Firearm Suicide in the United States
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In 2023, someone died of gun suicide every 19 minutes.
Suicide is a public health crisis in the United States, and firearms are the most fatal method of suicide attempt.1 Although the majority of suicide attempts do not result in death, attempts using a firearm are almost always lethal—nine out of 10 firearm suicide attempts result in death.2 The latest available gun death data reveals an alarming reality: 27,300 lives were lost to firearm suicide in 2023, the highest number ever recorded.3
27,300
27,300 people died by firearm suicide in 2023, the highest number ever recorded.
90%
The use of a gun in a suicide attempt is lethal in 90% of cases.
245%
Gun suicide rates among young Black people more than tripled (245%) from 2014 to 2023.
6/10
Nearly 6 out of every 10 gun deaths were suicides in the United States.
Gun Violence in the United States 2023: Examining the Gun Suicide Epidemic
Read our new Annual Firearm Mortality Report, Gun Violence in the United States 2023: Examining the Gun Suicide Epidemic. The new report provides timely insights to support data-informed public health strategies and meaningful policy action.
Understanding the Intersection of Firearms and Suicide
Evidence consistently shows that access to firearms increases the risk of suicide.4,5,6,7,8,9,10 Access to a gun in the home increases the odds of suicide more than three-fold.11 Firearms are exceptionally dangerous when an individual is at risk for suicide because they are the most lethal suicide attempt method. In 2023, someone died of gun suicide every 19 minutes.
Research shows most people do not switch to another method if their preferred way to attempt suicide isn’t available, and without access to a gun, they’re much more likely to survive.12 Delaying a suicide attempt can also allow suicidal crises to pass and lead to fewer suicides. Ninety percent of people who survive a suicide attempt do not go on to die by suicide.13 The use of a firearm in a suicide attempt often means there is no second chance.
Firearms increase the risk of suicide for anyone living in the home, including children. A study found that household gun ownership was the best predictor of youth suicide. For every 10 percentage-point increase in estimated household gun ownership, the suicide rate among young people ages 14-19 years increased nearly 27%.14 Reducing access to lethal means, such as firearms, is critical to saving lives.
Ensuring that someone does not have access to a firearm during a potential suicidal crisis can often be the difference between life and death.
High Lethality of Firearms
Firearms are uniquely lethal compared to other methods of suicide attempt. Suicide attempts by firearm are almost always deadly — 9 out of 10 firearm suicide attempts result in death.15 The vast majority (90%) of those who attempt suicide and survive will not go on to die by suicide.16 Reducing access to firearms for those who are suicidal both reduces the number of suicides and makes those who do attempt more likely to survive.
* The “All other methods combined” category includes: Other specified, classifiable Injury (697 deaths), Drowning (453), Fire/Flame (183), Other land transport (174), Other specified, not elsewhere classified Injury (125), and Unspecified Injury (71).
"It's a myth that if someone survives a suicide attempt, they'll inevitably try again or simply find another method. That's not what the data shows. The majority of people—about 94% of people who survive a suicide attempt—will continue to survive."
— Paul Nestadt, MD, Psychiatrist, Core Faculty at the Johns Hopkins Center for Gun Violence Solutions, Medical Director of the Johns Hopkins Center for Suicide Prevention
988 Suicide & Crisis Lifeline
If you or someone you know needs support, please call, text, or chat the at 988. Support is free, confidential, and available 24/7/365.
Firearm Suicide Prevention
Firearms often turn suicidal crises into fatal outcomes. Temporarily reducing access to lethal means—specifically firearms—by putting time and space between a person in crisis and the lethal means to harm themselves, increases the likelihood they will survive a suicide attempt.17
Though a person may consider suicide for a long time (providing opportunities for intervention and risk reduction), suicidal crises peak relatively quickly for many people. Given the lethality of firearms, access to firearms during that high-risk time period is a key factor in whether or not an individual will survive. While having a gun does not make someone more suicidal, access to guns does increase the risk of dying if they attempt suicide. While of suicide attempts using other methods are fatal, when a firearm is used, the fatality rate rises to 90%—meaning 9 out of 10 suicide attempts with a firearm result in death.
Suicide prevention and intervention create opportunities to access resources and treatment, build connections, and explore other options that may be difficult to see in the midst of suffering. Reducing access to lethal means is an effective suicide prevention intervention that may lead to (1) substituting means (which is less common) or (2) temporarily or permanently delaying suicide attempts. If suicide attempts are delayed altogether without means substitution, the suicidal crises again may pass and result in fewer suicides. Through either path, temporarily reducing access to firearms for individuals who are at an elevated risk of suicide is likely to reduce suicide rates at the population level.
Chart Source: Barber CW & Miller MJ. (2014). . American Journal of Preventive Medicine.
Lethal Means Safety Counseling
Lethal means safety counseling is a voluntary, patient-centered health care intervention that prevents injury and death by helping patients and their families reduce access to lethal means for those at risk for suicide. Health care professionals should engage collaboratively with patients and their families to help prevent gun injuries and deaths. Reducing access to lethal means, such as firearms, is an important part of a comprehensive approach to suicide prevention.
Understanding the Social Ecological Model for Firearm Suicide Prevention
Effective, evidence-based interventions that focus on limiting access to lethal means for firearm suicide prevention exist at many levels of intervention: individual, relationship, community, and societal. For more on the social ecological model of firearm suicide prevention, read: From Crisis to Action: Public Health Recommendations for Firearm Suicide Prevention.
Individual Level
Examines how personal factors and life experiences may contribute to an individual’s risk of suicide.
Relationship Level
Explores how close relationships—such as those with family, friends, and intimate partners—can affect an individual’s risk of suicide.
Community Level
Assesses how the social and physical environments—such as neighborhoods, schools, workplaces, and community resources—relate to factors that can influence suicide risk.
Societal Level
Examines the broader societal factors, including policies and social norms, that influence overall health.
Firearm Suicide Across States
Firearm suicide impacts communities across the country, but is more prevalent in some states. Suicide rates (by firearm and by other means) are generally higher in places where household firearm ownership is more common.18 Firearm suicide rates also vary greatly within states. Generally, the more rural a county is by population density, the higher the gun suicide rate. While it is important to look at the overall firearm suicide rates for states, we must also recognize that firearm suicides are a localized problem with significant variation across small geographic distances.
Firearm Suicides by State
Firearm suicides vary widely across states as a result of socioeconomic factors, demographics, and firearm policies. Guns drove overall suicide rates in the country as they were used in the majority of suicide deaths in states with the highest rates of gun suicide, whereas non-guns were used in most suicide deaths in states with the lowest rates of gun suicide.
- In 2023, Wyoming had the highest gun suicide rate, 10 times higher than Massachusetts, which had the lowest gun suicide rate.
- Wyoming, Montana, Alaska, and Idaho not only had the highest gun suicide rates but also had the highest overall suicide rates in the country in 2023. Guns drove the overall suicides among these states as six out of every 10 people who died from suicide used a gun.
- New Mexico had the highest rate of gun suicide among young people (ages 10–19) in the country in 2023. The state also had a gun suicide rate three times the national average.
Firearm Suicides by Urbanization
Gun suicide rates are closely related to urbanization. Generally, the more rural a county is by population density, the higher the gun suicide rate. Research shows rural counties experience higher rates of gun suicide because of limited access to mental health services, high rates of alcohol use, and the highest rates of gun ownership, thus allowing for easier accessibility and exposure to guns.19
- Rural counties had a higher percentage of gun suicides out of total suicides compared to metropolitan counties. Nearly two-thirds (63%) of all suicide deaths in rural counties were by gun, while more than one-third (37%) of suicide deaths were by non-gun.
- Large metropolitan counties had a lower percentage of gun suicides compared to rural counties as half of all suicide deaths were by gun, and the other half were by non-gun.
The 2013 urban classifications were combined for simplification. Large Central Metro and Large Fringe Metro classifications were combined as “Large Metro.”
The 2013 urban classifications were combined for simplification. Micropolitan and Noncore classifications were combined as “Rural.”
Strategies to Reduce Gun Suicides
Paul Nestadt, MD, and associate professor of psychiatry at the Johns Hopkins School of Medicine, joins to discuss four key strategies on how clinicians can help reduce gun violence and save lives.
Firearm Suicide Across Demographics
Firearm suicide impacts different populations in different ways. Understanding how different groups of people are at risk can help tailor suicide prevention efforts and interventions. While no population is immune from firearm suicide, some demographic groups are at higher risk. For example, in 2023, males had a significantly higher rate of gun suicide than females. Examining firearm suicide rates through the combined lenses of sex, race/ethnicity, and age offers a more comprehensive understanding of this public health issue.
Firearm Suicides by Sex and Race/Ethnicity
While gun violence and suicide can affect anyone, certain demographic groups face a disproportionately higher risk of gun suicide. In 2023, males had a significantly higher rate of gun suicide than females. Among racial and ethnic groups, white males had the highest rate of gun suicide accounting for nearly nine out of every 10 deaths. While not as high as for white males, gun suicide rates for other racial and ethnic groups have been on the rise in the last five years.
- The gun suicide rate of Black females increased by nearly two-thirds (65%) from 2019 to 2023, the highest relative increase of all female races and ethnicities.
- Male Native Hawaiian or Pacific Islanders were nearly 10 times as likely to die by gun suicide than their female counterparts in 2023.
- The gun suicide rate among Hispanic/Latino females increased by 25% from 2019 to 2023.
The number of gun suicide deaths for female Native Hawaiian/Other Pacific Islander was “suppressed” as the death count was less than 10.
Firearm Suicides By Age
Guns were the most common method used in suicides across most 10-year age groups in 2023, underscoring the impact of guns on most ages when considering suicide.
- Guns accounted for the majority of all suicides across the following 10-year age groups: ages 20–29 (56%), ages 50–59 (53%), ages 60–69 (59%), ages 70–79 (73%), ages 80–89 (77%), and ages 90+ (75%).
- Elderly people ages 70 and older were at higher risk to die by gun suicide. Seven out of 10 elderly suicides were by gun in 2023.
Ages 1–9 were excluded because the data was “suppressed,” or the death count was less than 10.
Firearm Suicides Among Young People
Overall, guns have been the leading cause of death for young people 1–17 for four consecutive years. The overall gun death rate for this age group nearly doubled (+95%) between 2014 to 2023. While the rise was mainly from an increase in gun homicides, gun suicides have also surged among young Black and Hispanic/Latino people (ages 10–19) over the past decade. Because CDC data on firearm suicide among 1–9-year-olds is suppressed, including 18–19-year-olds provides a more complete picture of firearm suicide trends among youth and emerging adults.
- Historically, young white people have had higher gun suicide rates than young people of other races and ethnicities. However, this dynamic has started to shift as the overall gun suicide rate among young Black people (ages 10–19) surpassed the rate of their white counterparts for the second consecutive year.
- The overall rate of gun suicides for young Hispanic/Latino people (ages 10–19) nearly doubled (+98%) from 2014 to 2023.
Safe Gun Storage Saves Lives
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Firearm Suicide Risk Among Veterans
Research shows that access to guns increases the risk of death by suicide.20 Veterans disproportionately carry the burden of gun suicide, in part due to their high rates of gun ownership, as nearly half of all veterans own at least one gun.21 Additionally, one in three veterans store their guns loaded and unlocked, further elevating the risk of suicide.22
According to the CDC’s National Violence Death Reporting System, 24,995 current and former military personnel died by suicide between 2018 and 2022. More than two-thirds (73%) of the suicides were by gun.23
Firearm Suicide Prevention Recommendations
Firearms are the deadliest suicide method in the U.S. due to their high lethality and accessibility. Firearm suicides can be prevented through evidence-based prevention interventions across multiple levels of the Social Ecological Model for Firearm Suicide Recommendations (individual, relationship, community, and society) to address the urgent issue of firearm suicide.
Safe and Secure Firearm Storage Practice (Individual Level)
More than half of all U.S. gun owners do not store all their firearms safely.24 Far too often, someone in crisis gains access to a firearm of a family member or friend that is left unlocked. Safe and secure firearms storage can reduce gun injuries and deaths. The gold standard for safe and secure storage is having firearms stored unloaded, locked up, and separate from ammunition. At a minimum, firearms should be stored locked to limit unauthorized access by children or teens and to prevent theft. Research has demonstrated a decreased risk of dying by suicide among adolescents when guns are stored safely.25
Voluntary Out-of-Home Storage (Individual Level)
When an individual is at increased risk of suicide, storing firearms in a secure location outside the home may be the safest option.26,27,28 Individuals may choose to voluntarily give their firearms to family or friends, a federally licensed firearms dealer, or a local law enforcement agency when they believe they might be at risk of harming themselves.
Voluntary Do-Not-Sell Lists (Individual Level)
In states that have Do-Not-Sell lists, an individual who is concerned about current or future suicide risk may voluntarily ask to be put on the list, which is accessed during the background check process when a person is attempting to purchase a firearm. The request may be suggested in consultation with a medical provider and is fully reversible.29
Extreme Risk Protection Order (ERPO) Petitions by Family/Household Members (Relationship Level)
Family and household members can hold valuable information about an individual’s well-being, firearm access, and potential signs of risk. An ERPO is a civil court order petitioned by law enforcement, a family member, or a health care provider that temporarily restricts firearm access for an individual who is behaving dangerously or presents a high risk of harm to self or others.30,31 Being able to petition for an ERPO empowers the family and household members to prevent gun violence. Family and household members are eligible to petition for ERPOs in 16 states.32 If they are unable to file an ERPO directly, family and household members can provide relevant information to their local law enforcement agency, which may then initiate a petition.
Extreme Risk Protection Order (ERPO)
Out-of-Home Firearm Storage by Family or Friends (Relationship Level)
Gun storage out of the home provides a safer degree of separation than storage in the home. Family or friends who recognize that a loved one may be at risk of harming themselves may intervene and offer to store the individual’s firearms for the duration of the crisis.33 Additionally, it is important for the family or friend offering or agreeing to store the firearms to practice safe storage and be aware of the risks associated with firearms in the household.34
Gun Storage Maps (Community Level)
Gun storage maps support suicide prevention by connecting individuals with voluntary, temporary safe storage options, especially during times of heightened risk.35 They have been developed in some states to help community members locate places, such as gun shops or law enforcement agencies, that offer temporary firearm storage.36 Pierce’s Pledge provides a nationwide resource listing Federal Firearms Licensee locations that indicate their willingness and availability to offer voluntary and temporary firearm storage.37 Considering that temporary transfer laws vary by state, the gun storage maps facilitate access to safe gun storage options outside of the home to prevent suicides.38
Gun Shop Projects (Community Level)
The Gun Shop Project, developed by the Harvard T.H. Chan School of Public Health in collaboration with other organizations, builds on partnerships between firearms retailers, ranges, clubs, and public health experts. The Gun Shop Project provides retailers, instructors, and customers of all experience levels with firearm suicide prevention educational materials that allow gun owners to learn the elevated risk of suicide that comes with owning a gun, and to take an active role in suicide prevention among their peers.39
Lethal Means Safety Counseling (Community Level)
- Lethal means safety counseling is a voluntary, patient-centered health care intervention that prevents injury and death by helping patients and their families reduce access to lethal means for those at risk. Health care professionals have an opportunity to engage collaboratively with at-risk patients to help prevent firearm-related injuries and deaths. Reducing access to lethal means, such as firearms, is an important part of a comprehensive approach to suicide prevention. Every patient at an elevated risk of firearm injury (or their parent or guardian, as appropriate) should receive lethal means safety counseling, even if they do not have access to lethal means, such as firearms, at the time of the counseling. Family or friends should be included in the counseling if possible.
Assessing access to firearms and implementing lethal means safety counseling is an essential part of comprehensive health care clinician-based suicide prevention programs. Most health care clinicians receive little to no formal training on how to speak to their patients or clients about firearm safety. Lethal means safety counseling training should include evidence to address common misconceptions, an overview of best counseling techniques including motivational interviewing, information about firearms, tools for health care clinicians for when individuals report that they do not have access to a firearm, and important legal information regarding firearm laws at the local, state, and federal levels.40,41,42
Safety Planning (Community Level)
Safety planning is an evidence-based and effective technique to reduce suicide risk.43 Working with the patient and the family, clinicians can guide patients to identify effective coping techniques to use during crisis events. Safety plans should be personalized to each patient, be developed collaboratively with each patient and family, be developmentally, culturally, and appropriate to the patient and family, and include specific activities and strategies that can be used at all times of day. Thinking about safety plans in advance can help patients prepare to get through intense suicidal feelings.44
Extreme Risk Protection Order Laws (Societal Level)
People who are not otherwise prohibited from owning a gun may be at clear risk of violence to themselves or others. Authorizing a temporary removal of firearms and prohibiting the individual from purchasing, possessing, or accessing firearms while the order is in effect, ERPOs provide an opportunity to intervene to prevent gun violence.45 In all states with ERPO laws, law enforcement can petition for an order. In many states, family members can also file a petition, and in a few states, health care providers have this authority as well. ERPOs interact at the societal level by providing an opportunity to remove a firearm at a critical opportunity to intervene and save lives. Research shows that for approximately every 20 ERPOs issued, one suicide was prevented.46,47
Firearm Purchaser Licensing Laws (Societal Level)
Firearm purchaser licensing (FPL) laws, also known as or permit-to-purchase laws, require individuals to apply for and obtain a license before purchasing a firearm.48 There are five evidence-based recommendations for an FPL law to be effective: proof of firearms safety training, fingerprinting, in-person step, comprehensive background checks, and waiting periods. Suicide can result from impulsive thoughts or actions. Putting time and space between a firearm and a person who is at risk of harming themselves can reduce the likelihood that they may use that firearm in a time of crisis. Additionally, the inclusion of suicide prevention training during this process is recommended as an additional prevention measure.
Child Access Prevention Laws (Societal Level)
4.6 million minors in the U.S. live in homes with at least one gun that is loaded and unlocked, exposing them to unsupervised access to firearms and increasing the risk of gun violence among children and youth.49 Many of these deaths can be prevented through strong Child Access Prevention (CAP) laws which require that guns stored in households with a child or teen be kept secured when unattended. Strong CAP laws are an effective tool to promote responsible firearm storage practices by holding negligent gun owners accountable when a child gains unauthorized access to a firearm. These laws are linked to sizable reductions in child and teen gun deaths, including reductions in youth suicide.50,51,52
The Center Resources
References
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- Cleveland EC, Azrael D, Simonetti JA, & Miller M. (2017). Firearm Ownership Among American Veterans: Findings from the 2015 National Firearm Survey. Injury Epidemiology.
- Simonetti JA, Azrael D, Rowhani-Rahbar A, & Miller M. (2018). Firearm Storage Practices Among American Veterans. American Journal of Preventive Medicine.
- WISQARS. (2022). National Violent Death Reporting System (NVDRS).
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