This research, drawing on the evidence of firearms suicides during 1997 to 2004, furthers the understanding of the relationship between access to means, method familiarity and method choice. It also supports more recent work arguing for a broader explanation of factors (including socidemographic) impacting on the use of firearms as a means of suicide [7
]. It demonstrates that not only is there a greater likelihood that those familiar with firearms and having access to them would select firearms as a means for suicide, but also that there is a greater likelihood of suicide by any means among this group.
Results from the logistic regression identified significant factors for those most commonly selecting firearms as a method of suicide. These included age, location and firearm access, with older males from regional areas with access to a firearm being the most likely group to use firearms to commit suicide.
The presence of firearms has been found to be associated with a significantly higher risk of suicide by the use of firearms in men than women. This is consistent with some other studies [42
]. Additionally, this research found that the risk of suicide by any means was more than doubled in those with a licence history (OR = 2.09, P
A number of other studies have explored the link between suicide and firearm access. At a regional level, associations between higher firearm availability and total suicide rates have been identified [21
]. However, small samples and the effects of overall firearm accessibility often make it difficult to confirm the relationship. Beautrais et al
], in a study of 197 suicide cases in New Zealand, found a positive, but non-significant, association between firearm access in the home and the selection of this means of suicide (OR = 1.4, P
> 0.05). Kellerman et al
] found an increased suicide risk (OR = 4.8) where a firearm was available in the home. Studies focusing on links between recent firearm access and suicide risk also found an increased risk among those who had recently purchased handguns [11
Given the significance of the finding of an elevated suicide risk in those with a history of firearm access, some consideration of the possible differences in this group is warranted. Few studies have explored the mental health [44
] and rates of depression and suicide ideation [45
] among those with access to firearms, but found no significant links. Gun owners are known to be a relatively consistent demographic group [46
]. In our study the profile of those choosing firearms as a means of suicide showed them to be older regional men, many of whom were farmers. The higher incidence of suicides in older men, and in regional localities, is well documented [38
], as are the higher rates among Australian farmers [47
]. In seeking to explain the higher suicide rates of farmers in the UK, Booth et al
. suggested a number of factors, including a more functional attitude to death associated with the nature of the farming lifestyle [49
]. Such attitudes are likely to be reinforced over time, with Hendrix [46
] suggesting a cultural transmission of values surrounding firearms. There is a need for further exploration of these relationships with elevated suicide rates.
Method choice: access versus selection
The present study (Figure ) showed that, amongst current licensees, firearms remained the preferred method of suicide (10.92 per 100,000), in contrast to those without a licence history for whom hanging was the most preferred method (6.31 per 100,000) and firearms the least preferred (1.03 per 100,000). Further, for those with documented familiarity with firearms, holding a current or past licence, there was a greater likelihood of their committing suicide compared to those without such a history (OR = 2.09, P < 0.001).
Of particular interest were individuals with an identified access to firearms who used other means of suicide (n
= 108). They were more likely to be younger people from ARIA1 areas - thus poorly aligning with the more usual characteristic of firearm suicides. Such a choice (by seven of the 15 males aged less than 25 years from ARIA1) is consistent with the increasing choice of hanging among young males, both in Australia [31
] and internationally [50
The evidence shows that those who accessed firearms without a licence were significantly more likely to be older, male and from ARIA2. This group aligns well with the profile of those selecting firearms, with the exception of current licence holders. There was no significant age difference for females; however, they were significantly more often from ARIA2 (Table ).
While the access restrictions introduced in 1996 were intended to limit firearm use to those with licences, there are a number of likely avenues by which illegal access can be achieved - for example, through access to firearms in the home, through work or social networks or through theft. Studies by Smith [15
] and Ikeda et al
] documented access without ownership, particularly by females and young males, who were the least likely to hold a licence. In their investigation of firearm theft, Bricknell and Mozous [16
] showed that a greater proportion of Queensland thefts occurred in rural and regional areas, and that only 57% of licensed owners complied with the safe storage requirements. Thus it can be seen that it is relatively easy for unlicensed people to obtain access to firearms.
While accessibility is a critical element of choice, this research demonstrates that a licence is not a necessary factor in determining firearm accessibility. Further, where access is present through a licence, this may also not be a sufficient factor in determining the choice of the method of suicide. The relevant number of those using other means demonstrates that the choice of method is also greatly influenced by age and location, with illegal access occurring more frequently in regional locations.
Owning a current firearm licence has been used as a proxy for current access. Although this is a good indicator of access, there are situations where a person with a licence may not have immediate access, for example, when away from their normal residence. On the other hand, for those without a licence there are a number of mechanisms by which firearms can be accessed. Those with a past licence may still retain their old weapon. Further, those without a license can obtain weapons stored by known licence holders (sometimes within their household) or illegal weapons.
The identification of licensed persons used the most detailed information available, integrating information from the QSR with that from the Firearms Registry. However, it is possible that inaccurate reporting or recording of information could have occurred in the documentation of some cases.
Firearm suicide is predominantly a method chosen by males; thus, the numbers of reported female cases were low and the possibility of identifying statistical differences, for example across age classes, was limited.
This study relied on data from the QSR, limiting the analysis to Queensland. Similar analyses for all of Australia, while certainly possible, are constrained in their effectiveness by recognised issues with national data quality [51