Self-reports from more than 23,000 high school students in 15 states for a school-based survey administered by the Centers for Disease Control reveal a strong association between firearm carrying and the risk of suicide by any method, according to a new study by Michael A. Lindsey of New York University and other mental health experts.
Published today in JAMA Network Open, the study finds that adolescents who acknowledged carrying a firearm within the previous 30 days were nearly four – or 3.72 – times as likely as non-carriers to have attempted suicide within the prior 12 months.
The "acquired capability" that comes with carrying a firearm— "including habituation to fear and fearlessness about death" —can be lethal for a teenager, given the typically rapid transition from suicidal thoughts to attempts, which for most individuals can be one hour, the study noted.
"Among adolescents, gun carrying may represent both increased access to lethal means during acute crisis and heightened capability for suicide, accelerating the transition from ideation to attempts," according to the study, which was led by Lindsey, a widely cited scholar on youth suicidality and child and adolescent mental health who is the dean of the NYU Silver School of Social Work and the Paulette Goddard Professor of Social Work.
Suicide is the second leading cause of death among high school adolescents (after accidental death), with firearms serving as the primary means of suicide among youth since 2020. However, prior researchers have focused on the risks of suicidality posed by youth access to guns in the home, rather than firearm carrying.
The current study found that more than 35 percent of non-Hispanic Black gun carriers indicated they attempted suicide during the 12 months before they were surveyed, having carried a gun three months prior to their survey response. That compared with 30 percent of Hispanic gun-carrying youth, and 21 percent of White gun-carrying youth. "Given that firearm suicide rates among Black youth have increased by 245% since 2014, these findings take on special urgency," said Lindsey.
Nationally, youth suicide declined starting in 1981, only to reverse course as of 2015, most rapidly among Black and Latinx youth. White youth, who for decades experienced the highest suicide rates among racial groups, have seen a 6% decrease in suicides since the start of 2015.
Lindsey worked closely with adolescent mental health specialists at NYU, UC Berkeley, and Harvard in analyzing the 2023 Centers for Disease Control and Prevention (CDC) Combined Youth Risk Behavior Survey (YRBS). The classroom-level survey, done every two years, monitors and compiles data on high-priority health risk behaviors and trends among high school students nationwide.
Among the findings of Lindsey and his coinvestigators is that heightened risk of a suicide attempt is not only strongly linked with firearm carrying but is independent of a gun-carrying adolescent's grade, race, ethnicity, or sex.
The researchers looked into whether states with strict gun laws reduced suicides and suicide attempts, but a clear picture was not readily determinable. Using Everytown for Gun Safety's 2023 measure of the strength of firearm laws state-by-state, the researchers found only that stronger laws appeared to be "modestly protective" for youth, which aligns with past research.
No matter how, or in what state, teenagers may procure a gun, toting it with them signals "a salient marker of risk," with a higher chance that a troubled adolescent will feel emboldened to cut their life short by any means (not necessarily with a firearm), the researchers wrote.
"Gun carrying may confer suicide risk not primarily as the method of attempt, but because it: (1) provides immediate access to lethal means during acute crises; (2) serves as an indicator of broader risk-taking and externalizing behaviors; and (3) signals heightened exposure to violence and trauma," according to the study.
They pointed to a "robustness of the association across demographic groups and policy environments" as evidence of the personal danger represented by firearm carrying among teenagers.
Describing multilevel suicide-prevention measures, the study recommended that mental health practitioners incorporate assessments of gun carrying into routine suicide risk screenings in pediatric and school-based settings, alongside lethal-means counseling for families in firearm-owning households, an evidence-based suicide prevention strategy.
The study also recommended comprehensive firearm legislation to prevent child access to firearms, safe storage, and age restrictions, with a particular emphasis on keeping adolescents from accessing firearms. Addressing youth suicide also requires measures to reduce racially/ethnically marginalized adolescents' exposure to violence, economic precarity, and unequal access to mental health care.
Along with Lindsey, the research investigation was conducted by Jasmin Brooks Stephens of UC Berkeley, Department of Psychology; Brittney Singletary of NYU Silver; Taylor McGuire of Harvard, Department of Psychology; and John Dixon of the NOXID Group.
