This story is part of a multi-part series, “Shots Fired,” which discusses the complexities of gun violence and deaths in Hampton Roads.
Editor’s note: This story discusses suicide. If you or someone you know is struggling or in crisis, call or text 988 or chat 988lifeline.org. Local crisis services can be reached at 757-656-7755.
In the amount of time it takes you to read this story, someone will decide to attempt suicide.
While homicides and mass shootings take up a plenty of space in conversations and politics surrounding gun deaths, more than half of all gun deaths nationwide are suicides. Preliminary counts from the Virginia Department of Health showed that 141 gun deaths in Hampton Roads last year were determined to be suicide, more than half of the region’s suicides overall.
The time it takes many people to decide to take their lives is short. In more than half the cases evaluated in a 2016 study, people went from contemplating suicide to attempting it in less than 30 minutes — sometimes in as few as five. Experts say gun access is a major driver of the mortality rate of these attempts. They say slowing access to guns and making effective mental health care easier to access can lead to meaningful change.
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Aftershocks
For more than 35 years, people who have lost a loved one to suicide have gathered in Portsmouth for Hampton Roads Survivors of Suicide’s support group. Since its creation, more than 1,000 have attended at some point, said founder Chris Gilchrist.
She has seen it all: anger, guilt, extreme sadness. A father in law enforcement who taught his child to shoot, only to have them die by suicide using a firearm. Older brothers who felt they could not protect their younger siblings. Parents blaming each other for being too strict, or too lenient. Spouses wracking their brains for signs they may have missed.
“I think (suicide is) a tragedy because I believe in looking back at the hundreds, hundreds and hundreds of suicides that have come through the group, and every one was preventable,” Gilchrist said.
Suicide, Gilchrist said, creates a ripple effect. Family members of people who take their own lives are five times more likely to die the same way, so Gilchrist meets with them once a month to support them. She said the meetings often match national trends in suicide. More men typically die by suicide, but she has noticed more women who have died by suicide using a firearm being represented.
“When you are depressed — and being suicidal is being severely depressed — you’re at risk, and your promise (to not die by suicide) means nothing. You’re not thinking straight. It’s just so difficult.”
At the beginning of the meetings, each person holds up a photograph of their loved one, telling the group who they were and how they died. It’s powerful, she said, to watch about a dozen people — of all sorts of backgrounds and beliefs — connecting through tragedy.
Hope, she said, is what can save us. Outside her office door, paper cranes line the walls, each one a different color and tied to the next. If you walk quickly down the hall, they rustle like quiet whispers. Each of the small paper birds symbolizes hope, Gilchrist said. It’s something she believes is a key to saving lives.
“We need to replace the stigma with the hope that comes in knowing the number one cause is depression, and depression is treatable,” she said. “That is what people don’t get. They more realize the stigma.”
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Firearms are pushing the needle in suicide statistics
In the United States, 49,476 people died by suicide in 2022, and more than half used a firearm, according to the most recent data available from the Centers for Disease Control. That’s an increase over the previous year, and for decades, Americans have been dying by suicide at an increasing rate, reaching a peak of about 15 per 100,000 people.
To experts, it’s a public health crisis. During the pandemic, more households were buying guns, said Dr. Paul Nestadt, a psychiatrist and researcher at Johns Hopkins University in Baltimore. Nestadt studies the role of firearms and opioids on suicide risk at the university’s Center for Gun Violence Solutions.
Millions of people became new gun owners from January 2019 to April 2021, according to a study published in 2021, and most had lived in homes without guns, meaning more inexperienced gun users. Researchers said this exposed more than 11 million people to household firearms, including more than 5 million children.
Because of political and social unrest in 2020, Nestadt said, more women and people of color began keeping guns in their homes, increasing the rate of suicide by firearms in their respective demographics.
Across the country, suicides using firearms largely outnumber homicides using firearms, and the same can be said for Virginia as a whole. In Hampton Roads, the numbers tell a different story. Since 2007, homicides and suicides have gone back and forth as the most common type of death using a firearm, but since 2020, homicides have outnumbered suicides. In 2022, Hampton Roads hit a peak for suicides using firearms, at 169.
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Navigating a broken system
Max Willey, vice president of the coastal Virginia chapter of National Alliance of Mental Illness, said since the pandemic, the group’s phone has been ringing virtually nonstop from people trying to get help. One of the most common requests is help navigating the mental health care system. The group offers peer-to-peer courses for family members of those with mental illness, which he said has been a big help.
“Mental health is health, and we ought to treat it just like high blood pressure and diabetes,” Willey said. “And if you’re trying to get treatment for something, and it takes six to nine months and you have a heart condition, it’s absurd.
“We’d never treat someone with that health condition like that. Mental health has to be treated the same way, and this is some things we advocate for.”
Despite the obstacles, Willey said a simple conversation can save a life. According to the Suicide Prevention Resource Center, someone who might be suicidal may suddenly become less interested in their appearance or hygiene, become withdrawn, change their eating habits, sleep less or sleep too much. They sometimes express feelings of hopelessness or being worthless.
“If someone is in crisis, or they’ve had suicide attempts or suicidal ideations, just remember, do everything you can to let them know that they are valued,” Willey said. “I’m not a certified therapist or anything, I just have lived experience with a family member.
“Listen actively, without prejudice and shaming the other person. When they start to break their silence with you about all the trauma that they’ve been experiencing, that means they’re asking for help.”
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Finding care for the ‘in-between’
Dr. Charles Dunham, a psychiatrist with Sentara’s Behavioral Health Care Clinic, said the pandemic opened a lot of conversation about mental health and resources, and his department has seen more need for their services in Hampton Roads.
“We’re seeing year over year increases and people looking for help going to our emergency departments,” he said. “And I think what we’re struggling to deal with as a society is how to get the resources to the right person at the right time, so what we’re working on with Sentara is to figure out that puzzle and how to try to figure out how to serve our communities.”
Specifically, Dunham said the mental health-care system can struggle with “in-between” patients, or patients who are not yet in a crisis but can’t wait weeks or months to see a provider or get medication. That’s partially why the hospital system opened its Behavioral Health Care Center in Virginia Beach. If a physician is noticing more dramatic changes with a patient, the care center can get them faster access to a mental health professional.
Dunham said most suicides fall within two categories: impulsive suicides and planned suicides.
“(Impulsive attempts) are ones that sometimes we can make the most impact on by talking to the patients and trying to figure out if they have something deadly at home, such as a firearm, and would they be willing to have family members look after that firearm for a while until they get to a place where they’re not at such a risk for suicide,” Dunham said.
If firearms are removed from a home at risk for suicide, Dunham said the suicide rate is reduced by half.
Preventing suicide before someone reaches crisis mode means a better survival rate for people with mental illness. According to suicide prevention project Means Matter, firearms were used in less than 1% of nonfatal suicide attempts. Researchers have found that only about 4% to 6% of people who survive a suicide attempt die by suicide later.
“(The other 95%) just keep surviving,” Nestadt said. “The method used in that first attempt is really important. If that method is lethal, they’re dead. If they use a nonlethal method, they’re not only likely to survive that attempt, but they’re likely to just keep on surviving.
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Small changes could mean saved lives, experts say
Experts say gun access is a major driver of deaths by suicide. In 2015, mental health professionals in the northern and western part of Virginia created Lock and Talk, a campaign that distributes trigger locks and cable locks for firearms and devices to secure medications.
Jordan Brooks, program manager, said the campaign is now implemented in community service boards across Virginia, and someone interested in receiving a free lock can just reach out to their local board or Lock and Talk directly.
“One thing that we are very firm on is that we don’t want to restrict anyone’s access or anyone’s rights,” Brooks said. “It’s overall safety for the home.”
In Virginia, you can also ban yourself from buying a gun.
Virginians can add themselves to the Virginia Voluntary Do Not Sell list by filling out and mailing in a form with Virginia State Police. Being on the list prohibits someone from being able to buy a firearm, and citizens can fill out a form to get their name off the list after a 21-day waiting period. The bill that created the list was passed in 2020, and the list went live in 2021.
But these policies aren’t widely used. Corinne Geller, public relations director for state police, said as of May, there were about two dozen people on the list across Virginia. Geller said state police do not keep regional data for the list, so it is unclear how many — if any — people in Hampton Roads have utilized the Voluntary Do Not Sell list.
Nestadt said one of the obstacles for this kind of legislation is that someone must anticipate they’ll have a crisis in the future, and for many who deal with mental illness, that is not the most realistic or effective way to prevent suicide.
Even something as simple as a waiting period could save lives, Nestadt said. Virginia lawmakers had initially passed a bill that would have created a five-day waiting period on gun purchases, but Gov. Glenn Youngkin vetoed it. The bill, proposed by Del. Cliff Hayes, a Chesapeake Democrat, intended to prevent impulsive violence or suicide. In his veto statement, Youngkin said the bill was unnecessary because Virginia has background checks.
Hayes said he carried the measure on behalf of victims’ families from the 2022 mass shooting at a Chesapeake Walmart, but Nestadt said the waiting period is especially helpful for suicidal individuals. Other successful legislation includes red flag laws, which permit a state court to order the temporary seizure of firearms from a person who they believe may present a danger.
Nestadt said that research has found that for every 11 guns seized, one suicide death is prevented.
“So in medical terms, that’s what we call a ‘number needed to treat,’ like how much medication or an intervention needed to save one life,” he said. “So whether that’s worth it, depends on your philosophy (and) your politics, because you are taking away someone’s right to have (a firearm), and you’re removing it temporarily. How many lives you need to save to make that worthwhile is an open question.”
While more strict access to firearms can limit risks of suicide, access to mental health care is the first step to help someone at risk.
“The biggest take-home message there is if somebody is suicidal and they do have access to firearms, (someone else needs) to access them until they’re feeling better. We’re not trying to take away people’s rights to firearms or anything like that,” Dunham said. “We do know from a science standpoint, that if you’re able to limit access, you do save lives that way.”
Eliza Noe, eliza.noe@virginiamedia.com
