Infectious Disease

Youth from rural communities are at increased risk of firearm-related suicide

October 13, 2021

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Disclosure:
Fleegler reports that Springer has given him book licenses. The authors of the study do not report any relevant financial information.

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Interventions that help limit youth access to handguns in times of crisis can particularly benefit rural remote communities, according to a cross-sectional study published in JAMA Network Open.

“Firearms are very lethal, so attempting suicide with a firearm is much more likely to result in death,” co-author Ashley Brooks-Russell, PhD, MPH, The director of the Center for Injury and Violence Prevention at the Colorado School of Public Health, University of Colorado Anschutz Medical Campus, told Healio Psychiatry. “Not much is known about youth access to firearms in the United States. ”

Brooks-Russell and colleagues analyzed data from 59,556 students who participated in the 2019 Healthy Children’s Colorado Survey, conducted at 256 Colorado high schools. Although most (56.8%) schools were in rural or small towns, more (57.8%) students attended urban and suburban schools. The researchers used a city-centered locale along a seven-level continuum for exposure, with the school location geocoded for spatial analysis. The most important results and measures were the weighted prevalence for easy access to handguns and four measures for mental health and suicidality from the previous year.

The results showed that increasing rurality was associated with the prevalence of perceived easy access to handguns. A total of 36.2% (95% CI, 35.2-37.1) of students in rural schools reported easy access, compared with 18.2% (95% CI, 17.3-19.1) at city schools. Although the spatial distribution of easy access to handguns and the measures of suicidality hardly overlapped, researchers at the school level found a connection between easy access to handguns and considering suicide, planning suicides and attempting suicide in the previous year. A total of 21 schools, 81% of which were rural, formed the highest quartile last year for the prevalence of both perceived easy access to handguns and planning of suicide.

“Given that suicide attempts can be unpredictable, we must best protect our teenagers from the deadly means of attempted suicide, especially access to firearms,” ​​said Brooks-Russell. “Knowing where the risk is greatest can help target the use of limited prevention resources. States with similar public health surveillance systems may be able to take a similar approach and understand the distribution of risk. “

In a related editorial Eric W. Fleegler, MD, MPH, of the Emergency Medicine Department at Harvard Medical School’s Boston Children’s Hospital, highlighted the overall limited knowledge of adolescent suicide risk.

“We have to avoid the fallacy of assuming that we know when adolescents are at high risk of suicide,” wrote Fleegler. “Pediatricians and parents alike need to recognize that we don’t always know when adolescents are in a crisis. We need to recognize that mental health crises can hit anyone, anytime, and that one of the best ways to reduce the risk of suicide is to cut off access to firearms before it’s too late. “

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