Decrease in Suicide Rates After a Change of Policy Reducing Access to Firearms in Adolescents: A Naturalistic Epidemiological Study

Division of Mental Health, Medical Corps, IDF, Ramat Gan, Israel.
Suicide and Life-Threatening Behavior (Impact Factor: 1.4). 10/2010; 40(5):421-4. DOI: 10.1521/suli.2010.40.5.421
Source: PubMed


The use of firearms is a common means of suicide. We examined the effect of a policy change in the Israeli Defense Forces reducing adolescents' access to firearms on rates of suicide. Following the policy change, suicide rates decreased significantly by 40%. Most of this decrease was due to decrease in suicide using firearms over the weekend. There were no significant changes in rates of suicide during weekdays. Decreasing access to firearms significantly decreases rates of suicide among adolescents. The results of this study illustrate the ability of a relatively simple change in policy to have a major impact on suicide rates.

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    • "Fourthly, the military service experience itself is a risk factor (Apter et al., 1993; Bodner et al., 2007; Lubin et al., 2010), due to difficult and stressful conditions characteristic of military service (Yacobi et al., 2013). Finally , availability of firearms is a ubiquitous risk factor for military suicide (Hoge and Castro, 2012; Lubin et al., 2010; Reisch et al., 2013). The profile of soldiers who died by suicide is different from those who made nonfatal suicide attempts (Apter et al., 2008; Maguen et al., 2015), according to previous studies it is estimated that for every suicide there are approximately 20–25 attempts that did not end in death (McIntosh, 2000; Simon and Shuman, 2008). "
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    ABSTRACT: A major risk factor for suicide is suicide attempts. The aim of the present study was to assess risk factors for nonfatal suicide attempts. Methods The study's cohort consisted of 246,814 soldiers who were divided into two groups: soldiers who made a suicide attempt (n=2310; 0.9%) and a control group of soldiers who did not (n=244,504; 99.1%). Socio-demographic and personal characteristics as well as psychiatric diagnoses were compared. Results The strongest risk factors for suicide attempt were serving less than 12 months (RR=7.09) and a history of unauthorized absence from service (RR=5.68). Moderate risk factors were low socioeconomic status (RR=2.17), psychiatric diagnoses at induction (RR=1.94), non-Jewish religion (RR=1.92), low intellectual rating score (RR=1.84), serving in non-combat unit (RR=1.72) and being born in the former Soviet Union (RR=1.61). A weak association was found between male gender and suicide attempt (RR=1.36). Soldiers who met more frequently with a primary care physician (PCP) had a higher risk for suicide attempt, as opposed to a mental health professional (MHCP), where frequent meetings were found to be a protective factor (P<0.0001). The psychiatric diagnoses associated with a suicide attempt were a cluster B personality disorder (RR=3.00), eating disorders (RR=2.78), mood disorders (RR=2.71) and adjustment disorders (RR=2.26). Mild suicidal behavior constitutes a much larger proportion than among civilians and may have secondary gain thus distorting the suicidal behavior data. Training primary care physicians as gatekeepers and improved monitoring, may reduce the rate of suicide attempts. Copyright © 2015 Elsevier B.V. All rights reserved.
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    • "Lubin et al.17) studied the importance of policy making in interventions directed at adolescent suicidal behavior. After the Israeli Defense Forces to changed their policy to reduce adolescent access to firearms, the suicide rates decreased significantly, by 40%.17) In New Zealand, after more restrictive firearms legislation was introduced in 1992, the mean annual rate of firearm-related suicide decreased by 46% for the total population, 66% for youth, and 39% for adults.18) "
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