Here & Now

Dr. Tony Thrasher on Mental Health and Suicide by Firearm

Frederica Freyberg:

A bipartisan bill making its way through the legislature would provide $150,000 over the next two years toward a grant program supporting suicide prevention in gun shops. The grant money could go to train staff at retailers who sell guns or at gun ranges to recognize signs that someone is considering suicide, provide prevention materials, or provide voluntary firearm storage for the owner of the weapon. We turn to Dr. Tony Thrasher, president of the Wisconsin Psychiatric Association, for his take on this proposal, and thanks very much for being here.

Tony Thrasher:

Thank you for having me.

Frederica Freyberg:

So, what is your take on this proposal?

Tony Thrasher:

I think it’s an excellent first step. Gun violence in Wisconsin, as gun violence nationally, is a public health issue. And it’s worsening, and while most people think of gun violence and the focus is on externalized violence such as homicide or mass shootings, the majority of gun violence in most states now is suicide. So this is a really good first step in a public health sense. Kind of the community looking out for everybody and getting this information into an area where there are a lot of firearms and a lot of people looking to purchase firearms. And whether you’re reaching somebody who is suicidal or a family member of someone who may be suicidal, it’s a really nice intervention that hopefully will have significant impact.

Frederica Freyberg:

So, what would gun retailers be looking for to recognize in someone who might be considering suicide?

Tony Thrasher:

I think there’s a lot of good conversations that happen at any retail intersection and any sort of marketing and sales component. So, I think getting those frontline individuals to look for signs of depression, sadness, mood lability, anxiety even. Sometimes going so far as to look for specific warning signs about people talking about the end of their life or feeling helpless or hopeless might be a really nice intersection for people to intervene or at least talk to somebody and offer services.

Frederica Freyberg:

How would they respond to those signs?

Tony Thrasher:

I think that’s going to be a very interesting scenario, depending upon which group is doing it and in what part of the state you may be. Most counties have crisis service type of intervention, so it’d be a nice pairing to have is if somebody does one of these grants, making sure they know who their mobile crisis workers are. They could come talk to somebody and help them through this. A lot of periods of suicidal ideation are very powerful and very episodic. And so, there’s good evidence that if we can get somebody to somebody when they’re having their worst day, that you can make a big difference. And not just abort that suicide attempt but abort future suicide attempts.

Frederica Freyberg:

Why is that kind of point of contact with a gun retailer or a gun range important?

Tony Thrasher:

I think there’s two components to it. One is, I think, what probably seems most apparent, which is if somebody is feeling impulsively self-harmful, and they don’t have a firearm, that is most likely where they would obtain a firearm. But I think the even bigger picture is one of culture. I think whenever you kind of look at the issue around firearms, it’s naturally can be divisive. Even when we wish in a public health sense that it was not. And so, in this case, by kind of setting up at that shop, we are starting a cultural shift. That it’s okay to talk about being suicidal, and it’s okay to talk about being depressed, even if you are someone who owns firearms or has family members who own firearms. I think it’s a neat way to start breaking down some of that stigma and just opening up the conversation. Hence, why that may be a better cultural component than anything else.

Frederica Freyberg:

Do you think it’s likely that someone would actually voluntarily hand over their firearm if a retailer or another person said, “Look, you look like you’re having a little bit of trouble.”

Tony Thrasher:

I do, and I think we see this a lot in safety planning with people that have suicidal thoughts is they’re already doing this. They’re often sharing it with family members or friends or perhaps engaging in other good means reduction issues like gun locks or specific gun safes they don’t have access to, or the codes are changed whenever they’re having periods of depression. So, I do think having this as another alternative, particularly with a lot of people that kind of work with their firearms on a regular basis, and perhaps ex-military, ex-law enforcement, that relationship with the retailer may be a friendship one, as well. So, you may have some kind of ties in between family, friends. “Who would I feel safe leaving this with for the short term?” I do think there’s a lot of possibilities there.

Frederica Freyberg:

The Department of Health Services reports that the suicide rate in Wisconsin increased 32% from 2000 to 2020. Are suicides still on the rise?

Tony Thrasher:

Yes, scarily enough, the population it’s rising most in is our younger generation. Ages 15 to 24, it is now the number one cause of death, which, if you go back 10 to 15 years ago, seems very, very shocking compared to what it used to be when we focused on things like impaired driving and accidents. But unfortunately, suicides are on the rise, and given that firearms are unfortunately the most lethal way to do that, it makes sense if we’re going to look at reducing suicide, we look at addressing that primary cause, which is firearms.

Frederica Freyberg:

Are there areas of the state that are suffering more?

Tony Thrasher:

Unfortunately, we start to see a lot of suicides, more so in rural areas than urban areas. I’m not so sure that’s a causative, as much as a correlative, but those are definitely areas with less resources, or it’s harder to get to the resource. And so, unlike Madison or Milwaukee, where your therapist may live within a 5-minute drive, you’re talking about people that live in areas that may not get to those services without driving hundreds of miles. So, in addition to other risk factors in the rural area, particularly farming communities where we’ve seen a rise in suicides over the past two years as well.

Frederica Freyberg:

So, other than not having kind of the mental health supports, potentially, what else is driving those trends?

Tony Thrasher:

You tend to see in the rural communities not just like you said probably a lack of connection to services, but also, you’re in a much more isolated area. So, we know a lot of treatment for depression and mitigation against suicide is connectedness, community. And while there are wonderful communities, they can be more spread out the more rural you get. You also find a higher possession rate of firearms in that area, too. So, once again, something that is of high suicide risk is much more probably obtainable in some of those areas than in other sections that have lower suicide rates. Which once again, when people are having their worst days, what you want to do is have a safe environment around them. And the more firearms there are, the less safe it becomes.

Frederica Freyberg:

So, you have described this as kind of a good first step, and you think that other professionals like yourselves in and in public health think the same?

Tony Thrasher:

Yes, very much so. And I think the nice thing about the public health realm is twofold. One is we’re dealing with it as a community. This isn’t an issue where we say it’s your job, or it’s your job, or they should be doing more. If it’s a true public health problem, then we all get together to try to fix it in doing what we can from each of our specific specialties. And secondly, public health interventions have worked. Seat belts have worked. Catalytic converters in cars have worked. Putting child-proof tops on medicine bottles has worked. Public health interventions can mitigate large-scale kind of risks to our health. And I think this is no different. So, it’s nice that this is kind of a first step, but I hope we continue to enlarge it in a public health sense, as we look at gun violence really as probably the primary public health thing facing our society right now.

Frederica Freyberg:

And what would the next steps be in your mind?

Tony Thrasher:

It would be nice to see further consideration of education beyond retail gun shops. Really getting this out into the open. I think education is huge because there’s a lot of people that own firearms that themselves have never been suicidal. So, you don’t think about it as a risk, as opposed to saying there’s other people that are in your house. There’s other people in your orbit. There’s other people you’ll come into contact with. They may be feeling that way, and as such, we want to mitigate their risk too. And of course, another consideration down the road is many states have initiated some ways to remove firearms based upon other criteria, against people’s will, which this bill is not that. This is a volitional possible handing over firearms, but there are other things, such as emergency restraining protective orders, that have been seen in other states across the country that has either reduced suicide rates or sometimes reduce violence to others rates as well.

Frederica Freyberg:

All right, Dr. Thrasher, thanks very much.

Tony Thrasher:

Thank you for having me.