In discussions of guns and gun policy in America, one statistics for me stands out: on average, 100,000+ Americans suffer gunshot injuries every year: and 30,000+ of those injuries are fatal injuries.  That's right: 30,000+ Americans die every year from gunshot injuries.  That's averages out to over 80 deaths from guns every day; more than 3 deaths during the average hour.  

Thirty thousand Americans dying every year from gunshot injuries is a slaughter.  Thirty thousand Americans shot dead every years is a disaster of war-time proportions. If we heard of 30,000 people being shot dead in another country during the course of one year, there would be serious talk of sending in a UN peace-keeping force.  Yet 30,000+ Americans are killed by guns every years, and no one bats an eye.  Because 30,000 shot dead in one year would be highly unusual in another country, but in America, that is the norm.  .Hurricane Katrina killed 1800+ Americans, and that was seen as a catastrophe requiring government action to prevent a repeat.  The horrible terrorist attacks of 2001 killed fewer that 3,000 Americans, but this toll was perceived as calamitous and a national emergency so extreme that, within two years' time, we had invaded two sovereign nations in order to ensure that the number of Americans killed in terrorist attacks is forever reduced.  Yet, every year we kill ten times that number of Americans, and no action is taken.  Our national legislature could not even bring itself to discuss a possible response to the ongoing slaughter after one of their own was shot in the head in public (though severely wounded, the representative survived and is recovering).

When I tell a gun enthusiast that 30,000+ Americans die every year from gunshot injuries, I typically get two kinds of responses.  Some gun enthusiasts will say something like, well, 100,000+ Americans die every year in hospitals, or 40,000+ Americans die every year in automobile accidents, so the number of Americans killed by gun fire every years is not really a big deal.  If one is willing to respond despite the effort to change the topic of conversation (from guns to hospitals or automobiles), one has to acknowledge that yes, large numbers of Americans die in hospitals and in motor vehicle accidents, but the demographics of who is dying, and our response to those deaths, is very different.  The vast majority of deaths in hospitals occur in people who have reached the end of their lives or have terminal illnesses - these are mostly unavoidable deaths.  Deaths from gunshot injuries occur in the old and the young, and every age in between; these are largely preventible deaths.  Moreover, for both cars and hospitals, there exist a national and concerted ongoing effort to reduce the number of deaths from these causes.  Laws are passed to make car manufacturers design and build safer cars, traffic lights are installed at intersections, hospital review board investigate causes of deaths in hospitals to implement better practices and eliminate errors, doctors are constantly trying new life-saving therapies.  There is no similar effort to reduce the number of deaths in America from guns.  Indeed, in recent years numerous laws have been passed making it easier to buy and use guns (and more guns is strongly associated with greater numbers of fatal gunshot injuries – see here: http://www.dailykos.com/...).

It is right and correct that we as a nation seek to reduce preventible deaths in hospitals and from motor vehicle accidents.  Yet the number of people who die every year in hospitals and cars in no way mitigates the national tragedy of 30,000+ Americans dying every year from gunshot injuries. Just as it is right and correct to seek to reduce the number of deaths that occur in hospitals and from cars, it is equally right and correct that we as a nation seek ways to reduce the number of Americans who die every year from gunshot injuries.  And that we are not doing.

The second kind of responses I hear from gun enthusiasts is that suicides make up a large proportion of the 30,000+ Americans who die every year from gunshot injuries.  Gun enthusiasts argue that suicides should not be counted in the tally of Americans who die every year from gunshot injury; and that the figure of 30,000+ yearly American deaths from guns is over-inflated by the inclusion of suicides.  The argument seems to be that death resulting from suicide is somewhat less of a tragedy because the death was intentional, or that the person who shoots himself (most completed suicides occur in men and guns are the most common method for male suicides) wants to die and will find a way to kill themselves whether they have a gun or not.  Therefore, argue the gun enthusiasts, the reported number of Americans who die by gunshot injury every year is exaggerated, and the correct tally should be reported as much lower.

Gun enthusiasts are correct that suicides make up a large proportion of those dying from gunshot injuries every year.  So let us assume that 50% of the fatal gunshot injuries that occur every year are due to suicide.  So that only 15,000+ Americans die a non-suicide death from a gunshot wound every year.  Only. 15,000+ deaths every year.  That is still a lot of dead Americans: still five times as many deaths as occurred on 9/11, and 9/11 is not a yearly event.  I would still be arguing that we as a civilized society should be seeking ways to reduce gun fatalities: that a yearly toll of  “only”15,000+ Americans dying from gunshot injuries is at least as much of a problem as the 9/11 attacks.  And that a mere 15,000+ Americans dying every year from gunshot injuries is a national emergency.

But all that is really beside the point.  Suicides do matter: these are needless and preventible deaths.  Death due to suicide is still a death which ripples out to effect family, friends, and co-workers, it is still an economic loss for a community, a suicide tells us that someone is going through an extreme of human suffering and going through it alone.  We as a nation cannot ignore and discount suicide and continue to pretend we value “life, liberty, and the pursuit of happiness”.

And apparently, on this point Pres. Obama and the US military agrees.  Friday (Sept 1, 2012), Pres. Obama signed an executive order instructing the Dept. of Veteran's Affairs to expand suicide prevention and mental health services for veterans.  Under the order, the VA will increase telephone hot-line services, increase access to mental health providers so any veteran in crisis can be seen within 24 hours, and launch a 12 month campaign to educate veterans about VA services.

See, suicide rates are increasing among our military service personnel and veterans, and have been for some time.  The CDC reports that in recent years 6000 veterans kill themselves annually; and about 18 veterans kill themselves every day (http://usnews.nbcnews.com/...).  The US Army reported that 38 active-duty and reserve soldiers killed themselves in the month of July, 2012, the highest number of monthly suicides in that group since the Army began keeping records.  During the previous month of June, 2012, 24 soldiers killed themselves (http://usnews.nbcnews.com/...).  And according to the New York Times, more soldiers now die by suicide than are killed in combat.  (http://www.nytimes.com/...)
Reliable statistics are lacking, but in all likelihood, the majority of those military suicides are accomplished using a firearm.  Soldiers generally have experience and familiarity with using guns, soldiers who kill themselves are also more likely to be men (men are more likely than women to complete a suicide), and men as a group overwhelmingly choose guns as the means of suicide.

Apparently, the President and the US military do not agree with the gun enthusiasts that people who shoot themselves do not matter, should not be counted, or that there is nothing that can be done because “those people want to die”.  And for most Americans, the automatic response when considering the tragedy of an active duty soldier or a veteran killing themselves is to jump up and say “We should do something to fix that” and not “we don't count those”.  Pres. Obama's executive order is an important step for better care of our military service veterans, and important for the prevention of needless deaths.

So to gun enthusiasts who complain that the statistic that 30,000+ Americans are killed every year due to gunshot injury is erroneously inflated because that statistic includes people who kill themselves, I will remind them that perhaps as many as 6,000 of those suicides were veterans, and most Americans do not agree with dis-counting military vets.

To me, the idea that nothing can or should be done to prevent suicide because someone who is thinking about killing themselves will kill themselves no matter what is a expression of ignorance about the nature of suicide.  The little science that has been done is yet very revealing.  Women make many more suicide attempts than men, while men complete suicides are higher rates than women.  Women most frequently choose drugs/poisons as their suicide method, men most frequently use guns as their method.  It follows that the rapid lethality of guns is a factor in turning a suicidal thought into a completed suicide.  

Gun enthusiasts do not want to acknowledge that 30,000+ Americans die every year so that gun enthusiasts can enjoy their guns (and/or depending on your political views, so the gun industry can enjoy ever-increasing profits).  So the gun enthusiasts/gun industry will try to minimize the reality by telling us that the figure 30,000 is inflated by people who kill themselves, that people who kill themselves should not be counted, and that no response is needed because people who kill themselves would be dead, guns or no guns.  These arguments are all factually and morally wrong, and repugnant to those who care about the lives of people suffering from mental illness..  Exactly how and why these arguments are wrong becomes plain when we think about suicide among US service personnel and veterans.  And the dynamics of suicide are no different in the civilian population.

Suicides do count.  The President is to be applauded for his strong stand in preventing suicide among our veterans and military personnel.  Let us follow his lead to better mental health services for all Americans.  A review of our nation's gun policy should be part of that effort.

Originally posted to Hugh Jim Bissell on Mon Sep 24, 2012 at 08:27 AM PDT.

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