Historically, suicide rates in Oregon have been among the highest in the United States. The Oregon Health Authority continues to show that suicide is the second leading cause of death among 10 to 24-year old’s in Oregon, and 83 percent of the firearm fatalities between 2010 and 2014 were due to suicide. Because firearms account for 50 percent of deaths by suicide nationwide, Elizabeth Marino, Assistant Professor of Anthropology at Oregon State University Cascades, and a team of researchers have been looking at the way we talk about suicide with gun owners.
“Rural communities have higher rates of suicide than urban communities,” Marino said. “We also knew that firearms had a particular cultural resonance with rural communities, so we thought it would be a good place to start.”
Cultural Messaging in Rural Communities
With over 40,000 people dying each year from suicide, it’s important to note that the majority of these people visit a primary care physician within a year of their deaths. Because of this, Marino and her team started looking at how suicide intervention could be facilitated by physicians. They decided to focus on rural communities because guns are an important part of rural life.
“We wanted to do two things: first, to ask firearm owners what guns meant to them, and what would be the best way to talk about them with a physician; and second, to ask firearm owners what they were doing in their own families and communities to help keep people safe when someone around them had suicidal ideation or were thinking about suicide,” Marino says.
The researchers believed that gun owners were the best resource for creating effective intervention strategies when it came to other gun owners that were experiencing suicidal thoughts. The idea was that general public health messages were not as impactful as tailored cultural messages that acknowledged the gun owners’ rights, while also demonstrating the importance of temporarily removing guns from their homes when friends and loved ones, or they themselves, were suicidal.
After working with gun owners, Marino and her team created brochures with the specific messaging. In the brochure for gun owners, they use language that specifically validates the right to have firearms, but also highlights the importance of responsibility when it comes to firearms and safety.
In one message they write, “If you are the person who is going through a tough time, it may feel risky to give your guns to a friend for safekeeping. We know it’s a big step, but it is just a temporary step until things get better. Remember that people who love guns love you. Temporarily entrusting guns to a friend or family member might just save your life.”
The brochure goes on to describe the warning signs for suicide, such as talking about wanting to die or kill oneself, talking about feelings of hopelessness or having no reason to live, increasing the use of alcohol or drugs, and withdrawing or feeling isolated.
It also describes ways to take action, including being willing to listen in a non-judgmental way, removing guns until the crisis passes, checking in with the person regularly, and encouraging the person to seek support through friends, family, clergy, or a doctor.
For physicians, Marino and her team encouraged talking to patients about removing firearms and how to do that effectively. In the brochure for physicians, they encourage normalizing gun ownership and letting patients know you respect their 2nd amendment rights, and that you also want to keep them safe.
Research suggests that primary care providers are hesitant to discuss firearms with their patients, and that gun owners are hesitant to talk about their guns if they think the data will be entered into their electronic health records. So, physicians are encouraged to step away from the computer and have this conversation while focusing completely on the patient, as a way to ensure trust.
How to Keep Guns Away from Those Who are Suicidal
Marino and her team worked with a national sample of over 800 people, asking respondents if they would hypothetically remove firearms from the home when they, a family member, or a friend was experiencing suicidal ideation.
“When we asked this question after showing respondents our culturally relevant message alongside information about suicide, the number of people self-reporting that they would take steps to limit access to firearms went up. When we asked these questions after showing respondents a control message or the standard public health message about suicide without our culturally relevant message, fewer people said they would consider removing firearms,” Marino says.
The research, which is supported by the Oregon Health Authority and was recently published in the Archives of Suicide Research, show that information alone can be ineffective. But tailoring that information to specific groups and acknowledging their cultural values is effective. What about just taking away guns by force?
On August 16, Governor Kate Brown signed Senate Bill 719 into law, a piece of gun control legislation that would allow extreme protection orders for those deemed to be an imminent threat to themselves or others.
People would be required to surrender all weapons if found to be a danger to the community or themselves. The process would begin with a family member or a law enforcement officer petitioning the court; the judge would then have to look at the petitioner’s statement, the subject’s history of suicide threats and acts of violence, and the types of crimes and convictions on the subject’s record. A mental health professional’s opinion could also be taken into account.
The bill is controversial, and has many gun-owners worried that law enforcement officials will abuse the power to take away guns, according to The Oregonian. The law doesn’t go into effect until January 1, 2018, and already there are legislators working on repealing it.
The question remains: what is more effective—talking to individuals and getting them to decide to remove their guns themselves, or forcing them through a court order? No matter which action is more effective, we need to keep looking at this issue.
When studying the death data from Oregon this year and comparing the counties, you’ll find that Multnomah County has the highest number of suicides with 70, but that’s out of 3,227, making it 2.2 percent of deaths.
Benton County actually has a higher rate of suicide—12 out of 343—making it just about 3.5 percent of deaths this year. We’re not totally rural, but we’re not exactly cosmopolitan, either.
With World Suicide Prevention Day just around the corner on September 10, it’s time to really start thinking about how we talk about suicide and how we can make the numbers go down. Marino finds the work of talking about suicide heartbreaking, but she finds working with the communities inspiring.
She says, “So many people in Oregon have suffered the death of a loved one by suicide, or have a loved one experiencing suicidal ideation. People with these experiences are working in their communities, formally and informally, to keep people safe and to usher them through hard times. Public health specialists and researchers can work alongside these communities to achieve healthy outcomes. We think these kinds of research/community partnerships are a way forward.”
For more information about suicide prevention, mental health support, and trainings, visit http://www.suicide.org/
By Anika Lautenbach