Why Don't Gun Control Advocates Talk More About Suicides? Cont'd

Editor’s Note: This article previously appeared in a different format as part of The Atlantic’s Notes section, retired in 2021.

Amit Routh, the reader who wrote the email that started this discussion thread, replies to the two readers who responded:

Hi again! Thank you for the thread and to the other readers for making such excellent points. I appreciate The Atlantic taking up my lunch breaks like The Dish used to.

To the first reader: Yes, “the U.S. does not have an especially high suicide rate,” but suicide still makes up the 10th leading cause of death in the U.S. (source). Firearms not only have the unfortunate distinction as the most commonly used means of suicide, but also the leading cause of intentional death overall (source).

As for the reader’s question of “if you remove access to firearms, do people go to less lethal avenues of suicide, or do they seek out equivalently lethal methods?,” research points to the former (source):

[T]here is now a large body of evidence suggesting that means restriction not only reduces suicides by that method but also reduces overall suicide rates. Means substitution, when it does occur, does not seem to overwhelm the benefits of means restriction. When a highly lethal method (e.g., firearms) is not easily available, the substituted method (e.g., drug overdose) may be far less lethal, thereby increasing chances for survival.

Moreover, every study that has looked at firearms access has found it is associated with increased suicide risk (source). That said, it’s not surprising that this reader reports having difficulty finding research on the public health impact of firearms. For nearly 20 years, the NRA has effectively banned the CDC from researching how firearms affect American morbidity and mortality (source). The chilling effect of the research ban and its resultant harm to science, to policy, and to all Americans cannot be understated. It would be akin to banning research  funding into liver disease or diabetes for two decades.

Interestingly enough, Jack Dickey, the ex-congressman who led the charge on this research ban, eventually regretted and reversed his position:

DICKEY: Well, I think you’re right. And the thing that really brought this to my mind was watching as the little barricades were set up between the interstate to stop head-on collisions. The highway industry spent money in their scientific research to figure out what could be done, assuming that they were going to allow cars to continue to be on our highways. Enormous reduction of head-on collisions has been caused just by that little 2-and-a-half, 3-foot fence. We could do the same in the gun industry.

INSKEEP: You’re saying there might be some way to not interfere with anybody’s right to own a gun but regulate it in such a way that fewer people are killed by guns?

DICKEY: That’s correct. I can’t tell you what that might be, but I know this. All this time that we have had, we would've found a solution, in my opinion. And I think it’s a shame that we haven't.

To the second reader: I am entirely in agreement that so much media coverage and gun control advocacy is wasted on high-capacity magazines, collapsible stocks, and whatever other “scary” components or “bad guns” people see in movies or mass shootings. Policies made out of fear and ignorance rarely succeed in doing more good than harm.

Despite this, I do not see success or flourishing in the American experiment. I see a deep misery both intentional and accidental, a constellation of tragedies made all the more heartbreaking given that so much of it all is self-inflicted. What kind of rule of law can be deemed a success in a country where suicide is the 10th leading cause of death and suicide by firearm is the leading cause of violent, intentional death?

There is also the question of which “private citizens really can be trusted with firearms.” Open carry in California was repealed by Ronald Reagan of all people, with the NRA’s support, due to the Black Panthers exercising that most fundamental of constitutional rights (source). The Atlantic in 2011 published “The Secret History of Guns.” It’s a fascinating piece that traces the surprising twists and turns involved in American gun rights and gun control over the centuries:

One thing conspicuously missing from [NRA President Karl T.] Frederick’s comments about gun control was the Second Amendment. When asked during his testimony on the National Firearms Act whether the proposed law violated “any constitutional provision,” he responded, “I have not given it any study from that point of view.” In other words, the president of the NRA hadn’t even considered whether the most far-reaching federal gun-control legislation in history conflicted with the Second Amendment. Preserving the ability of law-abiding people to have guns, Frederick would write elsewhere, “lies in an enlightened public sentiment and in intelligent legislative action. It is not to be found in the Constitution.”

Now, I agree that suicide should not be treated as a legal equivalent to murder; I see suicide as a public health issue, much like heart disease or substance abuse. And just like those public health issues, I believe the thing we need more than anything else is more public research. We need research that anyone and everyone, regardless of their thoughts on guns, can access, analyze, and attempt to reproduce.

Asking for gun control policy proposals while in a vacuum of knowledge would just be—pardon the expression—shooting in the dark. Or to take a page from First Amendment advocates, more public research is always better than less. Ultimately, if that research finds that firearms truly have no impact on American morbidity and mortality, wouldn’t that be a huge victory for the gun lobby and owners?

A reader in California, Jim Elliott, is more skeptical of gun control and looks to the other major approach to lowering gun deaths: mental health services. His core contention: “The data clearly show that without an investment in mental health or universal seizure, gun control is relatively immaterial in controlling suicides.” Here’s Jim in full:

As most people know, California generally has the strictest gun control regime in the nation. California also has a generally lower suicide rate; in a 10-year review of Prop 63, California’s mental health services funding amendment, the RAND Corporation found that from 1999-2009, California’s suicide rate was 9.4/100,000 compared to a national 11.1/100,000.

However, in 2014 the Sacramento Bee (an excellent newspaper!) did a comparison and found that during the previous decade (their data ran from 2001-2012), the total number of firearm homicides fell while firearm suicides remained consistent. (Looking at the Bee’s graphic, what’s interesting to me is that the suicide rate is highest in poorer, more conservative, white, and rural counties.)

Under California law, any person detained by a hospital or psychiatric facility on a “hold” for suicidal ideation or an attempt at suicide is forbidden from possessing firearms for five years through report to the California Department of Justice. This also applies for voluntary holds. Anyone who was subjected to a voluntary or involuntary 72-hour hold—a “5150” in our parlance, short for the section of the Welfare and Institutions Code that governs them—has one attempt to appeal to regain their right to a firearm before the five-year term. Anyone detained on an extended hold—a “5250”—may not appeal during that time.

Oh, and the police, who have seized your firearms during that first 72 hours, have the right to destroy them after 30 days post-seizure, whether or not you’ve appealed either the psychiatric hold or the prohibition on having them.

So, California pretty much has—absent universal forfeiture of the right to keep and bear arms and their seizure—gun control advocates’ ideal regime. It has had an Assault Weapons Ban law more restrictive than the federal AWB since 1989. It is no longer open carry, now requires registration of all firearms (not just handguns), and so forth—30 additional gun control laws since 1989.

What California does not have is a functional mental health system. (One of Jerry Brown’s first acts as governor in 2011 was to dissolve the Department of Mental Health and relegate most of its duties but none of its funds to the counties.)

The data clearly show that without an investment in mental health or universal seizure, gun control is relatively immaterial in controlling suicides. The majority of the 30 or so post-California AWB gun control laws were passed during the same time period evaluated by the Bee. A California Department of Health Services review of California’s suicide rate from 1980 to 1996 shows that it was declining during the decade before California’s AWB was passed, and continued to decrease following its passing; combined with the RAND study above, we see that it has remained relatively flat since 1996.  

So, no more red herrings: If you want to use suicide prevention to advocate for gun control, you advocate for either spending far more money on emergency and preventative mental health care and hope it works, or you advocate for total seizure and hope the rate of successful suicides decreases. Gun control alone accomplishes little.