The following material aims to increase your knowledge and understanding of suicide, particularly by firearm, among young people in America. We understand that this content may be personal to you. If you or someone you know is in a time of emotional crisis or needs to talk to someone, please call or text the 988 Suicide & Crisis Lifeline at 988 for free from anywhere in the US. See additional resources at the end of the page.
“In the blink of an eye, my whole life changed.” My son, Ty-Key, wrote these lyrics—searching for the words to express the loss of his best friend, Keondrick, who was shot and killed. Ty-Key survived that shooting, but five years later, at age 22, he took his own life with a gun. Ty-Key was always doing things. He was a football player, rapper, and the cool guy on the block. He was smart, too—he even had the opportunity to skip a grade. People knew him. People loved him—they always had. I miss him every day. In response to my son’s suicide, I have dedicated my life to preventing gun suicide, and providing grief counseling to help others find healing, because I want other young people to know that they can find help and there is hope.
Miami Knight, Ty-Key’s mom and a gun violence prevention advocate
Read more at Moments That Survive.
Death by suicide is a significant public health problem that claims the lives of thousands of young people ages 10 to 24 in the US each year.1Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. A yearly average was developed using five years of most recent available data: 2016 to 2020. Young people are defined as ages 10–24. The suicide rate among young people has increased almost every year since 2007 and is now at a near-record high. Over this same period, the homicide rate among young people has not increased annually, while adult suicide rates have increased at a slower rate.2Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death, 1999–2020. Crude rates for young people (ages 10–24) and adults (25 and older). Homicide includes legal intervention.
Suicide is the third leading cause of death for young Americans.
Suicide among young people has increased at an alarming rate.
There are multiple factors that can elevate the risk of suicide, and action must be taken to address the root causes. But one thing is clear: Reducing access to firearms can significantly reduce risk.
Suicide risk increases when these three factors—if not addressed—coincide to create a sense of hopelessness and despair:3American Foundation for Suicide Prevention, “Risk Factors, Protective Factors, and Warning Signs,” accessed May 2, 2022, https://bit.ly/3LBpBuB.
COVID-19 and Back to School
The unprecedented COVID-19 pandemic has significantly disrupted the lives of teens and young adults well beyond the direct impacts of the illness itself. Experts are concerned that social isolation, along with fear surrounding the virus, can increase feelings of anxiety and loneliness,4Centers for Disease Control and Prevention, “Support for Teens and Young Adults,” July 22, 2021, https://bit.ly/383Sml8; Josh Weaver, The Trevor Project, “How LGBTQ Youth Can Cope with Anxiety and Stress During COVID-19,” March 26, 2020, https://bit.ly/3FahFy0. two factors that elevate the risk of suicide for people of all ages. The Centers for Disease Control and Prevention’s (CDC) Adolescent Behaviors and Experiences Survey (ABES) collected during the first half of 2021 found that one in five high school students seriously contemplated suicide and nearly one in 10 attempted suicide in the past year.5Sherry Everett Jones et al., “Mental Health, Suicidality, and Connectedness among High School Students During the COVID-19 Pandemic—Adolescent Behaviors and Experiences Survey, United States, January–June 2021,” Morbidity and Mortality Weekly Report Supplement 71, no. 3 (April 2022): 16–21, https://dx.doi.org/10.15585/mmwr.su7103a3. Another recent CDC study uncovered a disturbing rise in the rate of emergency department visits for suspected suicide attempts among young people ages 12 to 25 during periods of the first year of the pandemic.6Ellen Yard et al., “Emergency Department Visits for Suspected Suicide Attempts Among Persons Aged 12–25 Years Before and During the COVID-19 Pandemic—United States, January 2019–May 2021,” Morbidity and Mortality Weekly Report 70, no. 24 (2021): 888–94, https://dx.doi.org/10.15585/mmwr.mm7024e1.
Students and families have had to adjust to a new normal as many schools and universities have resumed in-person learning in the midst of this pandemic. Consequently, the pandemic’s negative effects on mental health will likely continue as spikes in coronavirus cases due to variants have contributed to ongoing uncertainty.
An estimated 22 million guns were purchased in 2020, a 64 percent increase over 2019.
This all comes at a time when the US has seen a surge in gun sales. Driven by fear and anxiety during the COVID-19 pandemic, people bought an estimated 22 million guns in 2020 and nearly 19 million in 2021.7 Daniel Nass and Champe Barton, “How Many Guns Did Americans Buy Last Month? We’re Tracking the Sales Boom,” The Trace, February 1, 2022, https://www.thetrace.org/2020/08/gun-sales-estimates/. Roughly 30 million American children now live in homes with firearms—up 7 million since 2015. Researchers estimate that a staggering 4.6 million of these children live in households with at least one loaded and unlocked firearm.8Matthew Miller and Deborah Azrael, “Firearm Storage in US Households with Children: Findings from the 2021 National Firearm Survey,” JAMA Network Open 5, no. 2 (2022): e2148823, https://doi.org/10.1001/jamanetworkopen.2021.48823. This ready access to guns is deeply concerning given that nearly three in four firearm suicides by young people take place in or around a home,9Centers for Disease Control and Prevention, National Violent Death Reporting System (NVDRS), 2019. Ages 10–24. and over 80 percent of firearm suicides by children (age 18 or younger) involve a gun belonging to a family member.10 Renee M. Johnson et al., “Who Are the Owners of Firearms Used in Adolescent Suicides?” Suicide & Life-Threatening Behavior 40, no. 6 (2010): 609-11, https://bit.ly/3jwrlXU.
What is Secure Firearm Storage?
Gun owners can reduce the risk of suicide, and gun violence generally, by securing all guns in the home—storing them unloaded, locked, and separate from ammunition. Gun owners and non-gun owners can also reduce risks by asking about secure gun storage in all homes their children visit. These simple actions can save a child’s life.
Learn more about the Be SMART campaign to raise awareness about how secure gun storage can save lives.
The Firearm Matters
Addressing the role of firearms is essential in suicide prevention. We know that removing access to firearms is the easiest and quickest intervention to reduce risk. Most people who attempt suicide do not die—unless they use a gun. Four percent of suicide attempts that do not involve a firearm result in death. Conversely, approximately 90 percent of gun suicide attempts end in death.11Andrew Conner, Deborah Azrael, and Matthew Miller, “Suicide Case-Fatality Rates in the United States, 2007 to 2014: A Nationwide Population-Based Study,” Annals of Internal Medicine 171, no. 12 (2019): 885–95, https://doi.org/10.7326/M19-1324. Given that firearm suicide makes up over one-third of all youth gun deaths and nearly half of suicides among young people,12Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year average: 2016 to 2020. Ages 10–24. addressing firearm suicide is an essential element of any strategy to reduce suicide and gun violence in this country.
90 percent of suicide attempts with a gun are fatal, while 4 percent of those not involving a gun are fatal.
More than 3,100 young people die by firearm suicide each year.￼
The rate of firearm suicide among young people has increased 53 percent over the past decade.
Each year, thousands of young people die by firearm suicide—an average of nine people every day.13Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year average: 2016 to 2020. Ages 10–24. And the problem has only gotten worse. Between 2019 and 2020, the CDC registered a 2 percent increase in the firearm suicide rate.14Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in age-adjusted rates: 2019 vs. 2020. All ages. The age-adjusted firearm suicide rate was 6.84 in 2019 and 6.95 in 2020. During this same period, the firearm suicide rate among young people ages 10 to 24 increased 15 percent.15Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude rates: 2019 vs. 2020. Ages 10–24. The crude firearm suicide rate was 4.68 in 2019 and 5.37 in 2020. And for adolescents ages 10 to 14, the firearm suicide rate in 2020 was the highest reported by the CDC since 1968—a 31 percent increase from 2019.16Everytown analysis of Centers for Disease Control and Prevention, National Center for Health Statistics, WONDER, Underlying Cause of Death: 1968 to 1978; 1979 to 1998; and 1999 to 2020. The previous high crude firearm suicide rate among adolescents 10 to 14 was 0.99 in 1993. Based on percentage change in crude rates: 2019 vs. 2020. Ages 10–14. The crude firearm suicide rate was 0.83 in 2019 and 1.08 in 2020.
Longer-term trends show the rate of firearm suicide among those 10 to 24 years old has increased significantly (53 percent) over the past decade,17Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude rates: 2011 vs. 2020. Ages 10–24. with an even sharper increase among children 10 to 14. Among these pre-adolescents/young adolescents, the rate has increased a disturbing 146 percent from 2011 to 2020.18Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude rates: 2011 vs. 2020. Ages 10–14.
Young people have the fastest-growing rate of firearm suicide of any age group over the last decade.
Research has shown that access to firearms is strongly associated with higher youth (ages 10 to 19) suicide rates: For each 10 percent increase in household gun ownership in a state, the youth suicide rate increased by more than 25 percent.19Anita Knopov et al., “Household Gun Ownership and Youth Suicide Rates at the State Level, 2005–2015,” American Journal of Preventive Medicine 56, no. 3 (March 2019): 335–42, https://doi.org/10.1016/j.amepre.2018.10.027.
States with the highest rates of firearm suicide among young people are Alaska, Wyoming, Montana, Idaho, and New Mexico.20Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year crude rates: 2016 to 2020. Ages 10–24. States with the fastest-growing firearm suicide rates among young people over the past decade include Indiana (+139 percent), Colorado (+121 percent), Missouri (+114 percent), Georgia (+90 percent), and New Mexico (+90 percent).21Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude rates: 2011 vs. 2020. Ages 10–24.
Rates of Firearm Suicide among Young People by State (ages 10–24)
The rise in suicide rates, including firearm suicide, among youth is clear. Yet researchers have only been able to theorize what could be behind the trend, such as increased anxiety and depression,22Jean M. Twenge et al., “Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among US. Adolescents After 2010 and Links to Increased New Media Screen Time,” Clinical Psychological Science 6, no. 1 (November 2017): 3–17, https://doi.org/10.1177/2167702617723376. social media,23Rosemary Sedgwick et al., “Social Media, Internet Use and Suicide Attempts in Adolescents,” Current Opinion in Psychiatry 32, no. 6 (November 2019): 534–41, https://dx.doi.org/10.1097/FYCO.0000000000000547. cyberbullying,24Sameer Hinduja and Justin W. Patchin, “Connecting Adolescent Suicide to the Severity of Bullying and Cyberbullying,” Journal of School Violence 18, no. 3 (August 2018): 333–46, https://doi.org/10.1080/15388220.2018.1492417. and stigma.25Cate Curtis, “Youth Perceptions of Suicide and Help-seeking: ‘They’d Think I Was Weak or “Mental,“‘ Journal of Youth Studies 13, no. 6 (July 2010): 699–715, https://doi.org/10.1080/13676261003801747. We need more research to understand what is driving these increases.
Youth Firearm Suicide Demographics: Gender and Race and Ethnicity
The devastating toll of firearm suicide is impacting communities all across the US, but some groups are suffering a disproportionate impact.
Looking at gender, we find that boys and young men are disproportionately affected, representing nearly nine out of 10 firearm suicide victims.26Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year average: 2016 to 2020. Ages 10–24, by gender. In fact, they are seven times more likely to end their life with a gun than their female peers.27Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year crude rates: 2016 to 2020. Ages 10–24, by gender.
Boys and young men represent 9 out of 10 firearm suicide victims.
Among racial and ethnic groups, young American Indians and Alaska Natives (AIANs) have the highest firearm suicide rate followed by white and Black youth.28Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year crude rates: 2016 to 2020. Ages 10–24. AIAN, API, Black and white are defined as non-Latinx origin. Latinx defined as all races of Latinx origin. The rate among AIANs is likely an undercount due to racial misclassification among medical examiners.29Elizabeth Arias et al., “The Validity of Race and Hispanic Origin Reporting on Death Certificates in the United States,” Vital and Health Statistics 2, no.148 (October 2008), https://bit.ly/31Q7qx8. Firearm suicide rates across all racial and ethnic groups have increased dramatically over the past decade. While young Asians and Pacific Islanders (APIs) have the lowest overall rate of firearm suicide,30Everytown analysis of Centers for Disease Control and Prevention, WONDER, Underlying Cause of Death. Crude rates: 2016–2020. Ages 10–24. API, AIAN, Black, & white defined as non-Latinx origin. they have seen the steepest increase of rate firearm suicide over the past decade at 168 percent.31Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude adjusted rates: 2011 vs. 2020. Asians and Pacific Islanders (APIs) defined as non-Latinx. Latinx32Latinx refers to people of Latin American origin, while Hispanic refers to people of Spanish-speaking origin. Latinx is used here when we are referring to both Hispanic and Latinx communities. youth experienced a 128 percent rise, while Black youth saw a 115 percent increase in firearm suicide rates over this period.33Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude rates: 2011 vs. 2020. Ages 10–24. AIAN, API, Black and white are defined as non-Latinx origin. Latinx defined as all races of Latinx origin.
The firearm suicide rate among young American Indians and Alaska Natives is four times higher than that of the group with the lowest rate (Asians and Pacific Islanders).
Young Asians and Pacific Islanders have the fastest-growing firearm suicide rate of any racial/ethnic group.
Addressing the risk of suicide, whether by firearms or other means, requires culturally competent approaches specifically tailored for each population.34Suicide Prevention Resource Center, “Culturally Competent Approaches,” accessed May 2, 2022, https://bit.ly/3hgdswj. Views about suicide and help-seeking vary widely, so it is critical that all of these views and experiences are considered and addressed. An approach or solution that may work for one population, or even one subgroup within a population, may not be effective or appropriate for another. Research has shown that certain populations are at much higher risk of suicide, and that risk can be exacerbated by easy access to firearms.
Learn more about suicide among:
American Indian and Alaska Native Youth
American Indians and Alaska Natives (AIANs) have historically had some of the highest rates of suicide in the US, with younger AIAN people most heavily impacted.1Rachel A. Leavitt et al., “Suicides Among American Indian/Alaska Natives—National Violent Death Reporting System, 18 States, 2003–2014,” Morbidity and Mortality Weekly Report 67, no. 8 (2018): 237–42, http://dx.doi.org/10.15585/mmwr.mm6708a1. Substance abuse, exposure to violence, poverty, unemployment, intergenerational trauma, and mental health disorders have all compounded, elevating the risk of suicide among young AIAN people and leading to feelings of despair.2US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, “To Live to See the Great Day that Dawns: Preventing Suicide by American Indian and Alaska Native Youth and Young Adults,” April 2010, https://bit.ly/3seGSmk; US Department of Health and Human Services, Office of Minority Health, “Mental and Behavioral Health—American Indians/Alaska Natives,” May 19, 2021, https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=39; André B. Rosay, “Violence Against American Indian and Alaska Native Women and Men,” June 1, 2016, https://bit.ly/3shGVxE. Many young AIAN people live in more rural counties, where the youth firearm suicide rate for all racial and ethnic groups is 2.5 times higher than the rate in the most urban areas; for young AIAN people in these areas the rate is 3.8 times higher.3Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on five-year crude rates: 2016 to 2020. Ages 10–24. AIAN defined as non-Latinx origin. The most urban category includes “Large Central Metro” counties and the most rural category includes “NonCore (Nonmetro)” counties. Household gun ownership,4Knopov et al., “Household Gun Ownership and Youth Suicide Rates.” social isolation,5Jameson K. Hirsch and Kelly C. Cukrowicz, “Suicide in Rural Areas: An Updated Review of the Literature,” Journal of Rural Mental Health 38, no. 2 (2014): 65–78, https://doi.org/10.1037/rmh0000018. the opioid epidemic,6Nora Volkow, “Suicide Deaths Are a Major Component of the Opioid Crisis That Must Be Addressed,” National Institute on Drug Abuse (blog), September 19, 2019, https://bit.ly/3jm9NgW. and limited access to mental and behavioral health services7Centers for Disease Control and Prevention, “Preventing Suicide in Rural America,” Suicide Policy Brief, March 22, 2018, https://bit.ly/3bjo0Zg. are all associated with high rates of suicide in rural communities.
Expanding access to medical and mental health services in AIAN communities, particularly rural ones, is critical to suicide prevention. Experts recommend that suicide prevention programs targeting AIAN people should be developed in partnership with tribal communities, and they should incorporate culture and traditions, including known protective factors of belonging to one’s culture and a strong tribal/spiritual bond.8US Department of Health and Human Services, Substance Abuse and Mental Health Services Administration, “To Live to See the Great Day that Dawns.”
Learn more about suicide prevention in AIAN communities at the Center for Native American Youth and the US Department of Health and Human Services’ Indian Health Service and learn more about suicide prevention in rural areas at the Suicide Prevention Resource Center and the CDC.
White Americans experience the highest rate of firearm suicide.9Everytown analysis of Centers for Disease Control and Prevention, National Center for Health Statistics. WONDER Online Database, Underlying Cause of Death. Based on five-year age-adjusted rate: 2016 to 2020. All ages. White defined as non-Latinx origin. Among young people, white youth have the second-highest rate of firearm suicide,10Everytown analysis of Centers for Disease Control and Prevention, National Center for Health Statistics. WONDER Online Database, Underlying Cause of Death. Based on five-year crude rates: 2016 to 2020. Ages 10–24. White defined as non-Latinx origin. but constitute the majority (68 percent) of those who die by firearm suicide.11Everytown analysis of Centers for Disease Control and Prevention, National Center for Health Statistics. WONDER Online Database, Underlying Cause of Death. Based on five-year average: 2016 to 2020. Ages 10–24. White defined as non-Latinx origin. During the pandemic, a time when young people were disconnected from their support systems and services, two in five white high school students reported they had poor mental health—the highest rate of any racial/ethnic group—and more than one in five reported that they had considered attempting suicide.12Jones et al., “Mental Health, Suicidality, and Connectedness.”
White youth are more likely than other groups to have previously received care and have a mental health diagnosis prior to dying by suicide,13Christina Seowoo Lee and Y. Joel Wong, “Racial/Ethnic and Gender Differences in the Antecedents of Youth Suicide,” Cultural Diversity and Ethnic Minority Psychology 26, no. 4 (2020): 532–43, https://doi.org/10.1037/cdp0000326. indicating they have greater access to services. This finding combined with the link between household gun ownership and increased risk for youth suicide14Knopov et al., “Household Gun Ownership and Youth Suicide Rates.” and high rates of gun ownership among white people15Kim Parker et al., “The Demographics of Gun Ownership,” in America’s Complex Relationship with Guns (Pew Research Center, 2017), 16–28, https://pewrsr.ch/2YDCPkj. suggests that lethal means counseling and limiting access to firearms through secure storage are key components to suicide prevention efforts for this community.
Research has shown an alarming increase in suicide deaths and attempts among young Black people over the past decade. Studies on Black teens have shown that depression; traumatic experiences such as exposure to racism, discrimination, and neighborhood violence; and poor familial support are risk factors for suicide among this group.16Congressional Black Caucus, Emergency Taskforce on Black Youth Suicide and Mental Health, Ring the Alarm: The Crisis of Black Youth Suicide in America, (December 17, 2019), https://bit.ly/2COX5Yy. Young Black people are less likely than their white peers to receive care for mental health-related traumas,17US Department of Health and Human Services, African American Youth Suicide: Report to Congress, October 2020, https://bit.ly/3KogeNv. as they face a variety of barriers to accessing services.18Michael A. Lindsey and Amaris Watson, “Barriers to Mental Health and Treatment among Urban Adolescents and Emerging Adult Males of Color,” in Strategies for Deconstructing Racism in the Health and Human Services, ed. Alma J. Carten, Alan B. Siskind, and Mary Pender Greene (Oxford: Oxford University Press, 2016), 191–208; Robert Motley and Andrae Banks, “Black Males, Trauma, and Mental Health Service Use: A Systematic Review,” Perspectives on Social Work: The Journal of the Doctoral Students of the University of Houston Graduate School of Social Work 14, no. 1 (2018): 4–19. With schools serving as a primary provider of mental health services in many communities,19Rachel N. Lipari et al., “Adolescent Mental Health Service Use and Reasons for Using Services in Specialty, Educational, and General Medical Settings,” in The CBHSQ Report (Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013), http://www.ncbi.nlm.nih.gov/books/NBK362074/. policies that have created the school-to-prison pipeline20Libby Nelson and Dara Lind, “The School-To-Prison Pipeline, Explained,” Vox, October 27, 2015, https://www.vox.com/2015/2/24/8101289/school-discipline-race. prevent many Black youths from accessing the services they need. Young Black students who show symptoms of mental illness are disciplined and arrested more often than students of other racial/ethnic groups, rather than being given access to help.21“Data Highlights on School Climate and Safety in Our Nation’s Public Schools,” 2015–2016 Civil Rights Data Collection: School Climate and Safety, US Department of Education, Office for Civil Rights, 2018, https://bit.ly/3aVDJgx; Amir Whitaker et al., “Cops and No Counselors: How the Lack of School Mental Health Staff is Harming Students,” (American Civil Liberties Union, March 2019), https://bit.ly/3xzz0fF.
A dearth of Black psychologists22In 2019, there were an estimated 3,733 Black psychologists, making up only 3 percent of all practicing psychologists. American Psychological Association, “CWS Data Tool: Demographics of the US Psychology Workforce,” accessed February 28, 2022, https://www.apa.org/workforce/data-tools/demographics. and health care providers who are able to communicate with Black patients about experiences specific to their community are also obstacles to Black youths’ access to services.23Jennifer Mascia and Olga Pierce, “Youth Gun Suicide Is Rising, Particularly Among Children of Color,” The Trace, February 24, 2022, https://bit.ly/3vZS9HD. Additionally, racism and lack of empathy from health care providers exacerbate Black individuals’ mistrust of these professionals and may inhibit them from seeking help.24Liz Hamel et al., “The Undefeated Survey on Race and Health,” Kaiser Family Foundation, October 13, 2020, https://bit.ly/3OQ3V02. Important steps to prevent suicide include developing culturally competent guidelines for crisis center hotlines, such as ensuring values and beliefs are interwoven into any communication with a caller and improving access to mental health care for Black youth.25Congressional Black Caucus, “Ring the Alarm.”
With more than 400 young Latinx people dying each year by firearm suicide, this population ranks second-highest among racial and ethnic groups in the number of youth taken by firearm suicide.26Everytown analysis of Centers for Disease Control and Prevention, National Center for Health Statistics, WONDER Online Database, Underlying Cause of Death. Based on five-year average: 2016 to 2020. Ages 10–24. Latinx defined as all races of Latinx origin. Various factors such as intimate partner conflicts, family problems, abuse, poverty, not being born in the United States, stress surrounding immigration, and not having enough food to eat influence Latinx youth suicide attempts.27Lee and Wong, “Racial/Ethnic and Gender Differences in Antecedents;” Carolina Hausmann-Stabile and Lauren E. Gulbas, “Latina Adolescent Suicide Attempts: A Review of Familia, Cultural and Community Protective and Risk Factors,” in Handbook of Youth Suicide Prevention, (2021), https://doi.org/10.1007/978-3-030-82465-5_16; Meryn Hall et al., “Suicide Risk and Resiliency Factors Among Hispanic Teens in New Mexico: Schools Can Make a Difference,” Journal of School Health 88, no. 3 (2018): 227–36, https://doi.org/10.1111/josh.12599; Caroline Silva and Kimberly A. Van Orden, “Suicide among Hispanics in the United States,” Current Opinion in Psychology 22 (2018): 44–49, https://doi.org/10.1016/j.copsyc.2017.07.013; The Trevor Project, “The Trevor Project Research Brief: Latinx LGBTQ Youth Suicide Risk,” September 2020, https://bit.ly/3s0OacR. Latinx young people have low mental health service utilization due to stigma, poor mental health literacy, unfavorable attitudes toward help-seeking, costs, language barriers, and concerns about legal status, among other barriers.28Substance Abuse and Mental Health Services Administration, “2018 National Survey on Drug Use and Health: Hispanics, Latino or Spanish Origin or Descent,” accessed May 2, 2022, https://bit.ly/3MPeoHj; Leopold J. Cabassa, Luis H. Zayas, and Marissa C. Hansen, “Latino Adults’ Access to Mental Health Care: A Review of Epidemiological Studies,” Administration and Policy in Mental Health 33, no. 3 (2006): 316–30, https://dx.doi.org/10.1007/s10488-006-0040-8; Susan De Luca, Karen Schmeelk-Cone, and Peter Wyman, “Latino and Latina Adolescents’ Help-seeking Behaviors and Attitudes Regarding Suicide Compared to Peers with Recent Suicidal Ideation,” Suicide and Life-Threatening Behavior 45, no. 5 (2015): 577–87, https://doi.org/10.1111/sltb.12152; Mudita Rastogi, Nicole Massey-Hastings, and Elizabeth Wieling, “Barriers to Seeking Mental Health Services in the Latino/a Community: A Qualitative Analysis,” Journal of Systemic Therapies 31, no. 4 (2013): 1–17, https://doi.org/10.1521/jsyt.2012.31.4.1; National Alliance on Mental Illness, “Hispanic/Latinx,” accessed May 2, 2022, https://bit.ly/3kyaG8P. Further complicating this, only 7 percent of all practicing psychologists in the US are Latinx.29American Psychological Association, “CWS Data Tool.” Latinx youth may feel hesitant to discuss trauma stemming from their cultural identity and experiences with professionals who may not be able to grasp the full context of their circumstances. Nearly one in five Latinx high school students reported they seriously contemplated suicide during the pandemic.30Jones et al., “Mental Health, Suicidality, and Connectedness.” 19.7 percent of Latinx high school students reported seriously considering attempting suicide in the past year.
Research indicates that positive relationships with educators and other adults at school enable young Latinx students to feel more comfortable when speaking out about suicidal ideation, especially when they feel that the person they are confiding in takes them seriously, underscoring the importance of fostering a positive, supportive school environment.31Meryn Hall et al., “Suicide Risk and Resiliency Factors.” The Latinx community encompasses a wide range of ethnicities and linguistics, and this community needs better access to quality, culturally affirmative and linguistically accessible trauma-informed mental health resources.32Silva and Van Orden, “Suicide among Hispanics in the United States;” Cabassa, Zayas, and Hansen, “Latino Adults’ Access to Mental Health Care.”
Learn more about suicide prevention in the Latinx community from the Suicide Prevention Resource Center.
Asian and Pacific Islander Youth
While young Asian and Pacific Islander (API) people die by firearm suicide at a lower rate compared to other racial and ethnic groups, the firearm suicide rate among this group has accelerated in the past decade.33Everytown analysis of Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, WONDER, Underlying Cause of Death. Based on percentage change in crude rates: 2011 vs. 2020. Ages 10–24. API defined as non-Latinx origin. There are many factors elevating this risk of suicide, such as discrimination, ethnic marginalization, and acculturation.34Laura C. Wyatt et al., “Risk Factors of Suicide and Depression among Asian American, Native Hawaiian, and Pacific Islander Youth: A Systematic Literature Review,” Journal of Health Care for the Poor and Underserved 26, no. 2 (May 2015): 191–237, https://doi.org/10.1353/hpu.2015.0059. API youth experiencing suicidal ideation also indicate family conflicts and school pressures as significant stress-inducing factors.35Anna S. Lau et al., “Correlates of Suicidal Behaviors among Asian American Outpatient Youths,” Cultural Diversity and Ethnic Minority Psychology 8, no. 3 (2002): 199–213, http://dx.doi.org/10.1037/1099-9809.8.3.199; Lee and Wong, “Racial/Ethnic and Gender Differences in Antecedents;” Y. Joel Wong, Chris Brownson, and Alison E. Schwing, “Risk and Protective Factors Associated with Asian American Students’ Suicidal Ideation: A Multicampus, National Study,” Journal of College Student Development 52, no. 4 (2011): 396–408, https://doi.org/10.1353/csd.2011.0057. Asian Americans are known to seek help at the lowest rate in comparison to other demographics,36Substance Abuse and Mental Health Services, “National Survey on Drug Use and Health (NSDUH), 2020,” January 11, 2022, https://www.samhsa.gov/data/report/2020-nsduh-detailed-tables. See Table 8.17B: Received Mental Health Services in Past Year: Among People Aged 18 or Older; by Past Year Level of Mental Illness and Demographic Characteristics, Percentages, 2019 and 2020. as evidenced by research showing that API adolescents are three times less likely than their white peers to have a mental health diagnosis or have received treatment prior to dying by suicide.37Lee and Wong, “Racial/Ethnic and Gender Differences in Antecedents.”
The API community is incredibly diverse with a wide range of cultural and linguistic subgroups. While many national datasets fail to collect or disaggregate data by these subgroups, there is growing research highlighting the varying experiences of suicidal feelings among Asian populations.38Janice Ka Yan Cheng et al., “Lifetime Suicidal Ideation and Suicide Attempts in Asian Americans,” Asian American Journal of Psychology 1, no. 1 (2010): 18–30, https://dx.doi.org/10.1037/a0018799; The Trevor Project, “The Mental Health and Well-Being of Asian American and Pacific Islander (AAPI) LGBTQ Youth,” 2022, https://bit.ly/3LJUBcg. A survey of young API people who identified as LGBTQ+ conducted by The Trevor Project in 2020 showed wide variation among Asian and Pacific Islander subgroups with Native Hawaiian/Pacific Islanders reporting the highest rates of suicidal ideation in the past year, followed by Korean, Filipino, Indian, and Vietnamese youth, respectively, and Chinese LGBTQ+ youth reporting the lowest rates.39The Trevor Project, “Mental Health and Well-Being of AAPI Youth.” 49 percent of Pacific Islander/Native Hawaiian LGBTQ+ youth reported seriously considering suicide in the past year, compared to 47 percent of Korean LGBTQ+ youth, 41 percent of Filipino youth, 39 percent of Indian youth, 31 percent of Vietnamese youth, and 29 percent of Chinese youth. This underscores the need for further research and targeted, culturally oriented prevention efforts that are linguistically accessible.40Y. Joel Wong et al., “Asian Americans’ Proportion of Life in the United States and Suicide Ideation: The Moderating Effects of Ethnic Subgroups,” Asian American Journal of Psychology 5, no. 3 (2014): 237–42, https://doi.org/10.1037/a0033283; Lillian Polanco-Roman et al., “Emotion Expressivity, Suicidal Ideation, and Explanatory Factors: Differences by Asian American Subgroups Compared to White Emerging Adults,” Cultural Diversity & Ethnic Minority Psychology (2019), https://doi.org/10.1037/cdp0000313.
Studies show that LGBTQ+ people, especially LGBTQ+ youth, are at higher risk than their non-LGBTQ+ peers of contemplating and attempting suicide.41Asha Z. Ivey-Stephenson et al., “Suicidal Ideation and Behaviors Among High School Students—Youth Risk Behavior Survey, United States, 2019,” Morbidity and Mortality Weekly Report Supplement 69, no. 1 (August 21, 2020), http://dx.doi.org/10.15585/mmwr.su6901a6; Michelle M. Johns et al., “Transgender Identity and Experiences of Violence Victimization, Substance Use, Suicide Risk, and Sexual Risk Behaviors Among High School Students—19 States and Large Urban School Districts, 2017,” Morbidity and Mortality Weekly Report 68, no. 3 (January 25, 2019): 67–71, https://doi.org/10.15585/mmwr.mm6803a3; Jones et al., “Mental Health, Suicidality, and Connectedness.” This finding has persisted during the COVID-19 pandemic. The CDC ABES report found that nearly five in 10 lesbian, gay, or bisexual (LGB) high school students and nearly four in 10 students identifying as questioning or other sexual identities reported having seriously considered suicide during the pandemic—compared to more than one in 10 heterosexual students. And this population attempted suicide at a rate three to five times that of heterosexual students.42Jones et al., “Mental Health, Suicidality, and Connectedness.” 46.8 percent of LGB students, 39.5 percent of students identifying as questioning or other sexual identities, and 13.6 percent of heterosexual students reported having seriously considered suicide and 26.3 percent of LGB students, 16.5 percent of questioning/other students, and 5.2 percent of heterosexual students reported attempting suicide in the year prior to the survey. This elevated risk is attributed to the impact that heterosexism, homophobia, transphobia, social stigma, family rejection, bullying, and harassment have on their well-being.43Jun Sung Hong, Dorothy L. Espelage, and Michael J. Kral, “Understanding Suicide among Sexual Minority Youth in America: An Ecological Systems Analysis,” Journal of Adolescence 34, no. 5 (2011): 885–94, https://doi.org/10.1016/j.adolescence.2011.01.002; Laura Kann et al., “Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors Among Students in Grades 9–12—United States and Selected Sites, 2015,” Morbidity and Mortality Weekly Report Surveillance Summaries 65, no. 9 (August 12, 2016): 1–202, https://doi.org/10.15585/mmwr.ss6509a1; The Trevor Project, “Suicide Risk Factors,” July 16, 2021, https://bit.ly/325IIaQ; Joanna Almeida et al., “Emotional Distress among LGBT Youth: The Influence of Perceived Discrimination Based on Sexual Orientation,” Journal of Youth and Adolescence 38, no. 7 (2009): 1001–14, https://dx.doi.org/10.1007/s10964-009-9397-9. Isolation and being subject to discriminatory, anti-LGBTQ+ policies and rhetoric only further alienate this demographic and has crippling impacts on their mental health. Compared to heterosexual students, more than twice as many LGBTQ+ and questioning or other sexual identity students, respectively, reported having poor mental health during the pandemic.44Jones et al., “Mental Health, Suicidality, and Connectedness.” 30.3 percent of heterosexual students, 63.8 percent of LGB students, and 61.5 percent of other or questioning students reported having poor mental health during the pandemic.
Like other populations, LGBTQ+ people face barriers to accessing services such as high costs, inaccessibility, and fear of being rejected or treated with hostility and disrespect by health care providers.45Sandy E. James et al., “The Report of the 2015 US Transgender Survey,” National Center for Transgender Equality, December 2016, https://www.ustranssurvey.org/reports. A survey conducted by The Trevor Project during late 2020 found that nearly half of LGBTQ+ 13- to 24-year-olds wanted but could not access mental health counseling over the past year.46The Trevor Project, “National Survey on LGBTQ Youth Mental Health, 2021,” 2022, https://www.thetrevorproject.org/survey-2021. Measures to reduce the risk of suicide among LGBTQ+ youth include making culturally competent care more accessible, building strong connections to family members who accept their sexual orientation and/or gender identity, identifying positive role models they can relate to, and fostering a school environment where they feel safe and connected.47Hong, Espelage, and Kral, “Understanding Suicide among Sexual Minority Youth;” Kann et al., “Sexual Identity, Sex of Sexual Contacts, and Health-Related Behaviors.”
Learn more about preventing suicide among LGBTQ+ youth from The Trevor Project.
Recommendations for Action
Thousands of young lives are tragically cut short every year by suicide. There are actions we can take to mitigate the risk of suicide and potentially save lives. Effective suicide prevention among young people in the US requires a multi-faceted approach. Recommendations include:
Limiting easy and immediate access to firearms.
Mechanisms that create time and space between acquiring lethal means and someone experiencing crisis is proven to reduce the risk of suicide. The vast majority of all those who survive a suicide attempt do not go on to die by suicide.35David Owens, Judith Horrocks, and Allan House, “Fatal and Non-Fatal Repetition of Self-Harm: Systematic Review,” British Journal of Psychiatry 181, no. 3 (2002): 193-99, https://doi.org/10.1192/bjp.181.3.193. The following practices and policies limit easy and immediate access to firearms and are proven to reduce firearm suicide rates.
- Gun owners can make their homes and communities safer by storing their guns securely. This means storing them unloaded, locked, and separate from ammunition.
- Temporarily storing the gun securely outside of the home by transferring the firearm to another trusted person or storing it at a secure third-party location can be lifesaving when someone is in crisis.36Depending on state law, gun owners may be able to temporarily transfer firearm(s) to another person, such as a trusted family member or friend. Many businesses and agencies may consider temporarily storing firearms, including local law enforcement agencies, veteran service organizations, firearm retailers, shooting ranges, or commercial firearms storage facilities. Firearm storage maps have been developed to help community members find third-party storage options in several states and localities, including Colorado, Maryland, Mississippi, New Jersey, New York, and Washington State.
- Extreme risk laws, sometimes referred to as “red flag” laws, allow loved ones or law enforcement to intervene by petitioning a court for an order to temporarily prevent someone in crisis from accessing guns.
- Waiting period laws require a certain number of days to pass between the purchase of a gun and when the buyer can actually take possession of that gun. This creates a buffer between someone being in crisis and having access to a gun.
- Permit-to-purchase laws, in addition to background checks, ensure that a person attempting to buy a gun is not legally prohibited from having a gun.
Investing in research and prevention programs.
More research is needed to better understand the significant rise in youth firearm suicide and to develop targeted prevention efforts. There are a myriad of factors that influence risks for suicide, some of which are unique to specific populations. Therefore, it is critically important to have research that disaggregates data by subgroups and to develop interventions that are evidence-informed and culturally appropriate.37Lee and Wong, “Racial/Ethnic and Gender Differences in Antecedents;” Lau et al., “Correlates of Suicidal Behaviors;” Polanco-Roman et al., “Emotion Expressivity, Suicidal Ideation, and Explanatory Factors;” Lisa R. Fortuna et al., “Prevalence and Correlates of Lifetime Suicidal Ideation and Attempts among Latino Subgroups in the United States,” Journal of Clinical Psychology 68, no. 42 (2007): 572–81, https://dx.doi.org/10.4088/jcp.v68n0413; US Department of Health and Human Services, “African American Youth Suicide.” Failure to address the unique risk factors linked to demographic groups can negatively affect individuals in need, further exacerbate disparities, and impact program outcomes.38Sarah P. Carter et al., “Suicide Attempts among Racial and Ethnic Groups in a Nationally Representative Sample,” Journal of Racial and Ethnic Health Disparities (2021): 1–11, https://dx.doi.org/10.1007/s40615-021-01115-3.
Knowing the risk factors and warning signs.
Knowing the risk factors and warning signs that may indicate someone is at risk of taking their life is critical to saving lives. While these factors and behaviors, whether in yourself or in a loved one, do not automatically mean someone is at a risk for suicide, they may be significant and are important to recognize, especially if they are new or have increased. To learn more, read the American Association of Suicidology’s flyer on the warning signs of acute suicide risk, which include:
- Threatening or talking about wanting to hurt or kill themselves.
- Looking for ways to kill themselves, such as attempting to acquire a firearm or pills.
- Increased use of drugs and/or alcohol.
- Feeling like they have no reason to live or no sense of purpose in life.
- History or signs of depression, anxiety, agitation, and/or difficulty with sleep.
- Withdrawal from friends, family, and society.
- Reaching out to say goodbye to loved ones and/or giving away their possessions.
- A sudden and unexplainable improvement in their mood.39American Foundation for Suicide Prevention, “Risk Factors, Protective Factors, and Warning Signs.”
The Implementation of Anonymous Tip Lines by School Districts has Been Saving Lives.
Initially developed as a mechanism for students to anonymously report concerns about their classmates in order to stop school shootings, school tip lines are now more frequently being used by students to report others who are at risk of self-harm or are feeling suicidal.48Tyler Kingkade, “School Tip Lines Were Meant to Stop Shootings, but Uncovered a Teen Suicide Crisis,” NBC News, February 1, 2020, https://nbcnews.to/3gi4kpB. From the launch of statewide school safety tip lines in Oregon and Pennsylvania through the 2020–21 school year, the programs received 637 and 6,154 tips about suicide, respectively. This is compared to 324 tips in Oregon and 1,786 tips in Pennsylvania about threats against schools.49Safe Oregon, “Oregon Statewide School Safety Tip Line, 2020–2021 Annual Data Report,” 2021, https://bit.ly/3rPmsjn; Commonwealth of Pennsylvania, Office of Attorney General, “Safe2Say Something Annual Report, 2018-2019 School Year,” 2019, https://bit.ly/3gesv8f; Commonwealth of Pennsylvania, Office of Attorney General, “Safe2Say Something Annual Report, 2019-2020 School Year,” 2020, https://bit.ly/34ZWQr3; Commonwealth of Pennsylvania, Office of Attorney General, “Safe2Say Something Annual Report, 2020-2021 School Year,” 2021, https://bit.ly/3JrWLLS. Given the unprecedented uptake of these programs, Everytown recommends that more school districts implement anonymous tip lines to address the rise in youth suicide and keep our students safe.
Schools should consider using Sandy Hook Promise’s Know the Signs campaign and Say Something program, which is currently being used in several states. Pennsylvania has used this program to develop its Safe2Say Something tip line program, which trains students on warning signs and encourages them to report a classmate who may be at risk of harming themselves or others.50Sandy Hook Promise, “Our Proven Programs Create Change That Leads to Safer Schools,” accessed May 2, 2022, https://bit.ly/34L0ymx.
Learning how to talk about mental health.
If a friend, family member, or loved one is exhibiting any of the above warning signs and you are worried they are contemplating suicide, it is important to have an open and honest conversation with them and not wait with the hope that they will start to feel better. Talking to loved ones about suicide does not make them suicidal or plant the idea in their head.40 Christine Polihronis et al., “What’s the Harm in Asking? A Systematic Review and Meta-Analysis on the Risks of Asking about Suicide-Related Behaviors and Self-Harm with Quality Appraisal,” Archives of Suicide Research, (July 25, 2020), https://doi.org/10.1080/13811118.2020.1793857. In fact, you can make a difference by offering support and help. Let them know you are listening and taking them seriously:
- Show your support and that you care.
- Encourage them to keep talking, and actively listen by expressing curiosity and interest in the details.
- Ask them about changes in their life and how they are coping.
- Be direct if you suspect they are thinking about suicide. Use the words “suicide” or “kill yourself” if asking about suicidal thinking.
- Follow their lead and know when to take a break.
- Find a way to bring up the benefits of professional help, and provide them with resources on how to do so.
Reach out for help.
Suicide prevention hotlines, such as the National Suicide Prevention Lifeline (NSPL), are staffed by trained counselors who assess callers for suicide risk, provide crisis counseling, and offer referrals, including lethal means counseling when someone mentions that they have firearms or other lethal means in the home. These hotlines are saving lives each day. The NSPL received 2.4 million calls in 2020—a 4.4 percent increase in calls from the year prior,41 National Suicide Prevention Lifeline, “Suicide Prevention by the Numbers,” accessed February 9, 2022, https://suicidepreventionlifeline.org/by-the-numbers/. and the Crisis Text Line engaged in 6.9 million text conversations between August 2013 and December 2021.42Crisis Text Line, “Crisis Trends,” accessed February 14, 2022, https://crisistrends.org/. An evaluation of the NSPL found that 95 percent of callers reported that speaking with a NSPL counselor helped avert their suicide plans.43Federal Communications Commission, “Report on the National Suicide Hotline Improvement Act of 2018,” August 14, 2019, https://bit.ly/3355iQS. Free and confidential support when you, a loved one, or a peer needs to talk to someone is available.
FREE AND CONFIDENTIAL CRISIS LINES
- 988 Suicide & Crisis Lifeline (formerly the National Suicide Prevention Lifeline) provides free and confidential support for people in distress or suicidal crisis. Call or text 988 to talk with a counselor or visit 988lifeline.org/chat to chat online with one. Call, text, and chat lines are available 24 hours a day, 7 days a week (24/7).
- Crisis Text Line provides free live texting with a trained crisis counselor. Text HOME to 741741 from anywhere in the US 24/7.
- Teen Line connects teens who need someone to talk to with other trained teens who can listen and present available options. Call 1-800-852-8336 or text TEEN to 839863 from 6 p.m. – 9 p.m. PST.
- The Trevor Project provides crisis intervention and suicide prevention services to LGBTQ+ young people under age 25. Call 1-866-488-7386, text START to 678-678, or chat online with a counselor 24/7.
- Trans Lifeline Hotline provides support services by trans people, for trans and questioning callers in crisis 24/7. Call 1-877-565-8860.
- Veterans Crisis Line provides confidential support to anyone, regardless of Veteran Affairs status. Call 988 and press 1, text 838255, or chat online 24/7.
- Your Life Your Voice connects teens in need of help with crisis counselors 24/7. Call 1-800-448-3000 or text VOICE to 20121.
SUICIDE PREVENTION AND MENTAL HEALTH ORGANIZATIONS
- Active Minds has chapters on more than 800 campuses that work to empower college students to openly talk about their mental health so that no one struggles alone.
- Asian Mental Health Collective provides a list of culturally competent therapists for the API community and works to raise awareness about the importance of mental health care and challenging the stigma surrounding it.
- Black Mental Health Alliance aims to develop and promote culturally relevant trainings and services to support the health of Black people and other communities in the US.
- Center for Native American Youth of the Aspen Institute works to improve the health and safety of Native American youth through research, advocacy, and policy change.
- Loveland Foundation provides financial assistance to Black women and girls nationwide seeking therapy, with the goal of prioritizing opportunity, access, validation, and healing.
- National Alliance for Hispanic Health is a science-based and community-driven organization that focuses on improving the health and well-being of Hispanic people and providing quality care to all.
- American Association of Suicidology’s National Center for the Prevention of Youth Suicide works to identify youth at risk, develop strategies to move prevention upstream, and engage and empower youth to be partners in their suicide prevention efforts.
- Society for the Prevention of Teen Suicide, founded by two dads who lost teenage children to suicide, encourages public awareness of teen suicide through the development and promotion of educational training programs.
- You Matter, administered by the National Suicide Prevention Lifeline, creates a safe space for youth to share their stories about mental health.
Everytown Research & Policy is a program of Everytown for Gun Safety Support Fund, an independent, non-partisan organization dedicated to understanding and reducing gun violence. Everytown Research & Policy works to do so by conducting methodologically rigorous research, supporting evidence-based policies, and communicating this knowledge to the American public.