Family firearm culture prevalent among youth who died by firearm suicide

Key takeaways:

• Families often introduced youths who died by firearm suicide to firearms.
• Many parents said they had not thought of family-owned firearms as a threat, and several said they would have tried to reduce the risk.

SAN FRANCISCO — Youths who died by firearm suicide were often introduced to the weapons through family culture, according to data presented at the American Psychiatric Association.

“When we are talking about suicide, it is hard not to talk about firearm suicide, because the majority of suicides are completed by firearm, and ... two-thirds of firearm deaths are suicides” Paul S. Nestadt, MD, co-director of the Anxiety Disorders Clinic and an associate professor of psychiatry and behavioral sciences at Johns Hopkins School of Medicine in Baltimore, said during the presentation. “One of the reasons that so many suicides are by firearm even though most people don’t use firearm for their attempt is that firearm attempts are much more lethal.”

Nestadt and colleagues conducted psychological autopsies of nine youths aged 17 to 21 years who died by firearm suicide by interviewing close family members of the decedents. The researchers reviewed recordings of the 11 interviews to evaluate themes surrounding the suicides.

Analyses revealed that 90% of decedents had been exposed to firearms through family culture, and 67% completed suicide using a family-owned firearm. Notably, 78% of decedents had received mental health care, 78% had reported suicidal ideation, 78% had reported having a suicide plan and 44% had previously attempted suicide.

“Eight out of the nine decedents had had at least one of these [risk] factors, so these were people who were known to be at-risk,” Nestadt said.

Researchers identified a common theme of family firearm culture, with decedents having connected with family members through firearm traditions. Many interviewees also reported not having realized the risk firearms posed to decedents’ safety. Several said that if they had been advised by clinicians, they would have tried to mitigate the risks.

“Interventions must acknowledge culturally embedded routes of identity formation while rescripting firearms from expressions of family cohesion to instruments that may actually undermine that cohesion and may cost the life of a child,” Nestadt said.