The Atlantic

The lion’s share of American violence is inflicted by an individual on himself. That violence takes many forms. Suicide is its lethal incarnation, but every day, millions of Americans cut themselves, starve themselves, drink themselves into unconsciousness, or knowingly inject potentially deadly foreign substances into their body. For all the deserved media attention on the times an individual ends the life of another, little is said when the target of a person’s violence is himself, a far more common occurrence. And we have not paid enough attention to the role guns play in America’s suicide crisis.

In 2017, the American homicide rate was about 5.3 murders per 100,000 people. That year, the suicide rate was nearly three times higher—14 deaths per 100,000 people. So why is the mainstream debate on violence in America so hyper-focused on murder when suicide takes so many more lives?

This post was excerpted from Murphy’s recent book.

The American suicide rate, unlike the homicide rate, is less of a global outlier. Several other high-income nations, such as France, Switzerland, and Japan, have suicide rates higher than ours. The more troubling trend is that American suicides have increased by 30 percent since 2000—a jump not matched by other nations. Suicides in America are increasing, but overall they are just not as uniquely an American problem as gun homicides are.

There are, of course, other explanations for why the suicide problem is largely hidden from public discussion. For the overwhelming majority of Americans, who never experience suicidal thoughts, the threat of attack from another person is just much scarier, and more likely, than the threat of self-harm. We obsess over homicides because we feel we have much less control over what another person may do to us than what we may do to ourselves. And the unfortunate shame that many families feel surrounding the suicide of a loved one drives the discussion around causes and interventions underground. Murder is public spectacle. Suicide is private tragedy. Both are often the result of too-easy access to guns.

Michael Scholtes still has dark moments, 25 years after his last attempt to kill himself. “There are these moments when I am sure that suicide is the right choice,” he explains. “But they’re moments. It takes time to plan it. It takes time to build up the courage to follow through on those plans. And it takes an awful lot of effort, effort that is not easy when my depression is strong.” Knowing this, Scholtes, a Lutheran pastor, has made sure that a quick, effortless suicide is not available to him. Scholtes doesn’t own a gun, and this decision for him is purely about self-preservation. “If I had a gun and ammunition at my disposal?” he muses. “So much less time. So much less effort. So much less time to change my mind, and so much less chance of a failing attempt.”

Suicidal thoughts are dark, curious creatures. For most individuals who have them, they are temporary and passing, as Scholtes describes. One study of young people who had survived a suicide attempt found that nearly half of them waited less than 20 minutes to make the attempt after the first suicidal thought entered their mind. And so the most important task for someone who experiences one of these moments is to find assistance and try to wait it out. Nine out of 10 people who survive a suicidal attempt never end up taking their life.

But getting through the dark moments is difficult when quick lethal violence is right at hand. Guns are used in just 6 percent of all suicide attempts, but are responsible for 54 percent of successful suicide attempts. This makes a grim sort of sense: When you shoot a gun into your temple, it does what it’s intended to. That’s why 85 percent of suicide attempts with a firearm are lethal. Just 3 percent of suicide attempts by drug overdose are fatal.

Global suicide statistics cast doubt on blaming our self-harm epidemic on guns alone. If gun availability were the primary driver of suicides, then why would a country like Japan, a nation with almost no private gun ownership, have a higher suicide rate than the United States?

However, plenty of data suggest that the American suicide rate would be much lower if guns were not so prevalent in our civil society. A landmark 2018 National Institutes of Health–funded study conducted by the RAND Corporation found a strong correlation between communities with high rates of gun ownership and high suicide rates. The NIH study also confirmed other research showing that the stronger a state’s gun laws, the less likely the state is to have a high suicide rate. Universal background checks, locally issued gun permits, and waiting periods—policies that put time between a decision to purchase a gun and the gun’s receipt—all lead to fewer suicides.

Even more interesting data demonstrate that controlling the means of self-harm is an effective way to limit suicide. Consider the decision by the Israeli army to stop allowing soldiers to take their firearms home over the weekend. That one action led to a 40 percent reduction in soldier suicides, driven by—you guessed it—a dramatic reduction in firearm suicides on weekends. Or what about the massive gun-buyback program in Australia that took one-fifth of all guns out of private hands, which was followed by a 74 percent reduction in firearm suicides, without affecting the rates of non-firearm suicides at all? And finally, we can go back to 1950s England to find a dramatic drop in successful suicides after the primary means of self-harm, diverted domestic gas, was purged of the carbon monoxide that made it lethal.

Reducing the ease of access to the deadliest means of violence matters when the goal is to help someone survive what may well be just a fleeting instinct for self-harm. As the Harvard suicide researcher Matthew Miller says, “If you save a life in the short run, you likely save a life in the long run.”

This article is adapted from Murphy’s recent book, The Violence Inside Us: A Brief History of an Ongoing American Tragedy.

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