Identifying Points of Prevention in Firearm-Related Suicides: A Mixed-Methods Study Based on Coronial Records

Abstract

Purpose

Firearm-related suicide is a noteworthy and preventable public health issue that has drawn limited attention in Australian research. Firearms are highly lethal and remain in the top three methods of suicide among Australian males. This study examines suicides occurring in Tasmania, the jurisdiction with the highest rate of firearm-related suicide, with the aim of aiding suicide prevention strategies.

Methods

A mixed-methods approach was used to analyze data from the Tasmanian Suicide Register. The quantitative analysis examined socio-demographic factors, substance use, physical and mental health, and access to services for suicides occurring between January 1, 2012 and December 31, 2016. The qualitative analysis comprised firearm-related suicides occurring between January 1, 2012 and December 31, 2017.

Results

Firearms users were more likely than those employing other means of suicide to be male, retired, and residing in remote areas but were less likely to have had a previous mental illness diagnosis or evidence of suicidal ideation or self-harming behaviors. There was some evidence of increased impulsiveness among firearm users. We found 54% of decedents were licensed to own a firearm at the time of death. Firearms most often belonged to the decedent (52%) and 26% sourced a firearm from family or friends. Only 58% of cases involved a firearm with a dedicated storage facility.

Conclusions

Prevention efforts need to take into account the unique profiles of those at risk of firearm-related suicide. Impulsiveness and the varying levels of adherence to firearms safety practices point to the need for strategies that limit physical access to firearms.

HIGHLIGHTS

• Firearms-related suicides have a unique risk profile compared with other means of suicide.

• Mental illness diagnosis, suicidal thoughts, and self-harming behaviors were less commonly identified among firearms-related suicides than other means of suicide.

• Impulsiveness and the varying levels of adherence to firearms safety practices point to the need for strategies that limit physical access to firearms.

Keywords:

• Coroners’ records
• firearms
• gunshot
• prevention
• suicide

ETHICAL APPROVAL

Ethics approval was sought and received through Monash University Human Research Ethics Committee. Project ID: 18940

CONSENT FOR PUBLICATION

Consent to publish was originally sought from the Chief Coroner at the Coronial Division of the Magistrates Court of Tasmania.

AUTHORS’ CONTRIBUTIONS

Agatha Faulkner was involved in the development and implementation of the Tasmanian Suicide Register and coded all cases included in this report, she analyzed the data and was the lead writer. Debbie Scott and Rowan Ogeil both provided assistance with conceptualization, analysis, writing and structure of the report. Victor Stojcevski oversaw the introduction and development of the TSR as well as the initial conceptualization of this report. Victor also assisted in the drafting of this report.

ACKNOWLEDGMENTS

We would like to thank the coroners at the Coronial Division of the Magistrates Court of Tasmania who gave us permission to access to data. We also thank Marion Clarke and Kerry Shepherd from Firearms Services (Department of Police, Fire and Emergency Management, Tasmania) for their advice.

AUTHOR NOTES

Agatha Faulkner, Turning Point, Eastern Health, Australia. Rowan P. Ogeil and Deborah Scott, Turning Point, Eastern Health Clinical School and Monash University, Australia. Victor Stojcevski, Magistrates Court of Tasmania- Coronial Division, Australia.

Correspondence concerning this article should be addressed to Agatha Faulkner, Turning Point, Eastern Health, 110 Church Street, Richmond, 3121, Victoria, Australia.. Email: [email protected]

DATA AVAILABILITY STATEMENT

Contact lead author for inquiries. Data and codes are saved and available in line with ethics requirements.