Firearm Suicide Among Veterans
Veterans are at elevated risk for firearm suicide
Veterans are at especially high risk for firearm suicide because they have higher rates of firearm ownership and of suicide risk factors.1
Clinicians can reduce the risk of suicide by counseling at-risk veterans to reduce access to lethal means, especially firearms. Lethal means counseling has become a prominent piece of the Department of Veterans Affairs’ suicide prevention efforts. Clinicians should tailor their conversations and recommendations to veterans’ unique experiences and preferences.
About 7% of US adults are veterans, yet veterans make up 22% of Americans who die by firearm suicide.2-4 Veterans who die by suicide disproportionately use firearms: two-thirds of veteran suicides are by firearm, compared with 50% of suicides among those in the general population.2,3
Veterans are more likely to have certain risk factors for suicide compared to non-veteran adults, including underlying mental health conditions (like PTSD and depression), substance misuse, exposure to suicide, traumatic brain injury, and unaddressed chronic health conditions related to their military service.5-8
A large body of research indicates that having a gun in the household increases the risk of suicide among household members.9
Veterans more often own firearms compared to the non-veteran population: 45% vs 22%, respectively.10 Although suicide rates for male veterans are higher than those for female veterans, firearms are also the most common method of suicide among female veterans.11 Suicide screening and lethal means counseling may be especially important for female veterans given their distinctly high rates of firearm ownership compared to non-veteran females in general.3,10
Recent research among veterans receiving mental health care within the VA system indicates that half of veterans with suicidal thoughts or suicide plans live in households with firearms.12 Just 6% of veterans, however, think that a gun in the home increases risk for suicide.13 In addition, one-third of veterans store their guns loaded and not locked up, which further raises risk for suicide.14
Raising awareness of the increased risk of suicide for those with access to firearms and of the lethality of firearms in suicide attempts may be important for reducing veteran suicide.
Research suggests veterans believe there are some circumstances in which individuals should not have firearm access, including during periods of depression or substance misuse, and may be willing to reduce their access to firearms or that of others in such circumstances.13-15
What You Can Do
Reducing access to lethal means of suicide, such as firearms or medications, is one of the most effective suicide prevention strategies.1, 16-22 For firearms, lethal means safety interventions include a range of safer storage practices and temporary transfer of firearms. Although clinicians may screen patients for suicidal thoughts and provide counseling, they often do not talk about access to firearms and the importance of reducing access to lethal means in times of crisis, even within the VA system.12,23
Lethal means safety puts time and space between a suicidal person and lethal means until the crisis has passed.
Veterans may prefer when lethal means safety conversations happen in an authentic manner (rather than a formulaic or “checklist” approach), in the context of elevated risk, and within trusted patient-clinician relationships.15,24 Whenever possible, clinicians should engage a patient’s support systems, such as veteran peers or family members, to help reduce access to lethal means when risk is high.15,25 Rather than asking whether the patient has firearms at home, clinicians may find it helpful to employ phrasing that assumes and normalizes ownership. For more detail on having these conversations with patients, visit our How to Counsel page.
When a veteran has thoughts of suicide, the most appropriate intervention depends on their willingness to collaborate and the nature of the risk. When risk for suicide is not acute, practicing safe firearm storage can help reduce risk. However, the safest way to prevent access to firearms for someone at risk of suicide, especially if that person owns firearms, is to remove firearms from the home until heightened risk subsides. Patients and clinicians can work together with trusted peers and loved ones to decide on appropriate options for storage outside the home while someone is going through a time of crisis.
Voluntary, temporary transfer of firearms—to a family member, friend, other trusted person, gun shop, range, or other option—can be lifesaving.
Click to view references
- VA/DoD Clinical Practice Guideline for the Assessment and Management of Patients at Risk for Suicide.
- Web-based Injury Statistics Query and Reporting System (WISQARS) [online].
- 2020 National Veteran Suicide Prevention Annual Report.
- Those Who Served: America’s Veterans From World War II to the War on Terror.
- Nature and determinants of suicidal ideation among U.S. veterans: Results from the national health and resilience in veterans study. Journal of Affective Disorders.
- Substance use disorders and the risk of suicide mortality among men and women in the US Veterans Health Administration. Addiction.
- Exploring the association between exposure to suicide and suicide risk among military service members and veterans. Journal of Affective Disorders.
- US veterans and their unique issues: enhancing health care professional awareness. Advances in Medical Education and Practice.
- The accessibility of firearms and risk for suicide and homicide victimization among household members: a systematic review and meta-analysis. Annals of Internal Medicine.
- Firearm ownership among American veterans: findings from the 2015 National Firearm Survey. Injury Epidemiology.
- Understanding female veterans’ experiences and perspectives of firearms. Journal of Clinical Psychology.
- Possession of Household Firearms and Firearm-Related Discussions with Clinicians Among Veterans Receiving VA Mental Health Care. Archives of Suicide Research.
- Firearm Storage Practices and Risk Perceptions Among a Nationally Representative Sample of U.S. Veterans With and Without Self-Harm Risk Factors. Suicide and Life-Threatening Behavior.
- Firearm Storage Practices Among American Veterans. American Journal of Preventive Medicine.
- Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study. PLOS One.
- A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths. Journal of General Internal Medicine.
- Means restriction for suicide prevention. The Lancet.
- Firearm suicide: pathways to risk and methods of prevention. Current Opinion in Psychology.
- Comparison of the Safety Planning Intervention With Follow-up vs Usual Care of Suicidal Patients Treated in the Emergency Department. JAMA Psychiatry.
- Prevention of Firearm Suicide in the United States: What Works and What Is Possible. American Journal of Psychiatry.
- Addressing Suicide in the Veteran Population: Engaging a Public Health Approach. Frontiers in Psychiatry.
- The Surgeon General’s Call to Action to Implement the National Strategy for Suicide Prevention.
- Clinician Attitudes, Screening Practices, and Interventions to Reduce Firearm-Related Injury. Epidemiologic Reviews.
- Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives. Journal of General Internal Medicine.
- Acceptability of potential interventions to increase firearm safety among patients in VA mental health treatment. General Hospital Psychiatry.
Learn more about potential interventions
If guns are kept in the home, storing them safely can prevent firearm injury.
Storing guns outside the home when someone is at risk can be lifesaving.
For more information, see these peer-reviewed articles.
Dobscha, S.K., Clark, K.D., Newell, S., et al. (2021). Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives. Journal of General Internal Medicine.
Theis, J., Hoops, K., Booty M., et al. (2020). Firearm Suicide Among Veterans of the U.S. Military: A Systematic Review. Military Medicine.
Simonetti, J.A., Dorsey Holliman, B., Holiday, R., et al. (2020). Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study. PLOS One.
Dempsey, C.L., Benedek, D.M., Zuromski, K.L., et al. (2019). Association of Firearm Ownership, Use, Accessibility, and Storage Practices With Suicide Risk Among US Army Soldiers. JAMA Network Open.
Additional Resources on Veteran Firearm Suicide Prevention
2020 National Veteran Suicide Prevention Annual Report
This report reviews and analyzes Veteran suicide data from 2005 to 2018, overall and across categories, including the number of suicide deaths, the average number of suicides per day, suicide rates by race and ethnicity, and data in the situational context of the coronavirus disease 2019 (COVID-19) pandemic.
Reducing Firearm & Other Household Safety Risks for Veterans and Their Families
A brochure for Veterans Means Safety. If you own a firearm, or live in a household where there are firearms, the following information can help keep you and those around you safe.
Rocky Mountain MIRECC for Veteran Suicide Prevention
Educational products, podcasts, training videos, and firearm safety tip sheets for veteran suicide prevention.
This continuing education course on veteran suicide prevention was developed in collaboration with the Department of Veterans Affairs and is presented by Dr. Megan McCarthy, Deputy Director, Suicide Prevention.
Make the Connection
Online resource in partnership with the U.S. Department of Veterans Affairs designed to connect Veterans, their family members and friends, and other supporters with information, resources, and solutions to issues affecting their lives.
A suicide prevention coaching tool from the Department of Veterans Affairs. This resource teaches how to reach to help someone in need and it teaches how to reach to help ourselves in times of crisis.