Wednesday, August 19, 2015

Guns, media and suicide: What providers need to know

By Dr. Jane Pearson, National Institute of Mental Health & Action Alliance; Cathy Barber, MPA, Harvard School of Public Health; Dr. Dan Reidenberg, Suicide Awareness Voices of Education; and Colleen Carr, National Action Alliance for Suicide Prevention Secretariat

Suicidal behavior is complex. Understanding factors like access to lethal means and the media’s potential influence on suicidal behavior is important when it comes to identifying suicide risk and intervening outside of health care settings.


Gun owners are no more likely to have experienced a mental health problem, thought about suicide or attempted suicide. However, gun owners are at twice the risk of dying by suicide as people who don’t have guns in the home.
  • Suicidal crises are often brief. One survey of suicide attempt survivors found that for nearly half of the respondents, while they had been struggling for varying amounts of time, the interval between first thinking about suicide and starting the attempt was ten minutes or less.
  • Lethality varies greatly by method. If a person attempting suicide substitutes virtually any method for a gun, they have a better chance of surviving. Approximately 8 percent of individuals who overdose in a suicide attempt die, while approximately 90 percent of people who use a gun in a suicide attempt die. Research is needed to better understand why people choose the methods they do. 
  • Long-term survival odds are good. Current estimates are that most people (90 percent) who attempt suicide and survive do not go on to die by suicide later. Understanding who re-attempts, and with what method, is a research gap. 
  • By reducing a person’s access to the most lethal suicide methods, particularly firearms, you can reduce their chance of dying and create more opportunities for treatment and recovery. 

What you can do as a behavioral health provider to help your patients: 

  • Complete the Suicide Prevention Resource Center’s (SPRC) free online training on Counseling on Access to Lethal Means (developed by Harvard, Dartmouth, and SPRC). 
  • Start a conversation that respects and normalizes gun ownership and suggest that the patient store their gun in a way that is inaccessible to them until they feel better. Underscore that both this mental health crisis and the alternate gun storage are temporary.
  • Recognize that a suicidal crisis can emerge quickly. Consider introducing safety planning and lethal means counseling to all patients struggling with mental health and substance abuse problems or experiencing difficult and traumatic life stressors, even if they are not currently suicidal.


Suicide contagion is real. Research has documented an increase in suicides following unsafe media coverage of suicide, and vulnerable adolescents are particularly at a greater risk of contagion following exposure to suicide in the media.

On the other hand, responsible media coverage of suicide and stories of positive coping and overcoming adverse circumstances have shown to have protective effects against suicide.

Unsafe media coverage of suicide includes: 
  • Presenting too simplistic of an explanation for suicide or normalizing suicide as a solution to a problem (e.g., an LGBT teen was bullied, so they killed themselves; a veteran had PTSD, so they killed themselves).
  • Repetitive, ongoing or excessive reporting of suicide. 
  • Sensational coverage of suicide (e.g., showing photos, or describing the details of the death or methods used). 
  • Glorifying suicide or someone who has died by suicide. 
  • Focusing on the positive characteristics of the suicide without balance to the challenges or illnesses surrounding it.

What you can do as a behavioral health provider:
  • Provide media contacts with the Recommendations for Reporting on Suicide created by suicide prevention and media experts. 
  • Provide accurate information to the media and help them better understand the complexity of suicide. 
  • Provide media resources for readers to include in coverage (including the National Suicide Prevention Lifeline, 800-273-TALK (8255). 
This post has been cross-posted on the National Council for Behavioral Health site.