Firearm Suicide Among Veterans

Veterans are at especially high risk for firearm suicide because they have higher rates of firearm ownership and of suicide risk factors.¹

Clinicians can reduce the risk of suicide by counseling at-risk veterans to reduce access to lethal means, especially firearms. Lethal means counseling has become a prominent piece of the Department of Veterans Affairs’ suicide prevention efforts. Clinicians should tailor their conversations and recommendations to veterans’ unique experiences and preferences.

The Numbers

About 7% of US adults are veterans, yet veterans make up 22% of Americans who die by firearm suicide.^2-4 Veterans who die by suicide disproportionately use firearms: two-thirds of veteran suicides are by firearm, compared with 50% of suicides among those in the general population.^2,3

Veterans are more likely to have certain risk factors for suicide compared to non-veteran adults, including underlying mental health conditions (like PTSD and depression), substance misuse, exposure to suicide, traumatic brain injury, and unaddressed chronic health conditions related to their military service.^5-8

A large body of research indicates that having a gun in the household increases the risk of suicide among household members.⁹

Firearm Access

Veterans more often own firearms compared to the non-veteran population: 45% vs 22%, respectively.¹⁰ Although suicide rates for male veterans are higher than those for female veterans, firearms are also the most common method of suicide among female veterans.¹¹ Suicide screening and lethal means counseling may be especially important for female veterans given their distinctly high rates of firearm ownership compared to non-veteran females in general.^3,10 

Recent research among veterans receiving mental health care within the VA system indicates that half of veterans with suicidal thoughts or suicide plans live in households with firearms.¹² Just 6% of veterans, however, think that a gun in the home increases risk for suicide.¹³ In addition, one-third of veterans store their guns loaded and not locked up, which further raises risk for suicide.¹⁴

Raising awareness of the increased risk of suicide for those with access to firearms and of the lethality of firearms in suicide attempts may be important for reducing veteran suicide.

Research suggests veterans believe there are some circumstances in which individuals should not have firearm access, including during periods of depression or substance misuse, and may be willing to reduce their access to firearms or that of others in such circumstances.^13-15

What You Can Do

A patient-centered approach to lethal means safety that is nonjudgmental and framed in the context of injury prevention may be most productive for preventing firearm suicide.¹⁶ Reducing access to lethal means of suicide, such as firearms or medications, is one of the most effective suicide prevention strategies.^{1, 17-23} For firearms, lethal means safety interventions include a range of safer storage practices and temporary transfer of firearms. Although clinicians may screen patients for suicidal thoughts and provide counseling, they often do not talk about access to firearms and the importance of reducing access to lethal means in times of crisis, even within the VA system.^12,24Lethal means safety puts time and space between a suicidal person and lethal means until the crisis has passed.

Veterans may prefer when lethal means safety conversations happen in an authentic manner (rather than a formulaic or “checklist” approach), in the context of elevated risk, and within trusted patient-clinician relationships.^15,25 Whenever possible, clinicians should engage a patient’s support systems, such as veteran peers or family members, to help reduce access to lethal means when risk is high.^15,26 Rather than asking whether the patient has firearms at home, clinicians may find it helpful to employ phrasing that assumes and normalizes ownership. For more detail on having these conversations with patients, visit our How to Counsel page.

When a veteran has thoughts of suicide, the most appropriate intervention depends on their willingness to collaborate and the nature of the risk. When risk for suicide is not acute, practicing safe firearm storage can help reduce risk. However, the safest way to prevent access to firearms for someone at risk of suicide, especially if that person owns firearms, is to remove firearms from the home until heightened risk subsides. Patients and clinicians can work together with trusted peers and loved ones to decide on appropriate options for storage outside the home while someone is going through a time of crisis.

Voluntary, temporary transfer of firearms—to a family member, friend, other trusted person, gun shop, range, or other option—can be lifesaving.

In cases where the patient is not willing to collaborate and risk is high, mental health holds or risk protection orders may be merited.

Page last updated May 2022.

For more information, see these peer-reviewed articles.

Dobscha, S.K., Clark, K.D., Newell, S., et al. (2021). Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives. Journal of General Internal Medicine. 

Theis, J., Hoops, K., Booty M., et al. (2020). Firearm Suicide Among Veterans of the U.S. Military: A Systematic Review. Military Medicine. 

 Simonetti, J.A., Dorsey Holliman, B., Holiday, R., et al. (2020). Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study. PLOS One. 

Dempsey, C.L., Benedek, D.M., Zuromski, K.L., et al. (2019). Association of Firearm Ownership, Use, Accessibility, and Storage Practices With Suicide Risk Among US Army Soldiers. JAMA Network Open.