This commentary is by Paul Manganiello, M.D., a resident of Norwich who is emeritus professor of obstetrics and gynecology at Geisel School of Medicine at Dartmouth and co-medical director of the Good Neighbor Clinic in White River Junction.
From the Vermont Department of Health, the latest data on death by suicide 2020 shows Vermont has been trending in the wrong direction.
In 2005, the death by suicide rate was 12 per 100,000 Vermonters, while in 2021 it was reported to be 21 per 100,000! This compares to the United States’ death rates of 11 per 100,000 in 2005 and 14 per 100,000 in 2021.
In 2021, Vermont recorded the highest annual deaths by suicide at 142 individuals. Because of the lethality of firearms, however, and due to males choosing firearms as the means for death by suicide, the rate for males was 34 per 100,000, while for females it was 9 per 100,000.
The most recent statistic for self-harm visits to the hospital for those under age 14 was 113 per 100,000; for those between ages 15 and 24, the rate was 366 per 100,000, with females being seen at twice the rate for the males who, again, were more likely to choose a firearm.
Vermont populations at risk for self-harm or death by suicide include an adult with a disability, veterans who have served in the armed forces, and adults experiencing social isolation.
Risk factors among Vermonters who die by suicide: About 70% have a mental health diagnosis; 50% are diagnosed with depression; and about 40% are already enrolled in mental health treatment.
Other risk factors: 20% to 30% have had a previous suicide attempt, have substance abuse disorder, or have a physical health issues.
Of death by suicide, 50% of the means were with a firearm; 90% of the attempted self-harm hospitalizations were due to poisoning (50%) or cutting (40%).
Not surprisingly, 90% of all deaths by suicide are due to firearms. Only 10% of Vermont’s firearm deaths are related to homicide. Fortunately, we have not had any mass shootings in Vermont, but a number of the mass shootings that our country has experienced over the past decade have also been associated with either by death-by-police or a self-inflicted fatal firearm discharge.
We know that approximately 45% of Vermont residents have firearms in their place of residence, making those residences at the highest risk for personal, family member, or intimate partner firearm injury and death.
We also know what best practices are for owning a firearm, and safe storage when not in the possession by the owner: keep firearms unloaded; lock firearm in a secure location; store and lock ammunition in a secure location, and in a location separate from the firearm.
We, as a state, have failed to make any progress in reducing death by suicide. As a society, we have become so numb to the daily firearm deaths and injuries that we fail to act.
We can reduce the number of deaths by suicide. The state needs to tackle this as a public health problem and set a goal of reducing death by suicide by 50% over the next biennium. We know what works.
The Rand Corp.’s objective analysis and effective solutions segment, Gun Policy in America: What does the Evidence Show?, looked at various studies. Its analysis of these studies suggest decreased firearm suicides when comparing states having waiting periods prior to obtaining a firearm, compared with those states that don’t. Oftentimes an individual contemplating death by suicide will act impulsively, and a waiting period of 72 hours would offer an individual with suicidal ideation the time they need to rethink their plan to die by suicide.
We know that more than 70% of individuals who survive a suicide attempt will never attempt suicide again. Those with access to firearms, due to their intrinsic lethality, unfortunately will not have a second chance.
Some individuals will push back on legislating a waiting period, saying it might prevent a person who feels personally threatened from obtaining a firearm for self-protection. But purchasing a firearm in a crisis should never be advised. A person newly purchasing a firearm should need to learn how to safely operate the firearm so that they would not be a danger either to themselves or others.
The time between making a decision to purchase a firearm and taking possession of the firearm (three days) would be better spent in learning how to operate the firearm safely.
A decrease in firearm suicides was also noted among young people in states with Child Access Prevention laws. In the Northeast, Vermont is the only state without such a law.
A Child Access Prevention law doesn’t require police to perform random house checks on individuals who have guns in their homes. If, however, someone is killed or injured by a firearm that has not been stored properly, the owner can be held liable and charged with a felony. This would not prevent a gun owner having a loaded gun in their possession when there is concern for their own personal safety.
In the future, gun manufacturers should be required to design firearms to include a locking mechanism or require them to supply a gun lock at the time of purchase. We don’t give individuals the option of having or not having a seat belt when we purchase an automobile.
President Biden’s Bipartisan Safer Communities Act includes $750 million to help states implement extreme risk protection orders — a court order to temporarily restrict a person’s access to firearms when that person poses a risk either to themselves or others.
This money is being made available to the states to conduct more education and outreach, which will assure that the public and local law enforcement will know when and how to activate an extreme risk protection order. We have ERPO in Vermont. Here’s the link from Everytown for Gun Safety, which has compiled frequently asked questions about the various state laws.
This year, we need to petition our legislators to do the right thing. There will not be only one way to address decreasing access to lethal means.
We cannot be fatalistic, throwing our hands up in despair; we can act to bring about meaningful change. We cannot support the status quo and accept this meaningless loss of life year after year. Now is the time to act.
