Prior suicide attempts are less common in suicide decedents who died by firearms relative to those who died by other means

Background: Suicide prevention efforts often center on the identification of risk factors (e.g., prior suicide attempts); however, lists of risk factors without consideration of context may prove incapable of impacting suicide rates. One contextual variable worth considering is attempt method. Methods: Utilizing data from the National Violent Death Reporting System (2005-2012), I examined suicide deaths (n=71,775) by firearms and other means to determine whether prior suicide attempts were more common in one group versus the other. Results: Significantly fewer suicide decedents who died by firearms reported a prior history of suicide attempts (12.10%) than did decedents who died by other means (28.66%). This result was further replicated within each state that contributed data to the NVDRS. Limitations: Only 17 states have contributed to the NVDRS thus far and, within those states, not all suicide deaths were reported. Due to the nature of the data, I was unable to test proposed mediators within our model. Conclusions: Suicide decedents who die by firearms may die on their first attempt more often than other decedents due to a capability and willingness to utilize a highly lethal means. Current risk assessment protocols may be ill equipped to identify such individuals prospectively on their own. Broader methods of implementing means restriction (e.g., legislation) may thus be pivotal in suicide prevention efforts. (C) 2015 Elsevier B.V. All rights reserved.