Communicating the science of suicide prevention: A call to action for psychologists.

INTRODUCTION: Suicide is a major public health concern within the United States, and prevention efforts are essential for decreasing the suicide rate. Researchers and clinicians have knowledge and effective treatments for preventing suicide; however, their impact is limited to those with access to services. Science Communication (SciComm) is an effective tool that can be integrated into the field of suicide prevention and can bridge the gap between scientific findings and the general population. SciComm can help disseminate evidence-based strategies for suicide prevention, dispel misinformation on suicide, and normalize help-seeking. PURPOSE: In this article, we propose specific, tangible ways that SciComm can be integrated into graduate school programs, mentorship, career advancement requirements and can help enact systemic change within the field of suicide prevention. Additionally, we discuss why it is important that the field of suicide prevention, specifically, adopts a SciComm framework. Embracing SciComm can help the field of suicide prevention to have a broader impact and can help to reduce rates of suicide.

US Residents' Recognition of Proper Use of Firearm Cable Locks.

This survey study examines the ability of firearm owners and nonowners to determine correct and incorrect cable lock use across different types of firearms.

Female military service members and veterans: Understanding treatment seeking behavior and previous suicide risk among suicide decedents.

To examine the differences in treatment seeking behaviors, previous suicidal thoughts, previous suicide attempts, and disclosure of suicidal thoughts among female service members (SM)/Veteran suicide decedents who used a firearm and those who used another method. Data was acquired from the National Violent Death Reporting System which is maintained and monitored by the Center for Disease Control and Prevention. Data included in the present study were from suicide deaths that occurred between 2003-2018. Female SM/Veterans who died by firearm suicide had lower proportions of current mental health or substance use treatment, lifetime mental health or substance use treatment, and previous suicide attempts compared to those who used another method. Female SM/Veterans who die by firearm suicide are less likely to encounter mental health services than those who use another method. Conversations on secure firearm storage need to occur outside of the health care setting.

Honor Endorsement and Increased Firearm Purchasing Behavior and Intentions During the COVID-19 Pandemic.

The surge in firearm sales from the onset of the COVID-19 pandemic have been linked to increases in firearm violence, which is of public concern given that having firearms in one's home is associated with increased risk for domestic violence and suicide. Consistent with pre-pandemic trends, individuals tended to purchase firearms for self-protection during COVID-19. Prior work indicates that protective firearm ownership is motivated not only by perceptions that the world (and one's local environment) is dangerous, but also by one's endorsement of masculinity norms found in U.S. cultures of honor (primarily southern and western states). Honor-based masculinity norms emphasis reputation defense, toughness, and an absolute intolerance of disrespect. The present research examined the relative motivating influences of various threat perceptions and masculine honor endorsement in predicting reasons for non-COVID-19 firearm ownership, firearm purchasing during COVID-19, and purchase intentions. Three separate samples (total N = 2483) of mostly White U.S. men completed online surveys during different months of the first year of the COVID-19 pandemic. Participants completed measures of their endorsement of masculine honor norms, factors associated with firearm purchasing (e.g., dangerous world beliefs, intolerance of uncertainty), and firearm purchasing behaviors. Results indicated that masculine honor endorsement was higher among (1) protective firearm owners compared to non-owners and non-protective owners, (2) firearm owners who purchased a firearm during COVID-19 compared to non-owners and non-purchasing owners, and (3) firearm owners with intentions to purchase firearms in the next year compared to those without intentions and undecided owners. Relative to other predictors (e.g., COVID-19 concerns, dangerous world beliefs), masculine honor endorsement was consistently the strongest predictor of these outcomes. Findings add to the literature by highlighting the strength of masculine honor endorsement in motivating (protective) firearm ownership. Implications for interpersonal violence and suicide are discussed.

Determining who military service members deem credible to discuss firearm safety for suicide prevention.

OBJECTIVES: To examine rankings of credible sources for discussing secure storage within a representative sample of firearm-owning service members, and examine how combinations of demographic variables impact the ranking of credible sources. METHODS: The probability-based sample was collected with the help of Ipsos. Participants were US service members who owned a firearm at the time of the survey (n = 719). RESULTS: The total sample ranked service members, Veterans, and members of law enforcement as the most credible sources and faith leaders, casual acquittances, and celebrities as the least credible sources. Black men ranked the NRA as a highly credible source whereas Black females ranked the NRA as one of the least preferred sources. Regardless of political preference, those who lived in non-metropolitan rural environments ranked members of law enforcement as highly credible sources. Those who lived in non-metropolitan rural and urban settings and identified as liberal ranked the National Shooting Sports Foundation as a highly credible source. CONCLUSIONS: Law enforcement officers, military members, and Veterans are ranked as highly credible sources by most subgroups of firearm-owning service members. Leveraging these voices in firearm safety conversations is necessary, may increase adherence to secure storage recommendations, and ultimately reduce suicide.

Perceptions of the utility of secure firearm storage methods as a suicide prevention tool among firearm owners who currently store their firearms loaded and unlocked.

BACKGROUND: Although secure firearm storage can prevent firearm injury and death, secure storage is relatively rare. This tendency may be driven in part by a perceived lack of utility for secure storage in preventing suicide and other gun violence-related outcomes. METHOD: We recruited a large (n = 3510) representative sample of residents from five US states and assessed the degree to which those who do and do not store their firearms securely perceive different utility in specific firearm storage practices for suicide prevention. To test for specificity, we examined if those differences hold when considering unintentional shooting and firearm theft prevention. RESULTS: Those who currently store their firearms unsecured reported lower perceived utility in several firearm storage practices, particularly for suicide and theft prevention. CONCLUSIONS: Our findings highlight that a lack of perceived utility in secure firearm storage may partially drive unsecure firearm storage. Efforts to promote secure storage must address this misperception.

Law enforcement and firearms: understanding firearm ownership and storage habits.

OBJECTIVE: This study seeks to better understand firearm ownership among law enforcement officers (LEO), with the goal of informing future firearm injury and suicide prevention efforts. We describe the frequency and sociodemographic correlates of firearm ownership and storage practices among, and examine the association between suicidal ideation and current firearm storage practices. METHODS: The present study used data from a large online study (n=6410) and included data from individuals who were currently or previously being employed as an LEO (n=369; M (SD) age=39.2 y (15.8 y), 75.2% male, 66.7% white). Self-report measures were used to assess for firearm ownership, storage habits and suicidal ideation. Descriptive statistics were used to describe the frequency of firearm ownership and logistic regressions were used to examine the extent to which demographic characteristics and suicidal ideation were associated with firearm ownership. RESULTS: Overall, 70.5% (n=261) of the sample reported firearm ownership. LEO who were older had significantly lower odds of reporting firearm ownership. Those who were married and those who reported lifetime suicidal ideation had significantly greater odds of reporting firearm ownership. Whereas firearm-owning LEO who reporting storing a firearm locked had significantly lower odds of reporting lifetime suicidal ideation, those who reported storing a firearm unloaded had significantly greater odds of reporting lifetime suicidal ideation. CONCLUSION: Findings have important public health implications and can be used to increase adherence with secure storage recommendations. Increasing secure storage may help reduce suicide risk among LEO, a sample at heightened risk for suicide.

Examining characteristics and experiences of Black firearm owners.

OBJECTIVE: The present study sought to better understand the characteristics of those who own firearms in the Black community; and to understand how Black firearm owners differ from nonfirearm owning Black individuals on a variety of variables related to safety, threat concerns, and suicide risk. METHODS: Two samples were utilized in this study. The first was a subsample of those who identified as Black from a nationally representative sample (N = 502) seeking to understand firearm ownership within the United States. The second used a subsample of those who identified as Black (N = 1086) from a representative sample from New Jersey, Minnesota, and Mississippi. Variables related to safety and threat concerns were included in the second sample. RESULTS: In both samples, multiple demographic variables, such as being a woman and having higher education, predicted firearm ownership. In the second sample, experiences of everyday discrimination and crime experiences were associated with firearm ownership. Additionally, Black firearm owners reported significantly more suicidal ideation than Black nonfirearm owners. CONCLUSION: The findings demonstrate the unique characteristics and experiences of Black firearm owners and show that firearm ownership is associated with increased suicide risk factors for Black adults. Findings should be used to advocate for the creation of more culturally relevant suicide prevention and firearm means safety strategies.

Threat sensitivity, intolerance of uncertainty, and firearm purchasing during a firearm purchasing surge.

The firearm purchasing surge that began in 2020 has seen an unprecedented number of firearms purchased within the United States. The present study examined if those who purchased during the surge differed in their levels of threat sensitivity and intolerance of uncertainty from firearm owners who did not purchase during the surge and from non-firearm owners. A sample of 6,404 participants from New Jersey, Minnesota, and Mississippi were recruited through Qualtrics Panels. Results indicated that surge purchasers have higher levels of intolerance of uncertainty and threat sensitivity relative to firearm owners who did not purchase during the surge and non-firearm owners. Additionally, first time purchasers reported greater threat sensitivity and intolerance of uncertainty relative to established firearm owners who purchased additional firearms during the purchasing surge. Findings from the present study increase our understanding of how sensitivity to threats and the ability to tolerate uncertainty differs among firearm owners purchasing at this time. The results help us determine what programs will increase safety among firearm owners (e.g., buy back options, safe storage maps, firearm safety trainings).

Interactions at the point of firearm purchase and subsequent use of locking devices.

BACKGROUND: Firearms account for over 40,000 deaths in the USA each year in addition to thousands of nonfatal injuries. One notable prevention strategy for firearm-related fatalities and nonfatal injuries is safe storage. Safe storage of firearms emphasizes using storage mechanisms that limit ready access of firearms to unauthorized users. Cable locks are one safe storage option that is easy to access and typically free, as they are included in many firearms sales. The present study examined the extent to which firearms retailers notifying purchasers at the point of sale about the included cable locks was associated with subsequent locking device use in two large samples and three subsamples. Exploratory analyses then examined demographic factors associated with frequency of seller notification of locks. METHODS: Sample 1 included 1203 firearm owners and sample 2 included 1556 firearm owners. Subsamples were drawn from sample 2 to examine if there were differences by state. The three subsamples included firearm owners from Minnesota (n = 515), Mississippi (535), and New Jersey (506). Logistic regressions were used to examine the association between frequency of sellers notifying buyers of locks and subsequent locking device use. Linear regressions were used to examine what demographic factors were associated with greater frequency of seller notification of locking devices. RESULTS: Results indicated a general trend such that more frequent notification of cable locks at the point of purchase was associated with greater likelihood of using locking devices to secure firearms. At the subsample level, these findings were most consistent for Mississippi relative to Minnesota and New Jersey. Exploratory analyses generally indicated those who were younger and those living in more densely populated areas were more likely to be notified about cable locks at the point of purchase. CONCLUSIONS: These findings suggest that interactions about cable locks at the point of firearm purchase has an impact on firearm storage behaviors. Such results indicate that encouraging firearm retailers to have these discussions with those purchasing firearms might be an important strategy for preventing firearm-related fatalities and nonfatal injuries.

Conformity to masculine role norms, firearm storage behaviors, and openness to means safety among two samples of firearm owners.

OBJECTIVE: Understanding the sociocultural characteristics that are associated with US firearm owners' current storage practices and openness to means safety can inform suicide prevention initiatives. Masculinity, which is dominant within the US gun culture, may be a particularly salient factor that influences firearm ownership, storage practices, and openness to means safety. A recent study by McDermott et al. (2021) found that firearm ownership was associated with a combination of being White, male, politically conservative, and endorsing higher conformity to the masculine norms of violence, risk taking, and power over women. The current study builds upon McDermott and colleagues' (2021) research by examining the unique contribution of conformity to nine masculine norms as predictors of current firearm storage practices and openness to firearms means safety. METHODS: Two samples of US firearm owners were recruited on Amazon's Mechanical Turk in 2019 (Sample 1; n = 200) and 2020 (Sample 2; n = 297). RESULTS: Higher adherence to the norms of emotional control, violence, and power over women were associated with less secure storage practices, but only in Sample 2. The hypothesis that self-reliance, emotional control, and risk taking would be associated with openness to means safety was largely unsupported. Adherence to the violence norm was observed to have the greatest association with both current storage practices and openness to changing storage practices. CONCLUSIONS: While several masculine norms were not consistently associated with our outcomes, the norm of violence may play a small role in firearm storage practices and openness to means safety for suicide prevention.

Public Perception of Gun Violence-Related Headline Accuracy and the Credibility of Media Sources.

The present study sought to determine the extent to which the message or messenger is more important for news media portrayal of gun violence prevention. Exploratory analyses also examined factors related to Fox News and MSNBC credibility. Participants (N = 3,500) were US adults matched to the 2010 US Census on several demographic variables. Two mock headlines were presented: "Gun violence is result of mental health problems" and "Storing firearms in a safe can help prevent suicides." Headlines were reported to be from either Fox News or MSNBC. Participants then rated accuracy of the headline and credibility of the news source. Headline content did not predict perceived accuracy of the headline. Perceived credibility of the messenger was associated with perceived accuracy for both mock headlines. Exploratory analyses indicated several demographic factors related to Fox News and MSNBC credibility. Regardless of the content of a headline, the degree to which participants perceived it as accurate was associated with how credible they believed the source to be. These findings highlight the importance of credible media portrayal of accurate information on gun violence prevention.

Demographic differences in the type of firearm and location of bodily injury in firearm suicide decedents.

This study describes the type of firearm used and location of bodily injury among demographic subgroups of suicide decedents. Data on those who died by suicide via firearm from the National Violent Death Reporting System (N = 117,126) between the years 2003-2018 was utilized. A series of five logistic regression analyses examining the age of decedent, type of firearm, location of wound site, loaded vs. unloaded firearms, and locked vs. unlocked storage, using predictors including gender, race, who owns the firearm and age were performed. Findings have important public health implications. Increasing safe storage or removing the specific types of firearms one is likely to use in their death from the home during a time of crisis may decrease risk of suicide.

Preferences for a potential therapist's suicide lived experience and use of therapy.

The present study is an examination of laypersons' preferences regarding therapists with lived mental health experiences. Specifically, we investigated participants' preferences for a treatment with a therapist who has sought personal therapy, experienced suicidal ideation, or made a suicide attempt. Additionally, we explored how participants' personal experiences may impact these preferences. Three hundred ninety-eight community members were recruited to complete an online survey through Amazon's Mechanical Turk. Participants completed delayed discounting paradigms which involve choices between a therapist with the experience (e.g., suicidal ideation) and a therapist without the experience providing treatment with varied levels of therapeutic efficacy (i.e., average percentage of client recovery). Overall, participants were willing to lose therapeutic efficacy in order to work with a therapist who has not been in prior mental health treatment (9.36% efficacy loss), experienced suicidal ideation (19.43% efficacy loss), and engaged in suicide attempts (20.18% efficacy loss). Across these therapist options, the strongest preference was for therapists with prior treatment compared to the other two conditions. Preferences differed somewhat depending on the participant's social stigma, history of suicide attempts, and prior suicidal ideation; however, these effects were small in size. Overall, participants preferred less effective therapists without a history of personal therapy, suicidal ideation, and suicide attempts, compared to more effective therapists with a history of these experiences. Findings from this study highlight the pervasiveness of negative attitudes toward suicidal thoughts and behaviors and lived experience. If replicable, these results emphasize a need for destigmatization of these experiences in mental health care. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Determining subgroups that exist among US firearm owners.

OBJECTIVE: To identify and verify classes of firearm owners that exist within the United States and determine the sources that classes deemed credible to discuss firearm safety for suicide prevention. METHODS: The study is composed of two parts. Part 1 (N = 1018) utilizes a nationally representative sample of firearm owners. Part 2 (N = 1064) consists of firearm owners from Mississippi, Minnesota, and New Jersey. RESULTS: Four unique classes were identified in Sample 1: multiple firearms class, single handgun class, few firearms class, and long-gun class. A three-class solution was found for sample 2. Two of the classes from sample 1 replicated: multiple firearms class and single handgun class. Although many of the classes differed in the ranking of credible sources, a combination of The American Foundation for Suicide Prevention, law enforcement officers, and family members was ranked as credible sources among all classes. CONCLUSIONS: Findings provide evidence of the heterogenous nature of firearm owners and can be utilized to better understand the subgroups of firearm owners. Additionally, the findings from the credible sources analyses can be leveraged to create more effective safe firearm storage messaging which may increase adherence with safe storage suggestions and ultimately reduce suicide rates.

Mental Health Treatment Seeking and History of Suicidal Thoughts Among Suicide Decedents by Mechanism, 2003-2018.

Importance: Understanding mental health and substance use treatment seeking and suicidality among suicide decedents is important to determine prevention efforts. Objective: To evaluate differences in treatment seeking and suicidality between suicide decedents who died by firearms and those who died by other methods. Design, Setting, and Participants: Cross-sectional data were collected on 234 652 suicide decedents from 2003 to 2018. Participant information was reported by their state of residence to the National Violent Death Reporting System. Statistical analysis was performed from July 1, 2021, to January 21, 2022. Main Outcomes and Measures: Main outcomes were treatment for mental health and substance use at time of death, previous treatment for mental health and substance use, history of suicidal ideation or plans, history of suicide attempts, and disclosure of suicidal ideation or plans. Results: A total of 234 652 participants (182 520 male [77.8%]; 205 966 White [87.8%]; mean [SD] age, 46.3 [18.2] years [range, 3-112 years]) were included in this study. Compared with suicide decedents who died by another method (n = 117 526 [50.1%]), those who died by firearm (n = 117 126 [49.9%]) were more likely to have disclosed thoughts or plans of suicide within the month prior to death (odds ratio [OR], 1.16 [95% CI, 1.13-1.18]) and were less likely to have previously attempted suicide (OR, 0.44 [95% CI, 0.43-0.46]). Compared with those who died by poisoning, those who used a firearm were more likely to have had a history of suicidal thoughts or plans (OR, 1.19 [95% CI, 1.15-1.23]) and to have disclosed their thoughts or plans of suicide within the month prior to death (OR, 1.06 [95% CI, 1.03-1.10]). Compared with those who died by hanging, those who used a firearm were more likely to have disclosed their thoughts or plans of suicide to another person within the month prior to their death (OR, 1.14 [95% CI, 1.11-1.17]). Conclusions and Relevance: These findings provide information that suggests who is at risk to die by firearm suicide. Community-based interventions in suicide prevention could help reduce access to firearms during a time of crisis. The finding that firearm suicide decedents were more likely to disclose their suicidal thoughts or plans provides an important avenue for prevention.

The Association of Suicidal Ideation With Firearm Purchasing During a Firearm Purchasing Surge.

Importance: Firearm access is associated with risk for suicide, and, since early 2020, the US has experienced an unprecedented surge in firearm sales. Objective: To assess frequency of suicidal ideation among individuals who purchased firearms during the surge period (surge purchasers), other firearm owners, and non-firearm owners. Design, Setting, and Participants: Cross-sectional online survey data were collected from January to June 2021. Participants were recruited via quota sampling through Qualtrics Panels. Within Minnesota, zip codes from Minneapolis and St Paul were oversampled. Participants included 6404 US adults recruited from 3 states: New Jersey (n = 3197), Minnesota (n = 1789), and Mississippi (n = 1418). Participants identified as becoming a first-time firearm owner during the surge period, being an established firearm owner who purchased a firearm during the surge period, being a firearm owner who did not buy firearms during the surge period, and not owning firearms. Main Outcomes and Measures: The primary outcomes were lifetime, past year, and past month suicidal ideation as measured by the Self-injurious Thoughts and Behaviors Interview-Revised. Results: The mean (SD) age within the full sample was 44.81 (18.45) years, with 3132 males (48.8%), 4706 White adults (73.4%), 2674 reporting annual household income less than $50 000 (41.7%), and 1546 (24.1%) reporting current firearm ownership. In the full sample, individuals who purchased firearms during the surge period were more likely than were non-firearm owners to report lifetime suicidal ideation (odds ratio [OR], 2.21; 95% CI, 1.82-2.68), past-year suicidal ideation (OR, 2.10; 95% CI, 1.72-2.55), and past-month suicidal ideation (OR, 1.80; 95% CI, 1.41-2.29). In addition, among individuals who purchased firearms during the surge period, first-time owners were more likely than established firearm owners to report lifetime suicidal ideation (OR, 2.12; 95% CI, 1.43-3.14) and past-year suicidal ideation (OR, 2.37; 95% CI, 1.59-3.53). Results were largely consistent across states. Conclusions and Relevance: In this survey study, results highlighted that individuals who acquired firearms during the purchasing surge were more likely than other firearm owners and non-firearm owners to have experienced suicidal thoughts. This is particularly true for individuals who purchased a firearm for the first time during the surge period. This illustrates the need to implement policies and interventions that increase safety among firearm purchasers (eg, safe firearm storage) as well as those that promote the acquisition of alternative forms of protection (eg, home alarm systems).

Differentiating suicide decedents who died by firearm verse hanging.

This present study sought to examine how demographics and the availability of means for suicide converge to impact method selection between firearms and hanging, which are the two most lethal and commonly used methods for suicide in the United States. Data were collected as part of a larger online study that gathered information about suicide decedents and the circumstances around their death from family members and friends; the most common sources being parents, friends, and other family members. This study used data from those who died by suicide by firearm or hanging (n = 149); and was restricted to those who identified as male and white. The study examined if age, education, marital status, military affiliation, and firearm ownership impacted method selection. Results indicated that age and owning a firearm were associated with using a firearm in a suicide death. Additionally, those who used a firearm were significantly younger and more likely to own a firearm than those who used another method; and those who died by hanging were significantly younger than those who used another method. Findings from this study can be leveraged to improve the effectiveness of means safety efforts and create more personalised public health messages on firearm safe storage.

Painful and provocative events: Determining which events are associated with increased odds of attempting suicide.

OBJECTIVE: The present study sought to determine which painful and provocative events differentiated those with suicidal ideation from those who attempted suicide. Additionally, it presents a novel way of utilizing the Painful and Provocative Scale (PPES) by looking at items dichotomously as experienced or not experienced, instead of the frequency at which they are experienced. METHOD: Participants (N = 666) were recruited as part of a large online study seeking to understand suicide risk across multiple high-risk groups (i.e., veterinarians, military service members, transgender individuals, and gun owners) for suicide. Participants in the present study were predominately white, female, and heterosexual. RESULTS: First, the PPES was examined as a dichotomous measure and results indicate that experiencing physical or sexual abuse, tying a noose, using intravenous drugs, or having injuries that required medical attention were associated with greater odds of attempting suicide; shooting a gun was associated with decreased odds. Next, the PPES was examined as a scale measure and findings indicate that increased exposure to rock climbing, experiencing physical or sexual abuse, or using intravenous drug were associated with increased odds of attempting suicide; while increased exposure to shooting a gun was associated with decreased odds. CONCLUSIONS: The present study adds to the literature on the ideation-to-action framework and provides evidence considering the frequency of experiences using the Painful and Provocative Event Scale may not provide substantial information beyond dichotomous scoring.

Suicidal Ideation Among Individuals Who Have Purchased Firearms During COVID-19.

INTRODUCTION: Given the increase in firearm purchases during the COVID-19 pandemic, this study seeks to determine the extent to which COVID-19 firearm purchasers differ in terms of suicide risk from nonfirearm owners and firearm owners who did not make a purchase during COVID-19. METHODS: Participants (N=3,500) were recruited through Qualtrics Panels to participate in an online survey examining methods for self-protection. ANCOVAs were utilized to assess suicidal ideation. Multivariate ANCOVAs were used to examine firearm storage practices and storage changes during COVID-19. Data were collected in late June and early July 2020, and analyses were conducted in July 2020. RESULTS: Individuals who purchased a firearm during COVID-19 more frequently reported lifetime, past-year, and past-month suicidal ideation than nonfirearm owners and firearm owners who did not make a purchase during COVID-19. COVID-19 purchasers with lifetime ideation were less likely to hide loaded firearms in a closet than those without lifetime ideation. COVID-19 purchasers with past-year or past-month ideation were more likely to use locking devices than COVID-19 purchasers without past-month ideation. CONCLUSIONS: In contrast to firearm owners more generally, COVID-19 firearm purchasers appear far more likely to have experienced suicidal ideation and appear less likely to use certain unsafe firearm storage methods but also report a greater number of storage changes during COVID-19 that made firearms less secure. Future research should seek to further understand those who purchased a firearm during COVID-19 and determine ways to increase secure storage among firearm owners.