Suicidal Behavior and Firearm Access: Results from the Second Injury Control and Risk Survey (ICARIS-2)

Background: Little is known about how suicidal plans are related to the presence of household firearms. Methods: We examined the association between living in a home with firearms and the likelihood and nature of self-reported suicidal thoughts, plans, and attempts using ICARIS-2, a nationally representative random-digit-dial telephone survey of English- and Spanish-speaking households in the U.S, 2001-2003. Results: Of 9,684 respondents, 7.4% (95CI 6.7-8.1) reported having suicidal thoughts in the past year, 21.3% (95CI 17.3-25.3) of whom had a suicide plan. Similar proportions of those with and without a firearm in their home reported suicidal thoughts and plans. Respondents living in a home with firearms were more likely than respondents in homes without firearms to report suicide plans that involved firearms (23.4% vs. 4.2%, p<0.001) and less likely to report plans with methods far less likely to prove fatal (e.g. pills). After adjustment for age, gender, race, income, and relationship status, respondents with a firearm in their home were six times more likely to report a suicide plan involving a firearm (Odds ratio [OR] 5.99, 95CI 1.65-21.75). A gun in the home greatly increased the odds that a woman would have a suicide plan involving a firearm (OR 134.4, 95CI 3.6-5052.7), but only modestly (and insignificantly) increased the odds among men. Conclusions: Given the high proportion of suicide attempts with guns that prove lethal, and the relatively low proportion of attempts with other methods that prove lethal, our findings support targeted education for firearm restriction among high risk groups.