Marvin Wool: The silent suicide epidemic

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The 1999 massacre at Columbine High marked a new era of outrage towards gun violence upon young people. During the ensuing two decades 11 mass shootings have caused 200 senseless in-school deaths provoking nearly non-stop national mourning.

Meanwhile however, another gun epidemic has stealthily been taking 25 times as many young lives. Firearm suicides among 10- to 24-year-olds have become the second leading cause of death in that group. At last count, in 2017, the annual toll was a whopping 261. That's five each week. Hardly a day goes by without private grieving by relatives and friends. But, for assorted reasons, few of those stories arouse the broader attention necessary to spark public outrage.

A major roadblock has been the NRA's strident mantra "it's not guns but people who kill." That's dead Wrong! It is most certainly guns and their availability which kill these distraught victims. Young people have other suicide options - suffocation by hanging, poisoning by drugs and wrist slashing. Each of these have far lower success rates than firearms and most young people have made several attempts with one or more of them before turning to a gun with its 85 percent success rate.

But the crucial enabling factor for young people to take this final lethal step is access to those guns. Three quarters of firearms used in youth suicide attempts are stored in or stolen from the victim's own home or that of a relative. In turn, one third of those hand guns are kept not only loaded but also unlocked. Shockingly, even most children under age 10 know where family guns are kept.

A report in May's JAMA Pediatrics estimates that interventions which motivate households to safely store guns could reduce youth firearm suicides by 6 percent to 36 percent. So what's the delay? First the NRA has driven the national debate by focusing on items to which there is strong resistance - stringent background checks and ineffectual mass mental health screening.

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The solution is focusing on a defined population where there is a real opportunity for successful intervention. Most first time suicide attempts are neither successful nor by gun. Therefore the ideal opportunity is when a young person presents to a health professional shortly after an unsuccessful attempt. It's at that precise point when home gun storage safety can best be addressed and treatment of underlying mental health disorders begun.

Of course, that's much more easily said than done. Resistance is based on two widely held beliefs. First is the right to privacy. Although there is no state or legal prohibition of health professionals discussing gun ownership or safety, in high gun ownership states there are strong societal taboos against doing so. Second is the 2nd Amendment right to own guns but not explicitly to care for them safely. No current issue is more worthy of bipartisan support than the saving of lives among those 261 young suicides

Which national politician might pull this off ? Certainly it's neither the President nor most of his GOP colleagues who are constitutionally unwilling (in both senses of the word). And sadly, not the titular head of the Democratic Party, ex-President Obama. He, in his second term, nominated Surgeon General Vivek Murthy an outspoken advocate of gun control as a public health issue. But in exchange for his long contentious Congressional confirmation, Dr.Murthy was muzzled by Mr. Obama and forced to scrub his website of every reference to guns.

By default we're left with one among the gaggle of 24 Democratic Presidential candidates. Most are Pro Gun Control. But who among them will be courageous enough for that long persuasive reach across the aisle? That effort won't elect that person President or even secure the Democratic nomination. But it will earn him or her a priceless legacy.

Dr. Marvin S. Wool, formerly HMO Medical Director at Lahey Clinic and Harvard Pilgrim Health Care. is an independent health care consultant. For three decades he has spent summers at his home in Townshend (more precisely Harmonyville) and winters in Boston. The opinions expressed by columnists do not necessarily reflect the views of the Brattleboro Reformer.


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