Emily Frazier, 27, widow of Ryan Frazier, who shot himself with a semiautomatic in 2008.

In the national debate over gun violencea debate stoked by mass murders such as last Decembers tragedy in a Newtown, Connecticut, elementary schoola glaring fact gets obscured: Far more people kill themselves with a firearm each year than are murdered with one. In 2010 in the U.S., 19,392 people committed suicide with guns, compared with 11,078 who were killed by others. According to Matthew Miller, associate director of the Harvard Injury Control Research Center (HICRC) at Harvard School of Public Health, If every life is important, and if youre trying to save people from dying by gunfire, then you cant ignore nearly two-thirds of the people who are dying. Suicide is the 10th-leading cause of death in the U.S.; in 2010, 38,364 people killed themselves. In more than half of these cases, they used firearms. Indeed, more people in this country kill themselves with guns than with all other intentional means combined, including hanging, poisoning or overdose, jumping, or cutting. Though guns are not the most common method by which people attempt suicide, they are the most lethal. About 85 percent of suicide attempts with a firearm end in death. (Drug overdose, the most widely used method in suicide attempts, is fatal in less than 3 percent of cases.) Moreover, guns are an irreversible solution to what is often a passing crisis. Suicidal individuals who take pills or inhale car exhaust or use razors have time to reconsider their actions or summon help. With a firearm, once the trigger is pulled, theres no turning back.
Not Why? but How?

When we think of suicide, we usually think of a desperate act capping years of torment. According to the National Institute of Mental Health, complex and deep-rooted problemssuch as depression and other mental disorders, drug and alcohol abuse, family violence, and a family history of suicideoften shadow victims. Suicide among males is four times higher than among females. In adults, separation or

divorce raises the risk of suicide attempts. In young people, physical or sexual abuse and disruptive behavior increase vulnerability. The harrowing fact of suicide demands a story: Why? But from a public health perspective, an equally illuminating question is How? Intent matters, but so does method, because the method by which one attempts suicide has a great deal to do with whether one lives or dies. What makes guns the most common mode of suicide in this country? The answer: They are both lethal and accessible. About one in three American households contains a gun. The price of this easy access is high. Gun owners and their families are much more likely to kill themselves than are non-gun-owners. A 2008 study by Miller and David Hemenway, HICRC director and author of the book Private Guns, Public Health, found that rates of firearm suicides in states with the highest rates of gun ownership are 3.7 times higher for men and 7.9 times higher for women, compared with states with the lowest gun ownershipthough the rates of non-firearm suicides are about the same. A gun in the home raises the suicide risk for everyone: gun owner, spouse and children alike. This stark connection holds true even when other factors are taken into account. It was a reasonable hypothesis to think that the type of person who chooses to own a gun is different from the type of person who chooses not to. Maybe theres a go-it-alone attitude that leads to less help seeking. Or maybe gun owners are more likely to live in rural areas, and rural locales are associated with greater suicidality, explains Catherine Barber, director of HICRCs Means Matter campaign, a suicide prevention effort that focuses on the ways people attempt to take their own lives. But when we compared people in gun-owning households to people not in gun-owning households, there was no difference in terms of rates of mental illness or in terms of the proportion saying that they had seriously considered suicide, Barber says. Actually, among gun owners, a smaller proportion say that they had attempted suicide. So its not that gun owners are more suicidal. Its that theyre more likely

to die in the event that they become suicidal, because they are using a gun. While gun-suicide rates are higher in rural states, which have proportionally more gun owners, the gun-suicide link plays out in urban areas, too. In the early 1990s, the dramatic rise in young black male suicides was in lock step with the homicide epidemic of those years, says HSPHs Deborah Azrael, associate director of the Harvard Youth Violence Prevention Center. Young black male suicide rates approached those of young white malesthough black suicide rates had always been much lower than white suicide rates. It was entirely attributable to an increase in suicide by firearms. Put simply, the fatal link applies across the board. Its true of men, its true of women, its true of kids. Its true of blacks, its true of whites, says Azrael. Cut it however you want: In places where exposure to guns is higher, more people die of suicide.
Impulsive acts

The scientific study of suicide has partly been an effort to erase myths. Perhaps the biggest fallacy is that suicides are typically long-planned deeds. While this can be truepeople who attempt suicide often face a cascade of problemsempirical evidence suggests that they act in a moment of brief but heightened vulnerability. One of the things that got me interested in launching the Means Matter campaign was that I had been reading through thousands of thumbnail sketches of suicide deaths, to see if a reporting system we were testing was catching the feel for the case, says Barber. I started noticing that, jeez, this death happened the same day that the kid was arguing with his parents, or that the young man had just broken up with his girlfriend, or that the middle-aged guy had gotten word that the divorce papers had come through. That reactivity surprised me, because Id always pictured suicide as being a painful, deliberative process, something that was getting worse and worse, escalating until finally youve got it all planned out and you do it. It hadnt occurred to

me that it could be a cop arguing with his wife, and in the midst of the argument, pulling out his gun and killing himself. This impulsivity was underscored in a 2001 study in Houston of people ages 13 to 34 who had survived a near-lethal suicide attempt. Asked how much time had passed between when they decided to take their lives and when they actually made the attempt, a startling 24 percent said less than 5 minutes; 48 percent said less than 20 minutes; 70 percent said less than one hour; and 86 percent said less than eight hours. The episodic nature of suicidal feelings is also borne out in the aftermath: 9 out of 10 people who attempt suicide and survive do not go on to die by suicide later. As Miller puts it, If you save a life in the short run, you likely save a life in the long run.
Lethal environments

A central tenet of public health is that environment shapes individual behavior. In the realm of suicide, this truth has played out dramatically in recent history. When widely used lethal means are made less available or less deadly, suicide rates by that method decline, as do suicide rates overall. In Sri Lanka, for example, where pesticides are the leading suicide method, the suicide rate fell by half between 1995 and 2005, after the most highly human-toxic pesticides were restricted. Similarly, in the United Kingdom before the 1950s, domestic gas derived from coal contained 10 to 20 percent carbon monoxide, and poisoning by gas inhalation was the leading means of suicide. A source of natural gas virtually free of carbon monoxide was introduced in 1958; over time, as carbon monoxide in gas decreased, so did the number of suicides overalldriven by a drop in carbon monoxide suicides, even as other methods increased somewhat. Changing the means by which people try to kill themselves doesnt necessarily ease the suicidal impulse or even the rate of attempts. But it does save lives by reducing the deadliness of those attempts.

Dearth of data

Harvard School of Public Health researchers have conducted many of the key national studies linking gun access and suicide. Left to right: Matthew Miller, associate director of the Harvard Injury Control Research Center (HICRC); Deborah Azrael, associate director of the Harvard Youth Violence Prevention Center; and Catherine Barber, director of HICRCs Means Matter campaign. Though these basic facts are known, there is a striking dearth of research on guns and suicide. In the U.S., government officials dont even have current data on where household gun ownership rates are higher or lower. The only survey large enough to produce state-level estimates of gun ownership was conducted by the federal Behavioral Risk Factor Surveillance System, the worlds largest ongoing telephone health survey. The survey asked questions about gun ownership in 2001, 2002 and, for the last time, in 2004. It was HICRC investigators who analyzed this state-level data to show that suicide rates run in tandem with gun ownership rates.

Today, the U.S. Centers for Disease Control and Preventions National Violent Death Reporting System, which collects data from police and coroners reports and death certificates on every suicide and homicide, covers only 18 states. Compare this with the National Highway Traffic Safety Administrations Fatality Analysis Reporting System, which amasses extensive details within 30 days of every fatal car crash on public roads, from the time and location of the accident to weather conditions to the role of alcohol and drugs. Partly as a result of this bureaucratic diligence, the fatality rate from car crashes has dropped by about a third over the last two decades. Could the same dedication bring down suicides? Matthew Miller thinks it can. Better data is a good place to start. That way, discussions are grounded in facts rather than distorted by ideology. It can only help foster social-norm-shifting conversations similar to those that took place around cigarette smoking, safety belt use and driving drunk, he says. Id like physicians to feel its their responsibility to tell people about the risks. Theres no reason that you should have a conversation about a bike helmet or a seat belt, but not firearms. But change also takes time. With public health, when you dont have the one-size-fits-all solution, you chip away at the problem, says Barber. Preventing suicides will likely require many approaches, from education and media campaigns to skilled treatment and community support. Ultimately, the goal is to transcend politicswhich is why those who have lost loved ones to gun suicide should have the last word: Ryan is my baby. I remember once telling him, If anything happens to you, I would cease to exist. And thats what it feels like. Its a pain like no other. I would encourage open conversationactually talking about it. Preventing just one person from going through what I went through and will go through for the rest of my lifethat would be enough for me. Wendy Tapp, mother of 19-year-old Ryan Tapp, who shot himself with a handgun in 2011

URSDAY, Aug. 1 (HealthDay News) -- Fewer people in America's largest cities are being murdered by guns, but the rate of suicide by gun has increased in recent years, U.S. health officials said Thursday. The report on gun violence from the U.S. Centers for Disease Control and Prevention (CDC) found that the overall gun-murder rate dropped by about 15 percent overall between 2006-2007 and 2009-2010 in a majority of the nation's 50 largest cities. However, the suicide-by-gun rate rose 10 to 15 percent in nearly three-quarters of those cities during the same time frame. "There is good news and concerning news in this article," said report co-author James Mercy, of the violence prevention division within the CDC's National Center for Injury Prevention and Control. The rate of gun murders at the hands of youths aged 10 to 19 exceeded gun murders by adults, and accounted for nearly 3,400 firearm killings in 2009-2010. More than 1,500 teens and preteens took their own lives by gun in that time period, according to the findings, published in the Aug. 2 issue of the CDC's Morbidity and Mortality Weekly Report. In total, more than 22,500 gun murders and more than 38,000 gun suicides were tallied for 2009-2010, the researchers found. Overall, "the firearm homicide rate has actually declined for the three years that we covered in this study. And this is consistent with the long-term decline that we witnessed in firearm homicide rates in the U.S.," said Mercy. He credited police efforts to curb gang violence and the healthier U.S. economy for improvements in the overall rate of gun murders.

Suicides by gun jumped almost 2 percentage points in Oklahoma City and from less than 8 percent to more than 9 percent in the Tampa, Fla., area. In Salt Lake City, gun suicides climbed to more than 11 percent from less than 9 percent in the earlier gun-violence report. "Guns are the most prevalent form of suicide in the United States," Mercy said. This increase in gun suicides is part of an overall upturn in people killing themselves, he added. Unemployment and other economic factors related to the recent recession have been cited in the overall increase in suicides, he noted. The grim statistics highlight the need for stricter gun restrictions, one expert said. "If there is any question that gun control is a big problem, here's a good example of why," said Dr. Victor Fornari, chief of child and adolescent psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y. "Access to firearms is a serious public health problem," he said. "Limiting access to firearms would reduce homicide as well as suicide. As long as guns are available there are going to be these violent outcomes." Mercy thinks violence prevention is key. "One area where we have made a lot of progress is in preventing youth violence," he said. Programs for teens that teach skills for conflict-resolution have been effective, he noted. And programs that focus on family cohesion and proper supervision are also beneficial, Mercy said. Neighborhood watch programs also help stem violence, Mercy added.

Cities that have seen gun murders decline include New Orleans, where the rate fell from 23 percent to 19 percent; the Los Angeles area, with a drop from 6 percent to just over 4 percent; and Richmond, Va., where gun murders dropped from 7.4 percent to less than 6 percent. Suicides are more difficult to prevent than gun murders, Mercy said. This involves identifying people at risk and getting them help and making them feel less isolated, he explained. Overall, safe gun storage is essential for cutting down on murders and suicides. "Everyone believes in the value of storing firearms safely," he said. Additional research is needed to assess the value of other preventive strategies, the CDC authors stated. These might include waiting periods to curtail impulsive suicidal behavior, improving gun-design safety and conducting background checks to prevent high-risk individuals from obtaining deadly weapons.

The rate of suicide using guns has gone up in most of the 50 most populous U.S. metropolitan areas, but the murder rate has fallen, according to new statistics released Thursday. The U.S. Centers for Disease Control and Prevention, which is reasserting its right to study and report on gun deaths, says the economy is a clear factor in the rise in suicides, as is access to guns. Thursdays report focuses on big metropolitan areas and on youths aged 10 to 19. The CDC team found that more than 22,000 people were killed using guns in 2009 and 2010. That compares to 25,406 firearm murders in 2006 and 2007. The good news is that we saw that firearm homicides had declined over the two-year

period we examined, said James Mercy of the CDCs division of violence prevention. That reflects a 20-year trend for murders, he told NBC News. But killings are still high among youths. The second leading cause of deaths among teenagers was homicide, and 83 percent of these killings involved a gun. New Orleans has by far the highest per capita rate of homicides using guns-- 23.2 murders per 100,000 people in 2006-2007 and 19 per 100,000 in 2009-2010. Other cities with high murder rates include Memphis, with a rate of 11.4 in 2006 and 9.4 in 2010; Birmingham, Ala., with a rate of 11 in 2006-2007 and 8.4 in 2009-2010 and Baltimore, with a murder rate of 10.3 in 2006-2007 and 7.7 in 2009-2010. New Yorks homicide rate was 3.2 per 100,000 in 2006-2007 and 2.8 per 100,000 in 2009-2010. The rate in Portland, Ore., was 1.4 per 100,000 in both time periods. Suicides, on the

Gun violence may be broadly defined as a category of violence and crime committed with the use of a firearm; it may[1] or may not[2][3] include actions ruled as self-defense, actions for law enforcement, or the safe lawful use of firearms for sport, hunting, and target practice. Gun violence encompasses intentional crime characterized as homicide (although not all homicide is automatically a crime) and assault with a deadly weapon, as well as unintentional injury and death resulting from the misuse of firearms, sometimes by children and adolescents.[4][dead link] Gun violence statistics also may include self-inflicted gunshot wounds (both suicide, attempted suicide and suicide/homicide combinations sometimes seen within families).[5] Not included in this subject are statistics regarding military or para-military activities, the information applies to the actions of civilians. The phrase "gun crime" is consistently used by both gun-control and gun-rights policy advocates, with differing emphases: the former group advocates reducing gun violence by enacting and enforcing regulations on guns, gun owners, and the gun industry, while the latter group advocates education on how to be a responsible gun owner. [6][7] Levels of gun violence vary greatly across the world, with very high rates in Brazil, Venezuela, Mexico, South Africa, Colombia, El Salvador, Guatemala, Honduras, and Jamaica, as well as high levels in Russia, The Philippines, Thailand, and some other underdeveloped countries. Levels of gun violence are very low in Singapore and Japan, and are low in New Zealand, the United Kingdomand many other countries.[8] The United States has the highest rate of gun related injuries (not deaths per capita) among developed countries, though it also has the highest rate of gun ownership and the highest rate of officers.[9] Some research shows an association between household firearm ownership and gun suicide rates.[10][11] For example, it was found that individuals in a firearm owning home are close to five times more likely to commit suicide than those individuals who do not own firearms.[12] However, other research found a statistical association among a group of fourteen developed nations but that statistical association was lost when additional countries were included.[13] During the 1980s and early 1990s, there was a strong upward trend in adolescent suicides with a gun,[14] as well as a sharp overall increase in suicides among those age 75 and over.[15] In the United States, where suicides outnumber homicides 2:1,[16] firearms remain the most common method of suicide, accounting for 52.1% of all suicides committed during 2005. [17]

Research also indicates no association vis--vis safe-storage laws of guns that are owned, and gun suicide rates, and studies that attempt to link gun ownership to likely victimology often fail to account for the presence of guns owned by other people leading to a conclusion that safe-storage laws do not appear to affect gun suicide rates or juvenile accidental gun death.[18][19] Gun control advocates argue that the strongest evidence linking availability of guns to injury and mortality rates comes in studies of domestic violence, most often referring to the series of studies by Arthur Kellermann. In response to public suggestions by some advocates of firearms for home defense, that homeowners were at high risk of injury from home invasions and would be wise to acquire a firearm for purposes of protection, Kellermann investigated the circumstances surrounding all in-home homicides in three cities of about half a million population each over five years. He found that the risk of a homicide was in fact slightly higher in homes where a handgun was present, rather than lower. From the details of the homicides he concluded that the risk of a crime of passion or other domestic dispute ending in a fatal injury was much higher when a gun was readily available (essentially all the increased risk being in homes where a handgun was kept loaded and unlocked), compared to a lower rate of fatality in domestic violence not involving a firearm. This increase in mortality, he postulated, was large enough to overwhelm any protective effect the presence of a gun might have by deterring or defending against burglaries or home invasions, which occurred much less frequently. The increased risk averaged over all homes containing guns was similar in size to that correlated with an individual with a criminal record living in the home, but substantially less than that associated with demographic factors known to be risks for violence, such as renting a home versus ownership, or living alone versus with others.[22] Critics of Kellermann's work and its use by advocates of gun control point out that since it deliberately ignores crimes of violence occurring outside the home (Kellermann states at the outset that the characteristics of such homicides are much more complex and ambiguous, and would be virtually impossible to classify rigorously enough), it is more directly a study of domestic violence than of gun ownership. Kellermann does in fact include in the conclusion of his 1993 paper several paragraphs referring to the need for further study of domestic violence and its causes and prevention. Researchers John Lott, Gary Kleck and many others dispute Kellermann's work.[23][24][25]

Kleck showed that no more than a handful of the homicides that Kellermann studied were committed with guns belonging to the victim or members of his or her household, and thus it was implausible that victim household gun ownership contributed to their homicide. Instead, the association that Kellermann found between gun ownership and victimization merely reflected the widely accepted notion that people who live in more dangerous circumstances are more likely to be murdered, but also were more likely to have acquired guns for self-protection prior to their death[26]Kleck and others argue that guns being used to protect property, save lives, and deter crime without killing the criminal accounts for the large majority of defensive gun uses.[27][28][29 he United Nations Office on Drugs and Crime defines robbery as the theft of property by force or threat of force. Assault is defined as a physical attack against the body of another person resulting in serious bodily injury. In the case of gun violence, the definitions become more specific and include only robbery and assault committed with the use of a firearm.[30] Firearms are used in this threatening capacity four to six times more than firearms used as a means of protection in fighting crime. [31] Hemenway's figures are widely disputed by other academics, who assert there are many more defensive uses of firearms than criminal uses. See John Lott's "More Guns, Less Crime". In terms of occurrence, developed countries have similar rates of assaults and robberies with firearms, which is a different trend than homicides by firearms.[32][33]

Suicide world wide

The World Health Organization says that more people are killed by suicide each year than by homicides and wars. It estimates that up to one million people die by suicide each year across the world, and that ten to 20 times more attempt it. It is the leading cause of death among teenagers and adults under 35 years of age. Overall, Belarus leads the world with 35.1 suicides per 100,000 people. Switzerland is 20th with 19.1 and the United States is 40th with 11.1. In almost every country, except China, more men kill themselves than women.

Some form of psychiatric disorder is present in 90 per cent of people who commit suicide. Depression accounts for 60 per cent.

Suicide in Switzerland
Every day, 3-4 people take their lives. That represents an annual suicide rate of 19.1 per 100,000 residents. About 1,300 kill themselves every year - roughly four times more than die in road accidents. Between 1 and 2 % of Swiss die by suicide. The highest rates are in the two half-cantons of Appenzell, and the lowest is in the Italian speaking canton of Ticino.

The United Nations Office on Drugs and Crime defines robbery as the theft of property by force or threat of force. Assault is defined as a physical attack against the body of another person resulting in serious bodily injury. In the case of gun violence, the definitions become more specific and include only robbery and assault committed with the use of a firearm.[30] Firearms are used in this threatening capacity four to six times more than firearms used as a means of protection in fighting crime.[31] Hemenway's figures are widely disputed by other academics, who assert there are many more defensive uses of firearms than criminal uses. See John Lott's "More Guns, Less Crime". In terms of occurrence, developed countries have similar rates of assaults and robberies with firearms, which is a different trend than homicides by firearms.[32][33]