Cathy Barber is a researcher who studies violent deaths and injuries. A number of years ago, she was helping to develop a new system for the federal government called the National Violent Death Reporting system.

“In the process of doing that, I would read through thousands of suicides, little thumbnail sketches of suicides,” Barber recalls. “I was surprised at how many suicides involved some sort of triggering event on the same day as the suicide—like an argument, or an arrest, or somebody getting kicked out of school.”

Barber was surprised because, like many others, she assumed that suicide is deliberative, something people plan. But these little sketches showed people acting impulsively.

Barber got curious. She found some research on people who survived a nearly fatal suicide. They were asked how long it was between the time they decided to attempt suicide and the moment they tried it.

“Twenty-four percent said less than five minutes, two-thirds said under an hour, [and] only 16 percent said a day or more.  You’d think, ‘This is such a huge decision.’ You’d think it would be a more deliberative one,” she says.

Barber says these people may have suffered long battles with depression, but the decision to go through suicide is fast, and it passes quickly.

This matters, Barber says, because if people could get through that tiny window of time and not complete a suicide, then they would have a chance. Many people never re-attempt suicide, although that’s a common assumption.

So Barber came to conclusion that is so simple, it’s surprising we don’t’ talk about it more. Harmful things—easily available harmful things—are what matter in that little tiny window.

“There is a huge difference across methods of suicide in how likely they are to actually kill,” Barber says. “Firearms are actually at the top of the heap.”

When you try to kill yourself with a gun, you almost always die. By contrast, poisoning, for instance, hardly ever works.

Gun deaths add up. In 2011, of the 30,867 gun deaths in the U.S., 19,766 were suicides. So public health researchers like Barber have started to think about guns in terms of something called “means restriction.”

The term comes from the U.K., where gas—sticking your head in the oven—was once a leading means of suicide.

“Back in the 1960s, they started replacing the source of gas with a non-toxic source, and suddenly suicides in Great Britain went down by a third,” Barber says. “And so that’s when we started realizing means restriction actually can save lives.”

But of course, with guns in the U.S., “means restriction” is not so simple.

Most of the gun laws currently under debate address homicide, not suicide. Laws that restrict the overall availability of guns in a home might curb suicides, but those kinds of laws are unlikely to ever be on the table.

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So Barber’s approach is to provide crucial people with information and resources about firearm suicide. Her project, based at Harvard University, is called Means Matters. She focuses on developing leadership with gun owners. For example, one project equips gun shop owners in suicide intervention.

But our nation’s strong feelings about gun laws sometimes spill over to affect these public health approaches.

Dr. Joseph O’Neil lives in Indiana. He used to work as a family doctor. As part of his regular checkup routine, he’d ask about general health and safety concerns.

“When I was talking about car seats, when I was talking about seatbelt use, I often asked families if there was a firearm in the house. And I had several families take exception to that,” O’Neil recalls.

Some patients were so upset with the question about guns that they switched doctors, he says. But O’Neil didn’t stop asking. He’d had patients injured by firearms. And he didn’t feel like he was doing his job if he didn’t bring up the question of guns in the home.

O’Neil later went on to become part of the Indiana Violent Death Prevention project.

They trained clergy in suicide prevention. Most of the clergy said they had counseled a suicidal person before. More than a third said they had actually lost someone in their congregation to suicide.

“Clergy felt more empowered to say, ‘By the way, I know you feel this way. Is there a gun in the home, would you be willing to get it out of the house?’” O’Neil says.

But O’Neil’s group never got the chance to follow up to see how well the project worked. Their funding, which was from a private foundation, ran out.

Funding is scarce for research on firearm injuries. The Centers for Disease Control (CDC) funds research on causes of death and injury. But since 1996, the US Congress—under pressure from the National Rifle Association—has restricted most CDC research on firearms. And the Consumer Product Safety Commission, which researches and legally regulates most household products, doesn’t oversee firearms.

O’Neil says compared with vehicles or toys, there just isn’t the same oversight or information on firearms.

“Since 1975, we’ve reduced the number of infants killed in motor vehicle accidents by 75 percent. For toddlers, [by] 50 percent. I wish we could do that for firearm injuries,” he says.

But for now, O’Neil said the restrictions on funding make it hard for him and others to develop the good kind of public health approaches that would get those results. “It’s sort of like going without a compass. We don’t know where we’ve been and we don’t know where we are going unless we have the data.”

O’Neil is passionate about addressing firearm suicides in his state. He says it can be really frustrating to see the need and not be able to provide any solutions.

Harvard researcher Cathy Barber has faced similar issues. She says that while homicides often get public attention, suicides are kept quieter.

“I think what looms so large in people’s eyes is the thing you can’t control—the stranger who is trying to rob you,” she says of the public debate about guns. “Whereas you think, ‘Well, I am not going to commit suicide and my family is not.’”

But for Lindsay Van Sickle, it’s no longer possible to think that way.

She says her father was a fun loving guy who had plenty of friends.  He was very outgoing, loved Jimmy Buffett, and was always the life of the party. “And I guess this kind of comes up with his death, but one of his hobbies was collecting guns and going to the shooting range,” she says.

Lindsay Van Sickle’s dad shot himself in July of 2011. A few years earlier, her mother had died in a traffic accident. Both deaths were sudden and difficult for Van Sickle. But she says the feelings of being a suicide survivor are unique, unlike anything else.

Lindsay Van Sickle with her father. Van Sickle says her father was outgoing and affectionate. Courtesy of Lindsay Van Sickle

Lindsay Van Sickle with her father. Van Sickle says her father was outgoing and affectionate.
Courtesy of Lindsay Van Sickle

She remembers lying and saying her dad died of a heart attack, just so she wouldn’t have to explain what really happened.

“Because you don’t know what to say… I’ve told people my dad took his life. They give this shocked look. At least if it was cancer, you can at least [say] ‘Oh, I am so sorry.’ But what do you say [when someone tells you] ‘Oh yeah, my dad shot himself?’”

Van Sickle says her dad grew up hunting. He collected guns from World War II. And she says he was always very responsible, stressing safety, locking things properly. His cousins and friends, who also were gun hobbyists, were shocked that he’d use something he loved and respected so much to end his own life.

It’s only now that anyone can imagine the gun as something that would end up hurting him.

“If you have a gun, even if it’s for hunting or protection, there may come a time in your life that you may be depressed. And that may be a means to take your life. So, yeah, I am definitely more nervous and scared about guns now based on what my dad did to himself,” Van Sickle says.

For the most part, she tries not to wonder about what could have gone differently. It’s just too hard, she says. But watching the national conversation about guns, she does think about what place suicide has as we talk about firarms. And waits for the rest of us to ask that question too.

This story was produced with help from Kaitlin Prest, Julia Barton, and Nancy Mullane in collaboration with WBEZ’s Front and Center series on guns.

Also see Means Matters and The Gun Shop Project.