Steven Lippmann, M.D.

There exists a wide-spread impression in America contending that procession of a firearm provides a good measure of self-protection. Is that really true?

Kentucky publicly documents all violent deaths in this state. The Kentucky Violent Death Reporting System records are available on-line (kvdrs.ky.gov).

They documented an average of 536 gun-related deaths in Kentucky each of the years between 2005-2010. Among these, a yearly average of 372 fatalities are suicides using a firearm. Therefore, shooting one self to death accounts for over 69% of all lethal gunshots in Kentucky.

These statistics do not count self-shooting survivors or deaths by a gun accident. The likeliest victim of a gunshot is self, then someone known to the shooter, or someone related to a criminal
act. Actual interruption of an on-going crime or self-protection is a rare event. Kentucky’s data on this subject generalizes to the rest of our country.

Since suicide by firearms is so frequent, psychiatrists should ask about  gun access at patient contacts. It remains a logical point of discussion for us, just like questioning about suicidal ideation.

Everyone with depression, anger issues, or impulsivity is encouraged to remove all gun availability, especially, when concerns about suicide are present. This is so important that family assistance may be needed. Co-existent substance abuse profoundly adds to the risk for a suicide, other shootings, or an accident. There is little evidence for guns providing much personal
protection.

With or without psychiatric concerns, whenever weapons are in a home, doctors should insist on trigger locks and that guns and ammunition be locked up, each in individual, separate places. Loaded guns have no place in a residence. Instruct everyone to treat firearms as if always loaded,
for example, never to allow a gun barrel to point toward anyone at anytime and users should undergo gun-safety education. Children should only be allowed access with adult supervision.

Because guns are now such a politically hot topic, these clinical suggestions often may not be popular to give or receive. Nevertheless, we ought to do it anyway.