review. CAR. 2016;13(10):1083–99. · DOI
- Shah S, Hoffman RE, Wake L, Marine WM. Adolescent suicide and household access to firearms in Colorado: results of a case-control study. J Adolesc Health. 2000;26(3):157–63. · DOI
- Simon TR, Swann AC, Powell KE, Potter LB, Kresnow M, O’Carroll PW. Characteristics of impulsive suicide attempts and attempters. Suicide Life Threat Behav. 2002;32:49–59. · DOI · Paper page
- Simonetti JA, Azrael D, Rowhani-Rahbar A, Miller M. 2018. Firearm storage practices among American veterans. Am J Prev Med. 2018. · DOI
- Simonetti JA, Dorsey Holliman B, Holiday R, Brenner LA, Monteith LL. Firearm-related experiences and perceptions among United States male veterans: a qualitative interview study. PLoS ONE. 2020;15(3):e0230135. · DOI
- Simonetti JA, Piegari R, Maynard C, Brenner LA, Mori A, Post EP, et al. Characteristics and injury mechanisms of veteran primary care suicide decedents with and without diagnosed mental illness. J GEN INTERN MED [Internet]. 2020 Mar 26 [cited 2020 Apr 8]; Available from: https://doi.org/10.1007/s11606-020-05787-1. · DOI
- Soloff PH. Characteristics of suicide attempts of patients with major depressive episode and borderline personality disorder: a comparative study. Am J Psychiatry. 2000;157(4):601–8. · DOI · Paper page
- Spangenberg KB, Wagner MT, Hendrix S, Bachman DL. Firearm presence in households of patients with Alzheimer’s disease and related dementias. J Am Geriatr Soc. 1999;47(10):1183–6. · DOI
- Stroebe W. Firearm possession and violent death: a critical review. Aggress Violent Behav. 2013;18(6):709–21. · DOI
- Swanson JW, Sampson NA, Petukhova MV, Zaslavsky AM, Appelbaum PS, Swartz MS, et al. Guns, impulsive angry behavior, and mental disorders: results from the national comorbidity survey replication (NCS-R): guns, impulsive angry behavior, and mental disorders. Behav Sci Law. 2015a;33(2–3):199–212. · DOI
- Swanson JW, McGinty EE, Fazel S, Mays VM. Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Ann Epidemiol. 2015b;25(5):366–76. · DOI · Paper page
- Swanson JW, Norko MA, Lin H-J, Frisman LK, Baranoski MV, Easter MM, et al. Implementation and effectiveness of Connecticut’s risk-based gun removal law: does it prevent suicides? Law Contemp Probl. 2017;80(2):179–208.
- Swanson JW, Nestadt PS, Barnhorst AV, Frattaroli S. Risk-based temporary firearm removal orders: a new legal tool for clinicians. Harv Rev Psychiatry. 2021;29(1):6–9. · DOI
- Theis J, Hoops K, Booty M, Nestadt P, Crifasi C. Firearm suicide among veterans of the U.S. military: a systematic review. Mil Med. 2021;186(5–6):e525–36. · DOI
- Valenstein M, Walters H, Pfeiffer PN, Ganoczy D, Miller M, Fiorillo M, et al. Acceptability of potential interventions to increase firearm safety among patients in VA mental health treatment. Gen Hosp Psychiatry. 2018;55:77–83. · DOI
- Wertz J, Azrael D, Hemenway D, Sorenson S, Miller M. Differences between new and long-standing US gun owners: results from a national survey. Am J Public Health. 2018;108(7):871–7. · DOI
- Wintemute GJ. Association between firearm ownership, firearm-related risk and risk reduction behaviours and alcohol-related risk behaviours. Inj Prev. 2011;17(6):422–7. · DOI
- Wintemute GJ. What you can do to stop firearm violence. Ann Intern Med. 2017;167(12):886–7. · DOI
Cited by
Shinan-Altman, S., Elyoseph, Z., & Levkovich, I. (2024) · PeerJ · doi:10.7717/peerj.17468 · Cited by 21
A Moving Target: Firearm Deaths, Mental Health, and the Role of Physicians
Soliman, L., Baines-Waiz, O., Rozel, J. S., Blankenship, K., & Rachal, J. (2024) · Current Psychiatry Reports · doi:10.1007/s11920-024-01569-2 · Cited by 1
Metadata
- Authors
- Pallin, R., & Barnhorst, A.
- Venue
- Injury Epidemiology
- Published
- 2021-10-04
- Volume
- 8
- Issue
- 1
- ISSN
- 2197-1714
- Cited by
- 22
- References
- 17
- Language
- en
- Licence
- creativecommons.org/licenses/by/4.0 (tdm)
- creativecommons.org/licenses/by/4.0 (vor)
- Funders
- university of california firearm violence research center at uc davis (university of california firearm violence research center at uc davis)
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
Data sources
Bibliographic data: Semantic Scholar, OpenAlex, Crossref.
Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.