1. Firearm and Suicide Prevention Advocates Working Together to Save Lives www.nhfsc.orgwww.nhfsc.org or elaine.m.frank@dartmouth.edu

2. Why talk about firearms and suicide? Firearms are the #1 method for suicide deaths in the US In Texas, 55% of suicide deaths used firearms, among those 65+ it is 79% For every firearm homicide in Texas, there are 1.8 firearm suicides Suicide is generally preventable

3. Preventability Many people who survive a nearly lethal attempt say something like this survivor: “I instantly realized that everything in my life that I’d thought was unfixable was totally fixable – except for having just jumped” from the Golden Gate Bridge 90% of those who survive a nearly lethal attempt do not go on to die by suicide (Owens, et al, 2002)

4. Decision Time Among survivors of near fatal suicides, when asked about time from their decision to complete suicide and the attempt: ● 24% said less than 5 minutes ● 47% more said an hour or less Simon TR et al, Characteristics of impulsive suicide attempts and attempters. SLTR 2001: 32 (supp) 49 – 59.

5. Putting time and distance between a suicidal person and Lethal Means may save their life!

6. Pesticides – Sri Lanka Pesticides are the leading suicide method in Asia, with an estimated 300,000 deaths annually worldwide. In Sri Lanka, suicide rates rose 8-fold from 1950 to 1995. Restrictions were placed on sales of the most highly human-toxic pesticides in the late ‘90s. Suicide rates dropped 50% from 1996 to 2005. Nonfatal poisonings and other suicides did not. Gunnell 2007. Int’l J of Epidemiology.

7. Why the Focus on Firearms? They are: The leading method for suicide deaths in the US. In Texas, more than all other methods combined Highly lethal Fast and Irreversible. No chance for rescue or change of heart once the trigger is pulled

8. Securing Access to Lethal Means for people at high risk Make highly lethal means less accessible Attempt suicide with less lethal means or Delay suicide attempt

9. Start of the NH Gun Shop Project -Three suicide deaths in six days within hours of gun purchase from a single NH gun shop -Gun shop owner, firing range instructor, suicide prevention and firearm advocates and public health researchers meet to determine if there is an effective way to respond -Built on previous collaborative work of the NH Firearm Safety Coalition

10. Recent-purchase Suicides About one in ten (8%) firearm suicides in NH are with recent- purchase guns “Recent purchase” = buying or renting firearm within one week of suicide (usually within hours) 8% is likely a slight underestimate; in two-thirds of cases interval between acquisition and death was not noted Source: Medical examiner reports on all 144 firearm suicides in NH over two-year period ending 6/30/09

11. Mission Engage gun community in suicide prevention - Educate shops and ranges about steps to delay or avoid selling/renting a firearm to a potentially suicidal customer – Educate their customers about making firearms less accessible if a friend or family member is suicidal – Promote National Suicide Prevention Lifeline to link with local crisis centers and other emergency services 1-800-273-TALK (8255 )

12. Project Development and Launch Draft materials revised after input from shops Packets mailed to independent gun shops (63) and firing ranges (2) They included: – Cover letter signed by recognized gun advocate – Tip Sheet on avoiding/delaying sales to potentially suicidal customers – Brochures, posters and Lifeline Cards All are available at www.nhfsc.orgwww.nhfsc.org Groups may adapt materials after signing letter of agreement on intent and purpose

15. Evaluation ● 48% were using at least one of the items ● Belief in preventability predicted material use. ● Little negative feedback from customers ● Collecting data on newly purchased gun suicides to seek outcome results ● Culture change is a long term process ● Many states, firearm groups and other groups are adapting the project

16. Partnerships with Gun Owner Groups Utah Firearm Instructor Module Colo Gun Shop Project CA Gun Shop Projects NV Gun Shows MA Firearm instructor Module VT Sportsman Clubs/Gun Shop VA Gun Shop Project TN Gun Shop Project MI Diner Placemats WA Safe Homes Project KS Gun Shop Project NH Birthplace! NM - AFSP KY - AFSP MO -AFSP AL - AFSP IA Gun Shop Project TX Suicide-Safer Homes App; Gun Shop Project RI Gun Shop Project NY Gun Shop Projects MD Gun Shop Project

17. NH Gun Shop Project Spreading

18. Spreading the Message

19. Test 1 Suicide Prevention at Las Vegas Gun Show

20. Placemats Used in Diners in Bad Axe, MI, during hunting season.

21. Texas Suicide Safer Homes App Available now: Both iTunes & Google Play Go to your App store and search “Suicide Safer Home” Please give us feedback via survey link in App

22. Additional Efforts Suicide Safer Home App developed in Texas Developing short videos for Firearm Instructors to add to classes. (Utah and NH) With support from the NRA and others Washington State unanimously passed a bill to establish a state-wide coalition to explore reducing access to both medications and firearms as part of its overall suicide prevention efforts. Working with Veterans Groups and the VA

23. Conclusions Suicide prevention is a good fit for firearm owners and builds on a strong safety culture We assume all of us are ANTI-SUICIDE (This is not a pro-gun or anti-gun issue) Belief that suicide is preventable is essential! Process and language are important Additional information: contact elaine.m.frank@Dartmouth.edu or go to www.nhfsc.org elaine.m.frank@Dartmouth.edu www.nhfsc.org