I am not prohibited from purchasing firearms, but I would like to be. Not because I am a danger to anyone else — because I am at an increased risk for suicide. My inpatient care doctor explained this to me years ago as she scribbled “bipolar II disorder” on my chart. “Suicidal ideation is a common symptom that has to be aggressively managed and treated,” she said. “Some people have to manage chronic pain. You have to manage recurring suicidality.” It was a blunt addition to her treatment recommendations, a footnote to file away as I planned for my long-term care.
Though it was jarring to hear her discuss suicide so plainly, I knew she was right. I had been struggling with suicidality for years as my untreated bipolar disorder raged and worsened. I was in the hospital because the suicidal thoughts and feelings became too intense and all-consuming. I recognized that I couldn’t manage them anymore. And I was desperate to keep myself safe.
Suicide should never be taken lightly — those who need help should seek it right away. But for people who are being treated for mood disorders, which often include recurring suicidality, acknowledging one’s risk for suicide can be part of a healthy self-care regimen. I receive ongoing treatment to manage my symptoms, which sometimes include suicidal ideation. There have been times when I’ve needed to turn my care over to others. But most of the time, I know what to do to protect myself — talk candidly about suicidal thoughts despite discomfort, seek more intensive care when I need it, choose not to be alone when I am not well.
And, perhaps most importantly, ensure I do not have access to guns.
Suicides comprise nearly two-thirds of all gun deaths in the United States
Though ill-informed politicians on both sides of the aisle often incorrectly blame mental illness for interpersonal violence and mass shootings, research shows the real risk associated with mental illness and guns is suicide. Suicides comprise nearly two-thirds of all gun deaths in the United States, and the large majority of those who die by suicide experienced symptoms of mental illness prior to their death.
Suicide is often an impulsive act in a moment of acute pain — usually, the period of heightened risk lasts only hours or minutes. In one study of near-lethal suicide attempt survivors, researchers found that one in four survivors deliberated for less than five minutes before making their attempt. Nearly 90 percent of survivors deliberated for less than eight hours.
Suicidal crises are fleeting, but it’s hard to remember that when you’re in the middle of one. Acute suicidality clouds your thinking. If a gun is readily available, a temporary moment of despair and a lapse in judgment usually becomes a permanent loss — firearms account for about half of all suicide deaths and are almost always lethal.
And while existing gun ownership is a well-documented risk factor for suicide, recent handgun buyers also appear to be at much greater risk for suicide. There are numerous tragic stories of individuals who legally bought guns during periods of crisis and ended their lives instantly. Many of these lives could have been saved if gun access had not been so easy; most individuals do not substitute another method of suicide if their preferred method is not available.
Those who fear impulsive gun suicide should be able to voluntarily put themselves on a no-buy list, preventing themselves from buying firearms from a licensed dealer. The process, which would be confidential and require identity verification, would allow individuals to enter their own names into the existing background check system, putting a barrier between themselves and one of the most lethal methods of suicide. It would allow high-risk individuals to be proactive and prepare for potential crises when they are well enough to do so. Contrary to the way some policymakers discuss people with mental illness, most of us are capable of making decisions about our own care. In periods of stability, we can make plans to keep ourselves safe.
A voluntary no-buy list would be an appealing option for people like me — non-gun owners who recognize their own risk and want to protect themselves during periods of suicidality. The sign-up process could be a voluntary option for those leaving inpatient and outpatient treatment facilities — presumably, individuals who are emerging from crisis and want to take steps to keep themselves safe.
Mental health professionals could offer their patients the option to sign up. Mental health support groups could provide information to those who are interested. Later, if individuals wanted to remove themselves from the no-buy list, they could do so after a waiting period — another safeguard against impulsivity.
Voluntary self-prohibition is an acknowledgment that suicide is preventable
Those who have not experienced acute suicidal crises or managed day-to-day suicidality may be skeptical that anyone would voluntarily sign up for such a list. But in a recent study in the journal Suicide and Life-Threatening Behavior, University of Alabama School of Law professor Fredrick Vars and his co-authors found that 46 percent of survey participants receiving inpatient and outpatient care in Alabama would be willing to sign up for a voluntary no-buy list. It is reasonable to predict that in states with lower rates of gun ownership, even more individuals would willingly sign up.
Voluntary self-prohibition would be an innovative, first-of-its-kind gun violence prevention strategy — the policy has not yet been introduced or enacted at the state or federal level. Even within the gun violence prevention movement, voluntary self-prohibition is not a mainstream concept; however, the policy is in line with a recent trend toward risk-based gun legislation at the state level.
Although a National Rifle Association–backed Republican Congress has blocked federal gun violence prevention legislation in recent years, risk-based policies have gained momentum in the states. Within the past several years, California and Washington state have enacted laws that allow family members and/or law enforcement to petition a judge to temporarily remove firearms from an individual in crisis.
The policy, which is based on behavioral risk factors for dangerousness rather than a mental health diagnosis, allows concerned relatives to get help for a family member they know to be suicidal, a recently unemployed loved one who is having thoughts of harming his or her colleagues, or a family member whose violence and co-occurring substance abuse suggest imminent danger. Voluntary self-prohibition would be a natural complement to these innovative state policies and could be incorporated into new or existing state legislation at minimal additional cost.
While a voluntary no-buy list would be an unprecedented gun violence prevention policy, self-regulation is not a novel concept. In some states, those who struggle with gambling addiction can voluntarily ban themselves from casinos. Individuals with alcoholism sometimes choose to take medication that makes alcohol physically intolerable. Protecting oneself from self-destructive behaviors is an expression of self-awareness and autonomy.
Even more powerfully, it is an acknowledgement of preventability. And suicide — inherently the most self-destructive impulse one can act upon — is, indeed, preventable. Ninety percent of those who survive a suicide attempt do not go on to die by suicide. They change their minds. They get effective treatment. They decide to keep themselves here.
There are few downsides to voluntary self-prohibition — it would be a lifesaving tool for those who choose to use it and would not burden those who do not. The gun lobby and their Republican allies regularly advocate both self-accountability and self-defense. They say we need to take responsibility for our lives. They say we need to protect ourselves. I agree.
For me, protecting myself means recognizing that suicidality will likely come again. It means bracing for darkness. It means preempting crises. It means defending the part of myself that wants to live from the fleeting part that does not. It means putting any available barrier between myself and firearms. It is the most basic type of self-defense. It is self-preservation.
Bryan Barks is the executive editor at the Coalition to Stop Gun Violence. Originally from Athens, Georgia, she lives in Washington, DC, with her husband.