VIENNA — One of the adult programs offered by the Heartland Regional Library System was held last week at the Vienna Library. It was titled “Conversations for Suicide Safer Homes.”

Four persons attended the presentation given by Safer Home Collaborative Field Coordinator, Kurt Dudenhoeffer. The presentation he gave is based on counseling on access to lethal means. It is one part of suicide prevention. The focus is on creating suicide safer environments. It is to help Missourians realize some facts about suicide in order to be able to help friends and family members who may be thinking about killing themselves. 

Dudenhoeffer, who also is a NRA member, said the reason he is talking about firearms and suicide is because suicide is a leading cause of death. Home is the primary setting where young people obtain firearms used in suicide. Talking about suicide is a research-informed best practice for preventing suicide. Gun owners have a role in preventing firearm suicide. Suicide is generally preventable. 

He said the 10 commandments of firearm safety are:

—Treat every firearm as if it were loaded.

—Always point the muzzle in the safest direction.

—Keep your finger off the trigger until you are ready to shoot.

—Be sure of your target—and what’s beyond.

—Know how to safely operate and maintain your firearm before shooting.

—Be sure that your firearm is safe to operate.

—Be sure your firearm and ammunition are compatible.

—Wear eye and ear protection when shooting.

—Never use alcohol or other drugs when operating or cleaning firearms.

—Safely store all guns and prevent theft and unauthorized access.

And a new one:

—Consider temporary off-site storage if you or a family member may be suicidal or going through a rough time.

In Missouri, according to 2016-2020 statistics, 54 percent of firearm deaths were suicide. The number reported was 3,462, which is more deaths than by homicide and legal intervention, which was 2,801.

Dudenhoeffer said there are three types of risks for suicide: individual, relationship and community and societal. Reasons range from mental health challenges such as depression, job loss, childhood abuse and neglect, bullying, relationship problems, sexual violence, barriers to health care, stigma associated with mental illness or help-seeking, and easy access to lethal means among people at risk. 

Persons around someone who is considering suicide may observe some warning signs. These are a change from what is typical or expected from the individual. They include mood such as being depressed, angry, impulsive or lethargic. Major life changes such as facing a breakup, having legal or money challenges or another personal loss. Substance use or misuse such as increase in prescription or recreational drugs or alcohol. Persons can observe behavior changes such as withdrawing from usual activities, writing or drawing about suicide or death. Also absenteeism, reckless behaviors, giving things away, and acquiring or having access to lethal means. Some people considering suicide display emotions of hopelessness, feeling trapped or stuck with no way out of circumstances, or unexplained euphoric shift like the weight has been lifted off their shoulders. 

Dudenhoeffer said about 10 percent of the people who attempt suicide eventually die of suicide. The time between suicide as an option and an attempt, according to survivors of near-fatal suicides, said an hour or less (45%) and 24% said less than five minutes. Putting time and distance between a suicidal person and lethal means may save a life. 

The leading lethal means of suicide in Missouri are poison, suffocation and firearms. Only 1 to 2% of those attempting suicide using sharps or overdose succeed. But, 90% of persons who use firearms do succeed and become fatalities. Dudenhoeffer said it’s hard to take back a pull of the trigger. 

The focus of the program is on firearms because of the statistics. In Missouri 60% of suicides are with a firearm and they are almost always fatal. For many, committing suicide is done on impulse, within 10 minutes between thoughts and action. Availability of a firearm plays a big role as 46% of Missourians have access to a firearm in the home. Firearms are culturally accepted in Missouri, which is a state that ‘shall issue/open carry’ laws. 

Access to firearms increases suicide risk as suicide rates vary with the rate of firearm ownership. Among youth 82% who die by suicide used a firearm owned by a family member, usually a parent. Parents underestimate the likelihood that their children have or could obtain their firearms. Among the sexes, men who own handguns are eight times more likely to die of gun suicides than men who don’t own handguns. And, women who own handguns are 35 times more likely than women who don’t. Two out of three firearm-related deaths in the US are a suicide.

Gun owners aren’t likely to be more suicidal, just more likely to die if they make an attempt.

Persons who feel an individual they know may be suicidal are asked to act quickly and talk to that person. Stress your concern for their safety. When approaching them about it, do it where it’s convenient, familiar, private and safe. Express care and concern for their well-being. Ask directly about suicide, saying, “Are you thinking about suicide?” or “Are you thinking about killing yourself?” To help with this, practice asking the question. 

When the answer is no, thank them for being honest and express concern for their safety. When the answer is yes, explore access to lethal means. Call the Suicide & Crisis Lifeline 988. You are not alone in this conversation. And, continue the conversation and follow-up steps. What changes can be made to reduce access to lethal methods such as removing ammunition from he home or in-home or out-of-home safe storage options, or to render the lethal method inoperable? Tell them that time and distance can reduce the risk of suicide death. 

Work together to create a plan to keep them safe. The goal is to keep them safe until they can get help or help can be brought to them. Don’t leave them alone until you trust they can be safe. Provide them with resources to access help for themselves in the event they need help in the future. And, keep the conversation going. Putting time and distance between a suicidal person and highly lethal means may save a life. 

For on-site storage of guns, consider locking all guns unloaded in a gun safe or lock box. Change the combination or key location in the event the person as risk for suicide knows them. Layer safety with a trigger, cable, or clamshell lock. Remove a key component of the firearm such as the firing pin. Consider distraction techniques such as photos of loved ones or reasons for living in the safe, freeze keys to the safe in ice. Surrender safe keys to a trusted friend. Store keys in a safety deposit box at the local bank. 

With personal protection firearms, know that suicide is a greater risk than home invasion. Consider other means of self-defense such as a baseball bat, mace or pepper spray or home security system.

Shift toward safety by keeping guns unloaded and locked as this lowers the risk of suicide. Hiding guns is usually not effective; family members usually know the hiding places. Those familiar with firearms may be at higher risk for firearm suicide. Hunter safety education is not a protective factor for firearm suicide. 

It’s not just firearms, as it is important to reduce access to other lethal methods. Dispose of out-of-date, unused, or excess medications and over-the-counter remedies. Store large quantities and unused medications in a pill safe or lock box. Reduce quantities of prescription and OTC medications, especially those used to control pain. A person at risk for suicide should not control lethal quantities of medication. 

In closing, Dudenhoeffer said when talking to a person who you suspect to be considering suicide, to begin with concern and empathy—“I care about you and want you to be safe.” Ask directly about suicide—“Are you thinking about killing yourself?” Focus on increasing safety and discuss the temporary nature of both suicidality and limited access to lethal means. Involve others in preventing suicide. Call the Suicide and Crisis Lifeline by calling 988.