Starting a Conversation
[ Spring 2013 ]
To foster open discussion about the consequences of gun ownership, public health researchers want to know much more about the lure of guns. Why do people own guns in the first place? How do they perceive the risks and benefits? Is the gun mainly for self-protection? Hunting? Target practice? Picking off wild animals that eat crops? And are there other ways to answer those needs that don’t involve guns?
They’d also like to know why people just got rid of their last gun or acquired their first. What drives decisions at these inflection points? Is it divorce from a gun-owning spouse? Moving to a city, where guns are less prevalent? The fact that young grandchildren are starting to visit?
And researchers are curious about the beliefs and experiences of non-gun-owners living in a home with a gun. Studies have shown that women are’t always aware that their partners or children are keeping guns, suggesting that these wives and mothers would disapprove if they did know.
Psychiatrists, psychologists and social workers have begun trainings on how to talk with suicidal patients and their families about reducing access to firearms at home. Unfortunately, people contemplating gun suicide are not always in treatment and often don’t display clues in advance–not even to themselves. According to Catherine Barber, director of the Harvard Injury Control Research Center’s Means Matter campaign, “They may think: ‘It’s not my assessment of the world that’s the problem, it’s the world. I’m headed back to jail, my girlfriend’s broken up with me, I’ve got no hope for the future.’” Even when deep despair prompts people to seek help, their clinicians often fail to ask about guns or feel uncomfortable broaching the topic, in part because they lack suicide prevention training.
All of which suggests that informal contacts, outside the familiar channels of mental health care, may serve as a stronger safety net. In public health lingo, these potentially lifesaving friends and colleagues are known as “gatekeepers.” They include teachers, school psychologists, truant officers, sports coaches, pediatricians, emergency department doctors, defense attorneys, court-mandated batterers’ counselors, social workers, rehab clinicians, employee-assistance staff, divorce attorneys, marriage counselors, and clergy. According to Barber, “It’s those people who need to get the message, because that’s where suicidal people intersect with the system.” The blunt question these gatekeepers should ask clients or friends who seem troubled: “Is there a gun in your home?”
Barber believes that most efforts to keep a firearm away from a suicidal person should be based on conversation, not confiscation. Though some situations–such as with delusional individuals–may be too dangerous to allow guns to remain nearby, in most cases an engaged and respectful approach is more effective. “You want to bring about safety through conversation,” she says. “Very rarely do you want to take control away from a person at risk of suicide.”