Forgotten Statistics

A Candid Conversation about Firearms and Suicide

Image by Tóth Viktor

In the wake of…

We’re riding the wave once again. A wave of mass-shootings, and viral political speeches. When you’ve been around for enough time, you begin to wonder whether this twisted script of groundhog day is ever going to be seen for what it really is; a script for inaction and unaccountability, that our public leaders knowingly regurgitate. For anyone like me, who doesn’t have the power to make real change on their own, I feel like this is a good time to revisit the issue on a personal level.

Personally, I’m finding that we are having the right conversations. Regrettably, I don’t think that we have the right perspective of the issue. Which is why I’d like for this article to invoke a new perspective of gun violence for you.

Mass shootings are a dark topic to study but I want you to know it will not be the primary topic of discussion, as it is in the news today. No, today I want to show you a world that is in my opinion, darker. The story of firearms, suicides and access to mental healthcare.

What states have the worst suicide rates?

Here is a map:

Now here is another map:

I made these maps based on data that I’ve gathered myself. Much of the visualizations you will see here are a product of my own data analysis with Tableau Public. If you don’t see a source listed below an image, then it is mine. One of the images above displays suicide rates across the country in 2020. The other image displays the percent of firearm deaths that were suicides in that same year.

Can you tell which one is which?

Clearing Assumptions

I decided to research suicide because I thought it would be interesting to analyze for my data portfolio. It would be a bit of data journalism to show my ability to tell a story with analytical insights. So the first thing I did after gathering suicide rates, was look at a blanket of possible correlating factors. I personally decided to go with mental healthcare access, overdose rates, homelessness and gun-ownership. I chose guns as one variable, but it wasn’t the focus when this project began. It just so happened that there were only two variables that stuck out:

1. Gun ownership per capita

2. Access to mental healthcare

Why does Wyoming have so many suicides?

When analyzing data, you want to make sure you’re aware of statistical outliers. Outliers can display the averages inaccurately and make it harder to see trends. That is how Wyoming became my first troubling example.

The suicide rates in Wyoming are so bad that there was a PBS special addressing the issue 6 years ago. In that video, community leaders and state politicians spoke of problems and progress. Today the state is still on top of the list at 30 suicide deaths per 100,000.

In the dashboard below I compared Wyoming to Oregon and Nevada, who all rank low in mental health access and share a high percentage of suicides by firearm. Yet, the suicide rates of NV and OR are but half of that of Wyoming’s.

One factor that needs to be considered, although surely not the only one, is the fact that Wyoming has 23 guns per capita. About 5 times more than the other two states and the highest in the country by a large margin.

It needs to be said that this example is not as simple as gun ownership. New Hampshire ranks worse in mental health access than Vermont and has ~3.5x the amount of guns, yet Vermont has a higher suicide rate and a higher % of those who attempt suicide by firearm. The biggest difference these neighboring states have is population. With New Hampshire at ~1.3m and Vermont at ~640k.

Like many societal issues, this one is complex. There are more ways to look at the numbers than there are days in the year.

For example, Wyoming has the lowest population in the country at ~576k, but Vermont is quite similar at ~640k. So if population was such a significant factor then why is Vermonts suicide rate only half that of Wyomings? Which leads me to believe gun ownership is a significant factor. Especially when you have one state like Wyoming, that is the statistical outlier in the country for gun ownership and suicide rate. I don’t believe such a relationship can be ignored, regardless of population size.

Do guns increase the rate of suicide?

The graph above shows a strong trend between the level of gun ownership in a state and the rate of suicides. Additionally, firearm deaths increase as the rate of ownership increases. These numbers led me to research the relationship between guns and suicide in the first place. At this point in my analysis I couldn’t just use my data, I had to educate myself on what research is already out there.

The fact of the matter is gun violence reaches ~321 people per day and ~111 of those people don’t survive. 58% of the people who die from those gunshot wounds, pulled the trigger themselves. So it turns out, our gun violence problem, is mainly a suicide problem and our suicide problem, is primarily a gun problem.

When it comes to suicide, poisoning (including overdose) is the most frequented method, but a firearms represent the most suicide deaths.

Source: https://www.nimh.nih.gov/health/statistics/suicide

Although poisoning is the most popular attempt, only 14% result in a fatality. Meaning 86% of the people behind these statistics have a second chance to choose life, but will they or do failed attempts just prolong the inevitable? At this point in my research I wondered if using a firearm was more humane than a botched suicide. Luckily, my curiosity led me to dig deeper than that assumption, to a study published in the Annals of Internal Medicine. Which stated that 9 out of 10 failed suicide attempts do not result in a second attempt. Ever.

Contrary to what I believed, suicide is a moment of vulnerability, brought on by unspoken pressure and a traumatic trigger. It turns out that the majority of people who commit suicide do so within hours of a sudden change in their lives or an event that causes emotional distress. After that impulse has passed, survivors regret that attempt. And luckily you can have the chance to regret an attempt, most of the time. You can find meaning after an attempt, most of the time. You can live through an attempt, most of the time. Unless that attempt is with a firearm.

In 2008, a New Hampshire community found themselves in shock when 3 unrelated people purchased a firearm from the same store, went home and shot themselves within days of each other. This sparked an investigation by the state medical examiner who found the following:

“among the 144 firearm suicides that occurred over a two-year period ending 6/30/09, nearly one in ten involved a gun that was purchased or rented within a week of the suicide (usually within hours) “.

This further outlines the impulsivity of the suicide and how one’s access to a firearm makes such a difference in those moments.

Source: https://www.nimh.nih.gov/health/statistics/suicide

As you can see in the chart above, 1.2 million adults attempted suicide in 2020, more than 45,000 succeeded. 52.83% of those died by firearm, which is over 23,000 people who didn’t get a second chance; who’s families will now have to pick up the pieces of the life they left behind too soon.

I don’t know if changing the means by which people try to kill themselves will significantly lower suicidal impulses or the rate of attempts. Firearms themselves only make up 5% of total attempts nationwide. What I do know is that the more we bring gun access into the conversation, the less people will die from these attempts.

5% of the attempts, 52% of the deaths. To me, this is an outrageous number; especially when you think about suicides making up 58% of all gun-related deaths. It makes me wonder why this conversation hasn’t been had on a national level yet.

Why doesn’t the CDC research gun violence?

In 1993, a CDC sponsored study found that there is more danger associated with having a gun than there is protection. The gun lobby got understandably nervous with this. So with the help of the NRA, they spent the next 3 years lobbying and by 1996 congress restricted the CDC’s budget with an amendment that threatens their funding if their research “may be used to advocate or promote gun control”

I’m not going to comment on this action here. What I do want is to bring it to light and leave a quote from a Harvard Public Health Report that analogizes this decision.

“People who do research on lung cancer are allowed to draw conclusions about smoking. The same with people who do research on environmental exposure to PCBs, or on motor vehicle design issues, or on drug overdoses. There’s no national organization pillorying them or actively seeking to defund them.”

Congress finally approved $25m for limited gun research in 2019. This is progress, but it’s pennies compared to what’s needed and the restrictions on the research do not do enough to tackle the problems we face today. This is corroborated by the 2020 Rand Corporation study. Which serves as the most comprehensive research on guns and gun policies that we have to date. The biggest insight they got out of that entire study was that we don’t have enough data on gun violence to make any impactful policy changes.

Does gun violence have to do with mental health?

Here are 5 Republican politicians who had an A+ rating from the NRA as late as 2016 and 3 of the once highest graded democrats (who still hold public office).

Richard Shelby is a Republican Senator from Alabama, the former chairman and current vice chair of the Senate Committee on Appropriations. He has been around since the 80s.

According to his campaign page he believes mental health is a big issue:

“Alternatively, I believe that we need to enforce the laws already on the books, combat the culture of violence in society, and address the underlying mental health issues that may contribute to such heinous acts”

If you don’t know who Marco Rubio is, then you’re probably not my target audience. After the Jacksonville shooting, Rubio had this to say:

“I remain committed to pushing for legislation that takes a multi-pronged approach to both addressing mental health and keeping guns out of the wrong hands.”

Chuck Grassley, is the longest serving senator in Iowa history, and he actually co-authored the Protecting Communities and Preserving the Second Amendment Act of 2015 & 2016. Chuck has touted this as a solution to the country’s mental health issue while still protecting the Second Amendment. So instead of giving you a quote, I’m going to lay out how his bill addresses mental health.

Here is every section of the bill that mentions mental health :

“a person who is mentally incapacitated, deemed mentally incompetent, or experiencing an extended loss of consciousness shall not be considered adjudicated as a mental defective under subsection (d)(4) or (g)(4) of section 922 of title 18 without the order or finding of a judge, magistrate, or other judicial authority of competent jurisdiction that such person is a danger to himself or herself or others.”

Ok so it changes a definition for section 922 of Title 18. But what are those sections of Title 18?

(d)(4) “It shall be unlawful for any person to sell or otherwise dispose of any firearm or ammunition to any person knowing or having reasonable cause to believe that such person”

&

(g)(4) “It shall be unlawful for any person”

In other words, it makes it easier for those with mental illnesses to purchase a weapon.

Mitch Mcconnell, had some recent words on gun violence in America on June 12th, 2022. After the framework for a bi-partison gun-control bill was agreed upon, he had this statement for the press:

“I continue to hope their discussions yield a bipartisan product that makes significant headway on key issues like mental health and school safety, respects the Second Amendment, earns broad support in the Senate and makes a difference for our country,”

Ted Cruz, who had more than one notorious moment after Uvalde, had this to say about possible solutions:

“We know what does prevent crime which is going after felons and fugitives and those with serious mental illness arresting them prosecuting them when they try to illegally buy firearms.”

Do the votes match the quotes?

I’m not going to drag you through the hours of reading I did on each bill above. But these bills are related to guns or mental health. The only thing these politicians seemed to vote yes on, is more access to guns and more access to mental illness records within criminal databases. It’s strange to me that these men will support putting mental health records side by side with criminal background checks, even though they continue to vote against expanding background checks.

The Affordable Care Act, provided coverage and protection to those with preexisting mental illnesses and set up incentives for college graduates who’s worked within mental health services. Every single person up there voted to repeal the ACA.

I’m not blind to the fact that we’re talking about multiple bills with multiple sections within each bill. Voting against one bill doesn’t mean you disagree with everything in it. What I can’t comprehend is how none of these people have been held accountable for their quotes on mental health. Not one of them has voted to expand mental health access nor proposed any legislation that would attempt to tackle the issue on a federal level.

This isn’t just a republican issue either. The Moderate Democrats; Manchin, Cueller and Bishop also tend to bring up mental health in the wake of mass shootings events and they’ve also been given money from the NRA.

Sanford Bishop and Henry Cueller have voting records that both support gun control legislation and mental health access in recent years. Once A rated by the NRA, they’ve continued to see lower and lower ratings recently, now sitting at ~42%. As their ratings from the NRA decline, their ratings from mental health organizations remain abismal.

The American Public Health Association, Depression and Bipolar Support Alliance and Eating Disorders Coalition have Bishop hovering around a 50% rating and Cueller receiving a negligible 0% from another one of these organizations.

Back to Joe Manchin, who has always favored expanding mental health access, but only if that means expanding access to mental health records for criminal background checks. In fact, he co-authored the Manchin-Toomey plan in 2013. Which aimed to improve the record keeping of mental health, put inplace specific restrictions on veterans who are deemed “mentally incompetent” to own a firearm and fund studies on mass shootings including their relation to mental health. Mitch Mcconnel not only voted against it, but as the leader of the Republican party, he pushed his conference to oppose the bill.

Most recently, Manchin stated his support for legislation aimed at expanding background checks, while also calling for “mental illness reform” in the wake of the mass shooting in Buffalo. I wouldn’t hold your breath on him fighting for this issue. As governor of West Virginia, Manchin vetoed the Mental Health Law Amendments of 2009. These amendments were to declare a mental health crisis in the state of West Virginia and provide resources to stop these underfunded programs stay afloat.

So Republican or Democrat, it seems like those with prior NRA funding will talk about mental health the most, but do the least to expand access.

Here is a chart showing democratic senators and representatives that were once A rated by the NRA. Meanwhile, the majority of republicans still have an A rating. As you can see, both sides have now siloed themsleves when it comes to NRA contributions and so have most of their solutions on gun control.

Should we take mental-health seriously as a gun-control measure?

Access to mental health isn’t just a primary talking point during a gun-violence debate, but also a major factor in suicide deaths. Which is why I looked for ways to rank access levels across each state.

I needed a way to compare mental healthcare access across state lines, to see whether or not expanding that access could make an impact. I ended up settling on secondary research through Mental Health America. Their study developed a national ranking of mental-health access by using data on adults who’ve reported mental illness, average out-of-pocket spending, mental health providers per capita, substance abuse, stated thoughts of suicide, percent of people insured and percent of people treated.

The healthcare access is worse in a state with a higher rankas the rank, meaning #1 provides the most access while #50 provides the least. When comparing these rankings with suicide rates, this is what I found:

Based on this ranking, it’s crystal clear that access to mental healthcare coincides with suicide rates. There is other research that has dug into this relationship deeper than I have, and they’ve come to the same consensus.

The ranking I used was from 2020 because that is how recent my suicide numbers are, but the 2022 rankings are available. So let’s see how they’ve changed since 2020 and pay particular attention to the states represented by the congressmen we looked at above.

• Alabama, home to Shelby, dropped 22 places to rank 47th

• Iowa, home to Grassley, dropped 12 places to rank 14th.

• Florida, home to Rubio, dropped 1 place to 25th.

• Kentucky, home to McConnell, went up 19 places to 13th.

• Texas, home to Cruz and Cueller dropped 3 places to 33rd.

• Georgia, home to Bishop, dropped 3 places to 33rd.

• West Virginia, home to Manchin, dropped 3 points to 23rd.

Everyone on this list has touted mental health as an area of serious concern when it comes to gun violence, yet, Mcconnel is the only one representing a state that has seen improvement in mental health access in recent years. This is because McConnel is a Senator, who has no direct influence over state politics. The State’s Governor is the one that pushes these initiatives and provides funding recommendations. Out of curiosity I looked up Kentucky’s governor. A Democrat, elected 2019, just in time to see that mental health access improvement from 2020–2022.

Has the pandemic increased the risk of suicide?

Mental Health Access and suicide do have a positive correlation that is fairly strong. Showing that those that ask for help have a better chance of getting the help they need. But it’s not just about who wants it. It’s about how many people know that they need help. And the answer is, most of us.

Depression and anxiety rates have been steadily increasing in this millenia, but they’ve been skyrocketing since the pandemic. Some of it is due to the disease itself, being sick and losing loved ones. Some of it is due to isolation and uncertainty. Uncertainty in our neighbors, uncertainty in our leaders, uncertainty in the economy and uncertainty with the state of the world.

Suicide rates have been declining since 2018 and 2020 is no different. It’s possible that we continue on that trendline. It is also clear by the maps above that the worst covid rates, coincide with states that have the most guns and the least mental healthcare access.

Are mass-shootings a suicide problem?

As the son of an NRA member who was taught to respect firearms, I have a broad perspective on guns. As I said in the beginning, there were multiple variables I was considering. The recent spike in mass shootings caught me by surprise and brought this issue to the forefront once again. I felt it unreasonable to write an entire story about guns and mental health without mentioning these recent tragedies.

In Buffalo we now have the shooter charged with hate crimes, due to a twisted fear he had of being replaced in society.

In Uvalde Texas an 18 year old with clear and public warning signs purchases his rifles just days before the shooting. He used equipment that makes an entire police force cower outside while he shoots over 100 rounds in the adjoining classrooms.

These tragedies, among others in recent days, have lawmakers pressured to come to an agreement on gun legislation. The framework they’ll be discussing will include mental health solutions. Dade Phelan, the Texas House Speaker has even asked for more money for mental health and school safety programs in his state after the events.

I’m happy to be corrected, but aren’t mass shootings a novel method of suicide as well? Most of these shooters do not go into that school expecting to see their day in court. Yet, whenever gun legistlation is brought up, suicides are never a topic of concern. The numbers are very clear, so it seems safe to assume that suicides don’t fit either side’s narrative, so they’re filtered out of the political discussion.

Gun violence and suicides.

Whenever I spoke about guns prior to this research I would speak in terms of violence. Mass shootings, gang violence, police shootings, homicide, homicide homicide.

That is what is kept in rotation on cable news and that is what gets engagement online; but what I’ve learned is that our truth is being distorted by our own assumptions. We are attracted to crime and violence and that is what we expect our public discourse on guns to be about. That is what we expect the problem is, so that is what is fed to us. Story after story, speech after speech and policy proposal after policy proposal. It’s all about violence because that is all we pay attention to.

When is the last time you’ve seen a politician mention suicide when bringing up gun legislation, despite it being the number one cause of firearm deaths by a landslide? The only time gun violence tends to reach a national discourse is when there is a mass shooting, which only accounted for 0.2% of homicides in the U.S. between 2000 and 2016. Since this is the only time we discuss guns, our politicians only propose research, funding and restrictions that focus on criminality, without focusing on what seems to be our biggest issue with guns; people turning them on themselves.

When we discuss gun-violence, especially mass shootings, we’re using words like monsters or criminals. Our politicians are even linking mental health records with criminal databases. It’s said to be a mental health problem, so why are we addressing it like a criminal one? Demonizing people is typically how you approach a war and in 2022 we already know that when our politicians declare a war on something, it usually gets worse.

We need to stop waging war on gun violence and start addressing it with data and compassion. We need to start giving suicide an amount of attention and discussion that is proportionate with the level of firearm deaths it causes. The numbers are in front of us and both sides seem to publicly acknowledge mental health as a significant factor. There is a mountain of bodies under our feet every time we argue over the motives of oneschool shooter and we cannot continue to ignore their tragedies because it doesn’t make a good enough story.

To the few who made it this far.

After completing this research, I think the most impactful points are that most firearm deaths are suicides and most suicides are out of a temporary impulse. Meaning that given a second chance, most people will choose life.

I think that there is progress to be made if we allow for the proper research into the subject, an expansion and de-stigmatization of mental health solutions and screenings that prove one has the capacity to respect the power of a firearm. Making sure people with suicidal urges don’t have access to the highest lethal method available, should be the bare minimum that we do for them. Making sure somebody has the mental and moral capacity to own something that is designed to kill so efficiently, should be the bare minimum that we do for our children as well.

We can’t continue to talk about gun violence, while ignoring the fact that suicides make up over half the gun deaths in this country. Guns and mental health have a complicated but important relationship. Allot needs to change to start to make true progress on this but all I ask to anyone who has made it this far, is to at least start changing the conversation around gun violence and push to allow more federal funding to study the issue.

Those that we’ve lost to suicide and those that we inevitabily will lose, deserve to be a part of this conversation, not just forgotten statistics.

Side Note.

One side note that I feel obligated to mention is that homelessness, drug use, overdose rates and suicides do seem to have some promise as their own story. You see, I actually found a negative relationship between Homelessness and OD rates and Homelessness and suicides. Meaning the more homeless, the less overdoses and the lower the suicide rate. At first I thought my data was inaccurate, but then I started reading about the issue of homeless death record keeping, or the lack thereof.

What happens is as homelessness increases, the amount of accurate data on any death decreases. Many homeless bodies are never identified, examined or even listed as homeless in their death record. There are cities across the country and non-profit organizations that are on the frontlines of this issue right now and their stories are that of David and Goliath. It’s an incredibly difficult goal to get accurate figures on the homeless but this goal will ultimately lead to more visibility and more ability to provide resources where they’re needed.

I think it’s important to mention now because I believe it deserves its own story. One that I may take up one day in the future.