Guns & Suicide: The Hidden Toll

Far more people kill themselves with a firearm each year than are murdered with one. In 2010 in the U.S., 19,392 people committed suicide with guns, compared with 11,078 who were killed by others. Suicide is the 10th-leading cause of death in the U.S.; in 2010, 38,364 people killed themselves. In more than half of these cases, they used firearms.

Access-to-guns-and-risk-of-suicide-chartIndeed, more people in this country kill themselves with guns than with all other intentional means combined, including hanging, poisoning or overdose, jumping, or cutting. Though guns are not the most common method by which people attempt suicide, they are the most lethal. About 85 percent of suicide attempts with a firearm end in death.

Rates of firearm suicides in states with the highest rates of gun ownership are 3.7 times higher for men and 7.9 times higher for women, compared with states with the lowest gun ownership—though the rates of non-firearm suicides are about the same.

“Cut it however you want: In places where exposure to guns is higher, more people die of suicide.”

When widely used lethal means are made less available or less deadly, suicide rates by that method decline, as do suicide rates overall.

It’s important that gun owners and non-gun-owners talk to one another. The question can’t be, “What do you think of gun control?” because everybody’s going to be for or against. The question needs to be, “How do we solve the problem of gun suicide?”

via Guns & Suicide: The Hidden Toll | Magazine Features | Harvard School of Public Health Magazine Features.



Gun Violence Research: “Let’s let the data lead. . .”

After the Sandy Hook school shooting, Rep. Jack Kingston R-GA was one of a few congressional Republicans who expressed a willingness to reconsider the need for gun control laws.

“Put guns on the table, also put video games on the table, put mental health on the table,” he said less than a week after the Newtown shootings. He told a local TV station that he wanted to see more research done to understand mass shootings. “Let’s let the data lead rather than our political opinions.”

For nearly 20 years, Congress has pushed the Centers for Disease Control and Prevention CDC to steer clear of firearms violence research. As chairman of the appropriations subcommittee that traditionally sets CDC funding, Kingston has been in a position to change that. Soon after Sandy Hook, Kingston said he had spoken to the head of the agency. “I think we can find some common ground,” Kingston said.

More than a year later, as Kingston competes in a crowded Republican primary race for a U.S. Senate seat, the congressman is no longer talking about common ground.In a statement to ProPublica, Kingston said he would oppose a proposal from President Obama for $10 million in CDC gun research funding. “The President’s request to fund propaganda for his gun-grabbing initiatives though the CDC will not be included in the FY2015 appropriations bill,” Kingston said.

Following Obama’s instructions, the authoritative Institute of Medicine put together a report on priorities for research on reducing gun violence. Among the questions that need answers, according to the report: Do background checks — the most popular and prominent gun control policy proposal — actually reduce gun violence? How often do Americans successfully use guns to protect themselves each year? And — a question that Kingston himself had raised repeatedly — what is the relationship between violence in video games and other media and “real-life” violence?

Dr. Mark Rosenberg, who led the CDC’s gun violence research in the 1990s, said that the National Rifle Association and other opponents of funding have often fueled a misconception: that Americans can be for guns or for gun research, but not both.

“The researchers at CDC are committed to two goals: one goal is preventing firearm injuries. The second goal is to preserve the rights of legitimate gun owners. They have been totally misportrayed,” Rosenberg said.

A long list of associations that represent medical professionals—including the American Medical Association, the American Psychological Association and the American Academy of Pediatrics — signed a letter last year urging Congress to fund gun violence prevention research.

CDC’s current funding for gun violence prevention research remains at $0.

via Republicans Say No to CDC Gun Violence Research – ProPublica.

With mental health legislation stalled in Congress, states act

States looking to address gun violence are overhauling mental health laws — and sometimes exposing rifts over how to best address the small but serious threat of violence.

There’s not much controversy among advocates when it comes to restoring funding that states had slashed during the economic lean years. But changing policies on involuntary commitment, or requiring therapists to report potentially dangerous patients, are stirring fears that well-intentioned policies could increase stigma and deter the very people who most need treatment from getting it.

“We’re seeing really a regressive response to mental health, instead of proactive,” said Debbie Plotnick, senior director of state policy for the advocacy group Mental Health America.

via With mental health legislation stalled in Congress, states act – Kathryn Smith –

An Epidemic of Shootings by Toddlers

Toddlers should be playing with flowers and other harmless objects, but recently, at least six picked up guns instead, with tragic consequences. Unsecured firearms are a significant health and safety risk, and young children account for the majority of such accidents at home because they often don’t understand what they are playing with. As the nation ignites with debate over gun control, these cases illustrate the critical need for a rational discussion on how to manage guns responsibly while ensuring public safety.

In Tennessee, Josephine G. Fanning died after being shot by a four-year-old child when he gained access to a gun that was set down just for a moment: by a law enforcement officer, no less. Sheriff’s Deputy Daniel Fanning unlocked a gun case to show a rifle to a guest at a cookout, removing a handgun in the process, and the child picked it up, firing a single fatal round. While the death is being treated as an accident, it’s a stark reminder that even law enforcement officers with extensive training can make unwise decisions when it comes to handling firearms.

In South Carolina, a three-year-old is dead from a self-inflicted gunshot would. Few details about the case are available, but the child apparently found the gun and pulled the trigger, suggesting that it was lying in an area accessible to children, and had been left both loaded and unlocked.

In Alabama, another four-year-old shot himself after finding an unsecured and unlocked handgun. The revolver was in a household belonging to someone who cannot legally own firearms due to previous violent criminal convictions.

In New Jersey, a four-year-old boy shot and killed a six-year-old playmate with a rifle that “accidentally discharged.” The specifics of where the rifle was and why it was left unsecured are not clear.

In Tennessee, a mother survived an abdominal wound after her two-year-old shot her with a handgun found under her pillow. She was asleep with her new baby at the time, making it remarkable that this case didn’t turn into a double tragedy.

In Georgia, another thankfully non-fatal tale, of a toddler who found an unsecured gun under a bed and shot himself in the thumb.

These cases are being used as a compelling argument for more extensive gun control in the United States, on the ground that we shouldn’t have to fear an epidemic of armed toddlers. But they’re also an argument for cracking down on responsible gun ownership.

They all involved situations in which potentially lethal weapons were left loaded, unlocked and unsecured in an area where they could be reached by a young child. In at least one case, the gun owner had sufficient training and experience to know better when it comes to appropriate gun handling and storage, yet thought it would be okay “just for a minute” to go against protocol.

In a nation with a deeply-embedded gun culture, it’s critical not just to discuss ways to keep guns from falling into the wrong hands, but also to talk about how to foster responsible, mature gun ownership. Unfortunately, the people most likely to pursue legal avenues including licensing, safety classes and refresher courses on gun safety are also those most likely to use guns responsibly, while criminals will continue to accrue weapons via illegal means, and store them unsafely.

Can the United States reform, and balance, its gun culture to protect the safety of children and members of the general public, or will extreme conservatives dominate the discussion about what nature these reforms will take?

via An Epidemic of Shootings by Toddlers | Care2 Causes.

Comprehensive public health approach urged to curb gun violence in U.S.

Three Harvard experts say the best way to curb gun violence in the U.S. is to take a broad public health approach, drawing on proven, evidence-based strategies that have successfully reduced other public health threats like smoking, car crashes, and accidental poisonings.

For instance, in much the same way that media, celebrities, peers, teachers, and physicians worked together in the latter decades of the 20th century to “de-glorify” cigarettes — previously seen as symbols of power, modernity, and sexuality — an analogous campaign “could justifiably equate gun violence with weakness, irrationality, and cowardice” and reduce its glorification in movies, television, and video games, the authors write.

“Gun violence is a public health crisis, and addressing this will require a comprehensive, multi-dimensional public health strategy,” said lead author Dariush Mozaffarian, associate professor in the Department of Epidemiology at Harvard School of Public Health (HSPH). “Our past successes in reducing other harmful behaviors and accidents provide a set of evidence-based tools to address the many underlying root causes of gun violence.”

With more than 30,000 Americans killed by guns each year — 85 deaths per day — setting limits and regulations on gun ownership is just one aspect to be considered in curbing the violence, the authors say.

They offer more than a dozen recommendations, based on successful strategies used in other public health crises. For example, they suggest a new, substantial national tax on all firearms and ammunition, to more accurately reflect the true societal costs of gun ownership and to provide a stable revenue source to target gun violence prevention. Such a tax would function like the tobacco tax, which provides crucial funding for smoking prevention efforts.

“Changing social norms is a fundamental public health strategy,” said Hemenway. “For common products like cigarettes, cars, and guns, many individuals, groups, and institutions need to become involved. As ‘friends don’t let friends drive drunk,’ similarly friends should help ensure that a friend going through a psychological crisis doesn’t have ready access to a firearm until the crisis is over.”

“Safety standards for gun ownership still represent one key facet of a comprehensive approach, just as automobiles and medications are widely used but subject to sensible safety policies,” the authors conclude.

via Comprehensive public health approach urged to curb gun violence in U.S..

Violence plays role in shorter US life expectancy

The United States suffers far more violent deaths than any other wealthy nation, due in part to the widespread possession of firearms and the practice of storing them at home in a place that is often unlocked, according to a report released Wednesday by two of the nation’s leading health research institutions.

The United States has about six violent deaths per 100,000 residents. None of the 16 other countries included in the review came anywhere close to that ratio. Finland was closest to the U.S. ranking with slightly more than two violent deaths per 100,000 residents.

For many years, Americans have been dying at younger ages that people in almost all other wealthy countries. In addition to the impact of gun violence, Americans consume the most calories among peer countries and get involved in more accidents that involve alcohol. The U.S. also suffers higher rates of drug-related deaths, infant mortality and AIDS.

In attempting to explain why Americans are so unhealthy, the researchers looked at three categories: the nation’s health care system, harmful behaviors and social and economic conditions. Researchers noted that the U.S. has a large uninsured population compared to other countries with comparable economies, and more limited access to primary care. And although the income of Americans is higher on average than that of other wealthy countries, the United States also has a higher level of poverty, especially among children.

Researchers said American culture probably plays an important role in the life expectancy rates falling short of other wealthy countries.

“We have a culture in our country that, among many Americans, cherishes personal autonomy and wants to limit intrusion of government and other entities on our personal lives and also wants to encourage free enterprise and the success of business and industry. Some of those forces may act against the ability to achieve optimal health outcomes,” said Dr. Steven H. Woolf of Virginia Commonwealth University, who served as chairman for the study panel.

The researchers reviewed an array of studies over the years. They estimated that homicide and suicide together account for about a quarter of the years of life lost for U.S. men compared to those in those peer countries. Homicide, they noted, is the second leading cause of death among adolescents and young adults aged 15-24. The large majority of those homicides involve firearms.

via Violence plays role in shorter US life expectancy – Health/Science –

64 Mentally Ill Die at Hands of Police in 2012

excerpts from Bullets Are Safety Net as 64 Mentally Ill Die at Hands of Police – Bloomberg.

Michael Mahoney, 36, had a hard life, spending months in juvenile detention centers and six years in prison before deciding to turn things around. He enrolled in welding courses and cared for his ailing father in their Oxnard, California, home. Then his schizophrenia took over. He lived his last months in fear and paranoia, once screaming out, “Kill me!”

Then someone did.

Mahoney died Aug. 14 of a gunshot wound to the chest after three officers, responding to a report of a man with a weapon, fired on him. He was one of 64 mentally-ill people who died after being shot with a gun or electroshock device by U.S. law enforcement this year, according to data compiled by Bloomberg. That’s about three times the number police indicated in a 2009 U.S. Department of Justice survey, the last year for which statistics are available.

Data: Bloomberg News found 64 people who died in violent encounters with police in 2012. Click here for the full list. (None of the officers in the 64 incidents Bloomberg documented has been found criminally liable.)

At least 16 of the 64 had schizophrenia, were prone to violence and avoided taking medications. Some had been released from hospitals after stays families thought were too brief to be therapeutic. Mahoney spent 45 hours in a psychiatric center where he’d been confined for his own safety, discharged nine days before he died with a flare gun in his hand.

In Saginaw, Michigan, on July 1, it was a folding knife. Milton Hall, a 49-year-old homeless man with schizophrenia, was shot 46 times after six officers responded to a call that he’d left a convenience store without paying for a cup of coffee, according to the attorney for his estate, Debra Freid. Hall had “acted aggressively,” brandishing the knife, according to police.

Some of the 64 did serious harm to others. Pralith Pralourng, 32, had taken nothing for his schizophrenia for more than a year in July when he injured a coworker with a box-cutter at a San Francisco chocolate factory. Police shot and killed Pralourng when he turned the box-cutter on them.

“It is a shame that a bullet is what our mental health safety net has become,” said Louis Josephson, chief executive officer of Riverbend Community Mental Health Inc. in Concord, New Hampshire, which offers outpatient and residential programs.

System’s Failures

The failures of the U.S. health care system in treating the seriously mentally ill have swelled the workload of police in all 50 states and put the emotionally disturbed at the mercy of officers who may have little or no training in defusing situations fueled by psychosis.

A preponderance of those in uniform have no idea how to deal with mental illness, and “man, are they quick to shoot,” said Michael Woody, president of CIT International, a Memphis- based nonprofit that organizes programs in 50 states and four countries in crisis intervention training, or CIT.

Only 10 percent of the nation’s 25,000 police departments offer CIT or teach de-escalation techniques to deal with the mentally ill in crises, psychotic or otherwise, according to a University of Memphis study.

In a 2011 survey, 82 percent of 2,400 police chiefs and sheriffs said calls to deal with the mentally ill had increased substantially over their time in office, according to Michael Biasotti, president of the New York State Association of Chiefs of Police and chief of the department in New Windsor.

Now the use of force against the mentally ill is a major focus of U.S. Department of Justice investigations, according to Jonathan Smith, head of the agency’s civil rights special litigation section. “You’ve got your finger on what is among the largest issues in law enforcement,” he said.

Smith tied the shootings, in part, to the diminishment of U.S. health care for the mentally ill. The number of beds in state hospitals has plummeted 92 per cent to 42,385 in 2011 from the mid-1950s. Laws in 44 states designed to force the most seriously ill to stay on their medication are often underused or ignored, according to Brian Stettin of the non-profit Treatment Advocacy Center.

The average duration of acute-care psychiatric hospital stays has dropped 60 percent since 1993, and is now at 7.8 days — far from the two weeks doctors say is the minimum for introducing new drug therapies and stabilizing patients.