Reducing suicide through gun control policy: red flags or false flags?

An exploration of the (tenuous) relationship between gun access laws and suicide prevention.

It’s no secret that having a firearm in the home increases the likelihood of a successful suicide attempt. Is it possible to reduce firearm suicides with stricter firearm access regulations? Which ones?

RAND, a self-described non-partisan, non-profit policy thinktank (whose issue priorities lean left) leads the pack in providing regularly updated systematic reviews of gun policy research, so they deserve credit for aggregating the research I summarize here.

First, there’s moderate support in existing research that waiting periods can reduce firearm suicide. However, as this study of gun owners in California spanning over 3 decades revealed, new gun owners are at heightened risk of suicide in the first month and then for a full year after taking possession of a firearm. Since California’s 10-day waiting period is the 2^nd longest in the nation after Hawaii, it’s unlikely that enacting longer waiting periods would meaningfully prevent suicides among people who are ultimately going to have access to firearms anyway.

Then, there’s also moderate supportive evidence that higher minimum age requirements for purchasing a firearm may decrease firearm suicides among young people. Finally, research studies consistently show that safe storage requirements and child access prevention laws are protective against firearm-related suicides and accidents, especially among younger people who may commit suicide using a firearm obtained from an adult in the home. These laws require gun owners to lock up or otherwise secure their firearms to prevent unauthorized users from accessing them and/or penalize gun owners if a minor child (the age varies by state) accesses a firearm that isn’t properly stored. Child access prevention laws are the most widespread, a slight majority of states have these, including states with otherwise permissive firearm regulations like Florida, New Hampshire, Texas. Laws requiring all gun owners (regardless of the presence of a child in the home) to secure their firearms with a trigger lock or in a safe are exceedingly rare, existing mostly at the municipal or county-level, and, like child access laws, are only enforceable after a violation has occurred.

Considering that over the past decade, suicide rates have increased the most (48%) in children age 12-17, increasing purchasing age requirements and expanding child access prevention laws may reduce firearm suicides among the younger cohort. These also enjoy broad-based support: According to a 2021 study examining gun policy opinions of Americans from surveys conducted in 2017 and 2019, over 70% of respondents of any ethnicity (white, Black, and Hispanics were compared in the study) support, “Requiring by law that a person lock up the guns in their home when not in use to prevent handling by children or teenagers without adult supervision” (Crifasi et al. 2021). Support for child access prevention laws was also high among gun owners, 68% of gun owners of any race were supportive, with support being highest among Black gun owners (82%).

This bodes well for more states successfully enacting child access prevention laws, but the existence of such laws doesn’t guarantee public awareness or compliance.

For instance, the 6-year old who brought his mother’s gun to school in Virginia and shot his teacher with it obtained the firearm by “climbing onto a drawer to reach the top of a dresser, where the gun was stored in his mother’s purse.” The mother was aware her child had a diagnosis for “defiance disorder” and that he’s previously taken her car keys, so she started keeping those in a lock box, but she still kept her gun in her purse. Virginia doesn’t require that all gun owners lock up/secure their weapons, but the state does require that people keep unsecured, loaded guns away from children under the age of 14. Ultimately, the prosecutor in this case dropped the misdemeanor charge of reckless storage of a firearm in exchange for the mother pleading guilty to child neglect.

Child access laws can only be enforced after the fact, so they need to be bolstered with firearm safety trainings, public health messaging, and news coverage of tragic cases of children accessing their parent’s unsecured firearms to harm themselves or others.

Then, suicide rates are also high and increasing among adult males in most age cohorts, with the noteworthy exception that suicides decreased among 45-64-year- olds. When a firearm is present in the home, the risk of firearm suicide for men was found to be 8 times higher (for women, it was 35x higher). Reducing firearm suicides among those most at risk of suicide, white gun-owning men living in rural areas children,young Black or African American men, and non-Hispanic American Indian or Alaska Native (AI/AN) personspresents a challenge for policymakers and public health professionals. Detection, intervention, and support are key. Removing firearms and ammunition from the home of an individual experiencing a mental health crisis is a key component of this, and there’s a lot of optimism (hype?), support, and resources directed toward Extreme Risk Protection Order (ERPO) laws as a mechanism for achieving this.

ERPO laws are a recent phenomenon, although they are modeled off domestic violence protection orders that have existed for decades. ERPOS, enable law enforcement, family/household members, and (sometimes), trusted professionals like teachers and medical professionals, to petition a court to temporarily restrict someone’s access to purchasing or possessing firearms if they’re proven to be a physical threat to themselves or others.

At the time of writing, 21 states and the District of Columbia had enacted ERPOs, mostly since 2019. Such policies are still in the implementation phase where they need to be studied and potentially retooled or bolstered to maximize their intended effect. Notably, they are also typically geared toward preventing mass shootings, not suicides, although the latter is a welcome and logical byproduct. A systematic review of the research conducted by RAND found that ERPOs have “uncertain” effects on suicides and violent crime, leading them to conclude the evidence is  “inconclusive.”

Nonetheless, they are incredibly popular among all demographics and gun owners and non-owners, and the Bi-Partisan Safer Communities Act earmarked $750 million for states to enact or expand existing ERPO infrastructure. The Bipartisan safer communities act passed with 15 Rs in Senate and 14 Rs in the House. By 2023, over 49 grants totaling roughly $200 million had been allocated for “for the creation and implementation of extreme risk protection order programs, state crisis intervention court proceedings, and related gun violence reduction initiatives.”

Much of this federal money is being funneled to states that already have ERPO laws on the books to assist them in better implementation.

• Washington: $5.2m allocated for expanding use and improving implementation of the state’s existing ERPO laws by increasing awareness and decreasing barriers.

• Colorado: $4.5m, with most of this allocated for ERPO training and expansion with a goal of increasing, “professional petitioner use and understanding of the appropriate use of ERPOs.”

• Michigan: $7.9m allocated for things like parent and youth services and judicial threat assessment training, expanded ERPO training and workshops, especially for domestic and sexual assault victims.

Among states that don’t presently have ERPO laws, these funds don’t (yet) seem to be having the intended effect of nudging them toward policy adoption. Instead, states like Kentucky, Oklahoma, and Montana where previous legislative attempts to pass ERPOs have failed, are receiving multi-million-dollar allocations to expand mental illness screening and crisis intervention programs and to divert people with firearm violations from the justice system through mental health, drug, and veteran’s courts.

Despite being opposed by stringent gun rights advocates, ERPOs are popular among the public, including those who own firearms. However, despite their popularity in the hypothetical, research shows they are rarely utilized by individuals, especially people of color, suggesting that these laws need better implementation to be effective. For instance, California was one of the first states to implement an ERPO policy, its version uses the term gun violence restraining order (GVRO) to describe court ordered firearm removals and has been in effect since 2016. Family and other household members, some employers and coworkers, plus teachers and school staff can petition the court to issue an ERPO. If approved by a judge, the individual subject to the petition may have their access to guns and ammunition restricted from 21 days to 5 years.

Kravitz-Wirtz, Aubel, and Pallin et al. surveyed 2870 adults in California about ERPOs in 2020. When asked whether they supported laws that enable either law enforcement or family members to ask the court to temporarily remove firearms from an individual or relative believed to be at risk of harming themselves or others, 77% of both white and Latino respondents supported law enforcement being able to remove weapons, along with 66% of Black respondents. Then, on average, gun owners were only slightly less supportive of law enforcement removal of weapons, 66% across all three racial groups, than non-owners. Across all three racial groups of gun owners (78%) supported allowing families to initiate court ordered removals of firearms, with 89% of black gun owners reporting support for this, a statistically significant higher level of support compared to white and Hispanic gun owners.

The racial disparity in support for law enforcement versus family-initiated ERPOs warrants deeper exploration, especially considering that uptake in California has been largely driven by law enforcement: between 2016-2019, 96% of petitions were initiated by law enforcement compared to just under 4% by household or family members (Pallin, Schleimer, and Pear et al. 2020). Were most people unaware of GVROs, or simply unwilling to petition for them? Kravitz-Wirtz, Aubel, and Pallin et al. also asked respondents questions about their awareness of GVROs, their attitudes toward the appropriate use of GVROs, and their willingness to personally initiate a petition under various scenarios.

The authors found the following:

1. Most people had never heard of a GVRO (73%). A few (9%) were aware of red flag laws, but 66% of respondents reported no awareness of GVROs or red flag laws.

2. Gun owners were slightly more aware of GVROS than non-owners (15% vs. 7%, respectively) and this was a statistically significant difference.

3. Overwhelming majorities of respondents agreed it was “sometimes, usually, or always) appropriate for judges to issue GVROs under each of the following five risk scenarios:

• Person experiencing an emotional crisis.

• Person with severe dementia or similar.

• Person who threatened to physically hurt themself.

• Person who threatened to physically hurt someone else/others.

• Person who threatened to physically hurt a group of people.

Notably, gun owners and non-owners were all highly supportive of GVROs being issued under all circumstances, with gun owners more supportive of them than non-owners across 4/5 scenarios. Likewise, when asked about willingness to personally initiate a GVRO under the same previously described scenarios, respondents were again overwhelmingly supportive of this in all scenarios, with nonowners who live with gun owners reporting the highest levels of willingness in all scenarios.

Among the 30% of respondents who reported unwillingness to petition a judge for an GVPO in 1 or more scenarios, the three most stated reasons were:

1. Lack of understanding about how GVPOs work.

2. Privacy concerns and belief that matters were personal/family.

3. Distrust in the fairness of the system.

In a similar vein, Schleimer, Pear, and Aubel et al. (2022) examined all ERPO court filings during the first three years of policy implementation, 2016–2018. In addition to most filings being initiated by law enforcement, they also found large, statistically significant racial disparities in the filing of ERPO petitions, with blacks and Latinos being dramatically less likely than whites to file petitions.

Such research suggests that despite the popularity of ERPOs, lack of awareness, understanding, and trust in the system are barriers that must be overcome for them to be used more broadly and effectively to reduce suicide among people experiencing mental distress who already have access to firearms. Household members, employers, and teachers may fear requesting a GVPO because they don’t want the intervention of law enforcement to do more harm them good. High profile incidents of law enforcement being called to assist during a mental health crisis resulting in lethal encounters are likely to have a chilling effect that might prevent people from petitioning the court for one of these GVPOs if they fear that a negative, even fatal encounter may result between their relative/household member and law enforcement when police turn up at their resident to seize their weapons.

While we may see more states adopt ERPOs in the near future, the successful implementation will be challenging. People need to be made aware of these policies and be made to feel more confident in utilizing them. Public awareness campaigns and trainings in educational and professional settings can spread awareness. Clearly outlined (and followed) best practices for the seizure of weapons that instill confidence in petitioners that their family members won’t be made less safe by the resulting encounter with law enforcement are also needed.