Paul Nestadt is about as steeped in suicide prevention as a person can be.
He treats suicidal patients as a psychiatrist, has co-authored scores of research papers on how and why people kill themselves, and teaches graduate courses on the subject.
But he’ll be the first to admit: “I can’t tell you which of my patients is likely to die by suicide in the next six months.”
Almost nobody can.
Research shows predictions of who will be suicidal are only slightly better than a coin toss. And they haven’t improved over 50 years.
But that doesn’t make Nestadt hopeless. Instead, it pushes him to pursue interventions that don’t require pinpointing people at risk.
Chief among them: making it harder for people to carry out the act of killing themselves.
“Instead of asking every doctor to figure out which patient will die by suicide and locking that patient up, it might be that we need to make sure there aren’t loaded guns available,” Nestadt said.
In an ongoing series, KFF Health News is examining approaches to suicide prevention that expand beyond providing people at risk with medication and therapy. Although those are lifesaving measures, many clinicians, researchers, and people who have lost loved ones to suicide agree that more is needed. The challenge is that when it comes to firearms, broad policy approaches quickly become constitutionally complicated and politically polarizing.
Research shows that limiting access to lethal means is one of the most promising approaches to save lives. It can involve erecting barriers on buildings and bridges to prevent people from jumping, as well as decreasing the number of pills someone can buy or be prescribed at once.
And reducing access to guns.
“That’s the one that will save the most lives,” said Nestadt, medical director at the Johns Hopkins Center for Suicide Prevention.
It may also be the most difficult to achieve.
More than 28,000 people killed themselves with a gun last year, representing more than half of all suicide deaths in the U.S., according to preliminary federal data. Even as overall suicide rates have dipped recently, gun suicides have hit record highs for five years in a row.
From 2021 to 2025, suicide deaths by gun hit record highs each year, even as homicides by gun decreased.
Source: The Firearm Mortality Epidemic: Examining the U.S. Data From 2024, Johns Hopkins Center for Gun Violence Solutions Note: Rates represent gun suicide deaths per 100,000 people. Credit: Aneri Pattani/KFF Health News
However, in the U.S., discussion around guns — even in the context of a traditionally bipartisan topic such as suicide prevention — is a political lightning rod. Mentions of background checks, waiting periods, or red flag laws often send people running to their respective corners. Gun owners and the firearm industry say many of the policies suicide prevention advocates seek threaten their Second Amendment rights, and many policymakers see the topic as a nonstarter.
President Donald Trump has been a strong ally of gun owners. His administration has rolled back dozens of firearms regulations and rescinded a previous surgeon general’s warning that called gun violence a public health crisis. It has also revoked grants focused on addressing community gun violence and cut federal staff working on the issue.
The White House did not respond to specific questions about how these actions may affect the nation’s high rate of gun suicides or what it’s doing to prevent such deaths. But spokesperson Lauren Bis said in a statement that “President Trump is committed to Making America Healthy Again and that includes mental health.” She pointed to the administration’s support for developing psychedelic treatments for mental illness and an announcement of $52.5 million in grants for veteran suicide prevention.
The Limits of Red Flag Laws
One gun policy that has gained some traction, despite pushback, is the extreme risk protection order, more commonly known as a red flag law.
Adopted in some form in 22 states and the District of Columbia, these laws allow judges to temporarily remove a person’s guns when evidence suggests they pose a danger to themself or others.
Although such laws are often passed in the wake of mass shootings, research suggests they’re more effective at preventing suicide.
Still, they require identifying someone at risk.
Someone like Dorothy Paugh’s dad.
In 1965, when Paugh was a young girl, her dad lost his job. He was distressed, not knowing how he’d support his wife and five children, Paugh said. He reviewed his life insurance policy, told his wife where he kept important documents, and bought a handgun.
“If my mom had been able to get an extreme risk protection order or if Dad’s best friend had asked to hold his gun for a while, maybe my dad would not have shot himself. He might have lived,” Paugh said.
Decades later, Paugh advocated for a red flag law in Maryland and sat in the legislative gallery when the measure was passed.
She believes the law is saving lives.
Studies across other states show that for every 10 to 20 guns removed under red flag laws, one suicide is averted, saving a life.
But Paugh also recognizes the law’s limitations.
“It wouldn’t have saved my son,” she said.
Dorothy Paugh’s father died by suicide in 1965. She lost her 25-year-old son, Peter, shown in the photo, to suicide in 2012. Both men shot themselves. Paugh has since become an advocate for gun policies that have been shown to reduce suicide deaths, such as red flag laws and mandatory waiting periods before completing a gun purchase. (C. Allen Paugh)Her 25-year-old son, Peter, fatally shot himself in 2012. He’d recently bought a house with his girlfriend and hosted a birthday celebration for his brother. He’d purchased a gift ahead of Mother’s Day — five novels by Charles Dickens, Paugh’s favorite author — that Paugh received after his death.
Unlike in her father’s case, Paugh said, no one saw warning signs for Peter. “I did not know that my son was suicidal. I didn’t have a clue,” she said. Even if a red flag law existed then, she wouldn’t have thought to use it.
The people most vulnerable to firearm suicide usually aren’t identified as such by family members or clinicians, said Michael Anestis, a clinical psychologist and the executive director of the New Jersey Gun Violence Research Center.
Studies have shown that among people who die by suicide, those who used guns were less likely to have sought mental health care in the past. And most veterans and service members who die by gun suicide never tell anyone about their suicidal thoughts in the months leading to their death.
That’s why red flag laws are just a first step in suicide prevention, Anestis said. They target specific individuals at high risk — the aspect that makes such laws more politically palatable — but they do not apply to the many other people who are quietly suicidal.
Paugh’s son, Peter, fatally shot himself in 2012. Paugh says she didn’t see warning signs that he was suicidal. Peter is pictured here hiking the Appalachian Trail in 2009. (Dorothy Paugh)Lessons From Road Safety
Nestadt, the Johns Hopkins psychiatrist, said the nation needs to approach suicide prevention the way it approaches car accidents.
“You’re not trying to figure out who’s at risk of an accident” by testing people’s reaction time or cataloging who gets into fender benders, Nestadt said.
Instead, governments implemented speed limits, passed seat belt laws, and required auto manufacturers to install air bags and shatter-resistant windshields. The crash death rate declined significantly.
Applying a similar strategy to suicide might involve requiring permits and background checks to buy a gun, as well as instituting waiting periods before completing the purchase.
One study found that enacting a permit-to-purchase law in Connecticut was associated with a roughly 15% decrease in gun suicide rates, while repealing such a law in Missouri was linked to a 16% increase in firearm suicide rates.
Suicide deaths by gun have been increasing for several years, even as suicides by suffocation — the second most common method — have been decreasing.
Source:
Hence then, the article about it s hard to predict who will be suicidal it s easier to ensure people can t shoot themselves was published today ( ) and is available on KHN ( Middle East ) The editorial team at PressBee has edited and verified it, and it may have been modified, fully republished, or quoted. You can read and follow the updates of this news or article from its original source.
Read More Details
Finally We wish PressBee provided you with enough information of ( It’s Hard To Predict Who Will Be Suicidal. It’s Easier To Ensure People Can’t Shoot Themselves. )
Also on site :
- Placer County deputies search for man who fired shots at law enforcement, rammed patrol car
- Sweet Magnolias Stars And Creator Say Goodbye To Canceled Netflix Drama: 'I Hope Serenity Will Always Have A Place In Your Heart'
- 01F Group Announces Investment in DANA, Indonesia's Leading Digital Financial Company, Reinforcing Long-Term Confidence in Asia's Fintech Opportunity