OSU researchers suggest mental health providers should individualize questions about suicidal ideation.
A new study found that current questions being asked to determine whether someone is suicidal are coming up short, particularly when it comes to handgun ownership and suicide risk. While mental health providers are doing their best to catch ideation before patients are at substantial risk of fatally harming themselves, the truth is, there just isn’t a “one size fits all” approach, and the authors of the study found that tweaking the firearm questions so that they’d be more situational in nature made a significant difference for gun owners.
“Not everyone experiences suicidal ideation in the same way. So, maybe our traditional ways of asking about suicidal thoughts are incomplete,” Ohio State College of Medicine researcher Craig Bryan said. “Just a simple shift in question, adding one more different perspective or a different angle to ask about suicidal thoughts could potentially help us identify people who are in a vulnerable state.”
Experts recommend updating assessments to include a wider range of questions. Not everyone who is suicidal meets “tell-tale” markers such as a decrease in interest in activities and/or putting a halt to planning for the future.
Stanford University researchers reported last year that owning a handgun is associated with a “dramatically elevated risk of suicide” after studying “26 million California residents over a 12-year period.” The authors stated, “The higher suicide risk was driven by higher rates of suicide by firearm.” David Studdert, LLB, ScD, MPH, professor of medicine at Stanford Health Policy and of law at Stanford Law School, the study’s lead author, stated, “Our findings confirm what virtually every study that has investigated this question over the last 30 years has concluded: Ready access to a gun is a major risk factor for suicide.” These findings were published on June 4 in The New England Journal of Medicine.
However, having access to a firearm does not automatically determine whether someone will use it to end their life.
“Suicide attempts are often impulsive acts, driven by transient life crises,” according to the Stanford authors. This suggests that pre-planning is generally not performed, and gun carriers can own their weapons for years, or even a lifetime, without issue. An unexpected crisis and feelings of helplessness and hopelessness are what make owning a gun risky. At the same time, the same can be said of suicidal persons who have access to pills or other potentially deadly “weapons.”
The authors warn, “Women in our cohort who owned guns and died by suicide usually used a gun. Handgun ownership may pose an especially high risk of suicide for women because of the pairing of their higher propensity to attempt suicide with access to and familiarity with an extremely lethal method.” They go on to suggest, “Most attempts are not fatal, and most people who attempt suicide do not go on to die in a future suicide. Whether a suicide attempt is fatal depends heavily on the lethality of the method used.”
Centers for Disease Control and Prevention (CDC) has shared, “There were more than 24,000 gun-related suicides in the United States in 2018.” The majority of these fatalities involved handguns.
Sources:
Study: Questions being used to identify people at risk of suicide often fall short
Study: Mental health assessments often fail to identify suicidal ideation among gun owners
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