Comparative circumstances of firearm versus non-firearm suicides

Introduction: Access to lethal means has been shown to have a significant effect on the risk of suicide. The lethality of firearms increases the likelihood that suicide attempts will be successful; the nature of the mechanism makes it possible to quickly act upon suicidal thoughts. This suggests that suicide circumstances may differ by means utilized. Data and methods: The New Jersey Violent Death Reporting System and New Jersey hospital discharge data were used to compare suicide circumstances and prior hospitalizations for suicides occurring from 2003 through 2007. Suicides were linked to hospitalizations occurring during the five years prior to death. Results: Firearm suicides were less likely to have mental health-related circumstances and more likely to have circumstances associated with physical health problems. While firearm and non-firearm suicide decedents were equally likely to have had prior hospitalizations, firearm suicide decedents were significantly less likely to have been hospitalized for mental health related reasons, and significantly more likely to have been hospitalized for all major categories of chronic diseases. Conclusions: These results are consistent with the hypotheses that firearm suicides are less likely than non-firearm suicides to be associated with mental health problems. Additionally, firearm suicides decedents had a higher rate of hospitalizations for physical health problems. Results suggest that primary care physicians should be alert to gun ownership as a risk factor for suicide for patients with chronic health conditions. Differences in circumstances by mechanism reported in the New Jersey Violent Death Reporting System are confirmed by analysis of hospitalization data.