National support for ‘red-flag’ gun laws could prevent many suicides

Red-flag gun laws, which allow for the temporary removal of guns from individuals at high risk of harming themselves or others, have broad public backing but haven’t yet gained national traction. That could change now that bipartisan support is mounting in Congress for the Extreme Risk Protection Order and Violence Prevention Act. Introduced by Sen. Marco Rubio (R-Fla.) and colleagues earlier this year, the legislation would not create a federal red-flag law but would instead give states incentives to adopt their own by providing grants for implementation. If approved, the bill will surely prevent deaths — including those from suicide — though its future is far from certain.

In an era when many have grown accustomed to mass shootings with no subsequent government response, Rubio’s proposal is a welcome attempt to help curb the terror engulfing our nation. Even the NRA has changed its long-standing opposition to red-flag gun laws, as long as they allow for adequate due process, which Rubio’s bill does provide. Opponents have voiced concern about the potential overreach or abuse of such laws. In states that already have them, only 0.02% to 0.04% of gun owners have been affected, demonstrating that these fears are unfounded. Still, to address them, Rubio’s bill requires that states make false reporting a felony.

While mass shootings may have motivated Rubio to introduce the legislation, its potential benefits go far beyond their realm. Although such shootings are increasing in frequency and deadliness, they thankfully remain rare. In 2018, they claimed the lives of 373 people, with 313 deaths so far this year. In contrast, more than 47,000 Americans died from suicide, and 1.4 million attempted it in 2017, the last year for which complete data are available. Suicide is our country’s 10th leading cause of death, and its frequency is increasing. Americans are 2 1/2 times more likely to take their own lives than to be murdered.

Any death is tragic, but suicide is particularly so because it is often impulsive. Most people who attempt suicide and survive regret making the attempt, and 70% never try again. Remarkably, firearms are used in only 6% of suicide attempts but cause more than half of all suicide deaths. Due to their destructive power, approximately 85% of suicide attempts involving firearms end in death. Their involvement in suicide attempts is also rising.

Red-flag gun laws have been shown to reduce firearm suicide rates, with one suicide averted for every 10 to 20 gun removals.

I grew up on a farm and am a gun owner myself, so I understand the importance of the right to own firearms, especially in rural America. But unlike most gun owners, my work as a psychiatrist has repeatedly brought me face to face with patients who have endured self-inflicted gunshot wounds and lived to regret them. I don’t, of course, see the many others who succumb to their injuries. But I don’t need to — my encounters with survivors have already made it impossible for me to close my eyes to the intrinsic link between guns and our suicide epidemic.

I often treat patients who have been hospitalized because they are suicidal or have survived a suicide attempt. They are usually stabilized with therapy and medications and discharged back into their communities within a week. But before that happens, I must figure out what to do when such individuals have one or more guns at home, since the rate of suicide following discharge is 30 times higher than in the general population.

It’s incredible to me that when a recently suicidal patient is cooperating with treatment, is not threatening to harm others, and is not legally committed — which covers the vast majority of patients — there is no mechanism in most states for a mental health provider to petition authorities to have their guns temporarily removed. The only option for providers when discharging these patients is to ask family members to take away their guns and encourage them to inform local police about the situation.

Once the patient is discharged, his or her family members are free to give back firearms whenever they decide the time is right. Sadly, many cave to pressure from the patient and return guns too soon, leading to suicides that could have been prevented.

With just one much-needed tweak, Rubio’s red-flag gun law could provide a long-needed fix to this serious problem. As currently written, states would allow only family members and law enforcement officers to petition a court for gun removal in order to receive federal funding. Although courts could mandate mental health evaluations, mental health providers are conspicuously absent as petitioners, despite the fact that we treat many patients who are estranged from family and unknown to law enforcement. Allowing mental health providers to generate such petitions would be a huge addition.

And while families might hesitate to submit a petition because they don’t want to anger their loved one, mental health providers would face no such emotional obstacle. If this bill helps states allow us to breach confidentiality and petition a court to remove guns from suicidal patients, many more lives could be saved. The longer that guns can be removed the better, since approximately 50% of post-discharge suicides occur within six months of discharge.

While red-flag gun laws might prevent some mass shootings, they would spare many more lives from suicide. That impact would be greatly magnified if mental health providers were allowed to play a more active role in our nation’s safety. Don’t leave us out if you want effective, common-sense gun control.

Brian Barnett, M.D., is an addiction psychiatrist at Cleveland Clinic’s Lutheran Hospital.