Jim Kling

November 02, 2016

DENVER — A risk-based gun removal law enacted in Connecticut in 1999, which allows police to temporarily seize firearms from people thought to be at risk of harming themselves or others, has prevented an estimated 72 suicide deaths, a new analysis suggests.

Because firearms are among the most lethal methods of suicide, attempts after gun removal are less successful, said Jeff Swanson, PhD, professor of psychiatry and behavioral sciences at Duke University in Durham, North Carolina.

This legal intervention could also lead at-risk individuals to get help, he told Medscape Medical News.

Dr Swanson reported the results of the analysis here at the American Public Health Association (APHA) 2016 Annual Meeting.

As part of the law, the gun removal process can be initiated by a member of the public who reports concerns about a gun owner. After extensive civil proceedings, a "risk warrant" can be issued. Guns can be held by police for 12 months, or longer if the order is renewed.

The law is really good at predicting risk and moving people from firearms to another method of suicide attempt. That's a lifesaver. Josh Horwitz

From 1999, when the law was enacted, to the end of 2013, there were 762 cases of gun removal in Connecticut. Calls came from a family member or an acquaintance in 49% of the cases, and 46% of the gun owners had a mental health disorder or substance use disorder in their history. During the average seizure, seven weapons were removed.

These 762 gun owners were more likely to be receiving treatment in the public behavioral healthcare system 1 year after gun removal than before gun removal (29% vs 12%).

The annual suicide rate in Connecticut is 12 per 100,000 people (0.01%). In contrast, 142 of the 762 owners whose guns were seized went on to attempt suicide, and 21 succeeded (2.75%).

The risk for suicide in this high-risk population is 40 times higher than in the general population, Dr Swanson reported.

The method of a suicide attempt has a strong effect on the death rate. Overall, the survival rate after a suicide attempt is about 90%; however, when a gun is used in a suicide attempt, the survival rate is only about 10%.

Of the 21 suicide deaths identified in this analysis, six involved a firearm despite the firearm seizure by police, 15 involved hanging, two involved gas, two involved drug overdose, and one involved a stab wound.

Hypothetically, if 101 (71%) of the 142 suicide attempts had involved a gun, an estimated 88 would have succeeded. For the remaining 41 suicide attempts that did not involve a gun, there would have likely been five more deaths, for a total of 93.

If that estimate is correct, it suggests that the law prevented 72 of these 93 attempts, or one suicide for every 10.6 cases of gun removal.

The fact that the risk for suicide is 40 times higher in the at-risk population than in the general population is striking, said session moderator Josh Horwitz, JD, executive director of the Education Fund to Stop Gun Violence.

The law "is really good at predicting risk and moving people from firearms to another method of suicide attempt. That's a lifesaver," Horwitz told Medscape Medical News.

"The Second Amendment confers a right to bear arms, but the right is not unlimited," said Dr Swanson, adding that the law has several layers of due process and the gun removal is temporary.

"It's going to be a balance," he said. "As researchers, we can bring evidence to bear to determine what those limits should be."

Similar laws have been passed in Indiana and California, nine states are considering such a law, and a comparable measure is on the ballot this election cycle in the state of Washington.

This study will be published in an upcoming issue of the Journal of Law and Contemporary Problems, Dr Swanson reported.

Dr Swanson and Horwitz have declared no relevant financial relationships.

American Public Health Association (APHA) 2016 Annual Meeting: Abstract 362135. Presented October 31, 2016.


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