Youth suicide is preventable.
A 16-year-old dies by suicide using a handgun owned by a parent. The teenager was getting good grades and was active on a school sports team. They left a note describing being bullied. There was no previous diagnosis of a mental health disorder or any signs of mental health distress.
What if this teenager didn’t have access to a firearm? Would the outcome have been different?
Suicide and firearms
Suicide is the second-leading cause of death among youth and young adults in America.
Firearms are the most common method of youth suicide.
In 2023, there were 6,417 suicides among 10- to 24-year-olds:
- 54% (3,460) by firearm
- 30% (1,791) by suffocation
- 9% (572) by poisoning
Means matter
Youth suicide is a tragedy with lasting repercussions for the youth’s family and larger community. But youth suicide is preventable if there are barriers to accessing lethal means.
Suicide is often an impulsive act as a response to a stressor or acute incident, like breaking up with a romantic partner or failing an important test. Most individuals act in less than 60 minutes from when they first consider suicide. Thus, preventing immediate access to lethal means — like firearms and medications — is critical.
When a person attempts suicide by overdosing on medications, symptoms usually develop and, with medical care, more than 90% survive.
That is not true with firearms. When a person uses a firearm for suicide, over 90% of the time that person will die. Often, they won’t even make it to the hospital.
That is why, for suicide prevention, “means matter.” Without addressing firearm access, suicide prevention efforts aren’t addressing youth suicide prevention.
Using data for prevention and advocacy
Although national statistics are important, state and local data are essential for informing prevention programs and advocacy efforts. From 2016-2021, suicide accounted for more than 50% of all firearm deaths among 10- to 19-year-olds in 19 states and among young adults ages 20-24 in 24 states. Especially in these states, policies that create barriers to unauthorized firearm access for youth are critical for suicide prevention.
Applying the public health framework
The Blueprint for Youth Suicide Prevention uses the public health framework to outline a multi-layered approach for prevention, which must include addressing youth access to firearms.
- Primary prevention: Health care systems should provide resources to educate patients and families about mental health and suicide prevention. This includes education about preventing unauthorized access to firearms in the home, even in the absence of known suicide risk.
- Selective prevention: Health care systems should screen patients for suicide risk, provide mental health resources and lethal means counseling, and partner with schools for mental health support and resources.
- Indicated prevention: For patients with acute suicide risk, health care systems should provide acute care and coordinated follow-up, including lethal means safety planning. This involves discussing firearm removal from the home with out-of-home options such as local firearm retailers, shooting ranges, self-storage rental units, law enforcement, armories, and pawn shops.
- Treatment: Health care systems should optimize mental health care and incorporate suicide risk assessment and firearm safety planning.
- Recovery: Health care systems should ensure follow-up care and connect families with community-based resources.
Importance of advocacy
In addition to using the public health framework for youth suicide prevention, health care systems and professionals should advocate for policies to decrease unauthorized access to firearms.
Sometimes talking directly about firearm injury prevention can be challenging, but framing the conversation around youth mental health and suicide can be an effective entry to the discussion. Local data can further emphasize the case for addressing firearm access in suicide prevention efforts at the community level.
Health systems level: Health care systems should incorporate lethal means counseling and safety planning, when indicated, into suicide prevention protocols.
Local and state levels: Local and state data on firearm suicide should inform advocacy for both mental health resources and policies that reduce unauthorized youth access to firearms. This includes advocating for legislation on child access prevention, three-day waiting periods, age limits for purchase, universal background checks, secure storage for firearms, and extreme risk protection orders (ERPOs).
Federal level: We should continue to advocate and call for increased funding for firearm injury prevention research, including studies focused on youth suicide.
Using local data helps to tell a compelling story of why firearm access must be addressed in your community for suicide prevention.
It is essential health care systems — especially children’s hospitals — advocate for policies that help prevent youth suicide and firearm injury to address this crisis.
