Epidemiology of Youth Firearm Suicides: Informing Prevention with Findings from the National Violent Death Reporting System

Background

Firearms are used in approximately half of all youth suicides, more than the next 3 leading methods of suicide combined.  Given the high lethality of firearms as a method, information about the circumstances of firearm suicide is important for prevention practice.

Methods

To better understand the circumstances of youth firearm suicide, we conducted descriptive analyses of data from the National Violent Death Reporting System (NVDRS), a population-based surveillance system that combines three data sources: medical examiner/coroner records including toxicology results; death certificates; and law enforcement records to provide important information on all violent deaths occurring in participating states.  NVDRS examines well-established risk factors and precipitating circumstances for suicide, as well as information pertaining to youth firearm access.

We analyzed NVDRS data on all firearm suicides by youth aged 10-24 years that occurred between 2005 and 2010 in the 16 participating NVDRS states (n=3,941). Additional analyses compared these circumstances with those of youth suicide decedents who used non-firearm methods (n=4,216).

Results

The leading circumstances associated with youth firearm suicides in this sample were: Problems with a dating partner (32%), crisis within the past 2 weeks (30%), and current depressed mood (29%).  In comparison, non-firearm youth suicide decedents were significantly more likely to have a history of mental health problems and treatment (χ²=186.95, p <.001), and prior suicide attempts (Χ²=195.24, p <.001).   The type of firearm most frequently used by the decedents was a handgun (60%), followed by rifle (17%), and shotgun (16%).  From the small percentage of decedents for which youth firearm access information was available (N=235; 7%), 60% used a firearm owned by a parent.  Incident narratives were reviewed to report further details regarding youth access to firearms and precipitating circumstances.  Results from additional subgroup analyses for minors (<18 years of age) and those reporting no known risk factors will be presented.

Conclusions

These descriptive results provide new insights into the circumstances of youth firearm suicide. The most frequent circumstances accompanying youth firearm suicides were related to acute life stressors and current depressed mood.  These decedents were less likely than other youth suicide decedents to have exhibited warning signs such as prior suicide attempts, and were less likely to have come to the attention of the mental health system.  These findings suggest that youth firearm suicides may often be situationally determined.  This underscores the potential importance of strategies such as enhancing youth coping skills and safe firearm storage for youth suicide prevention.