Study supports Do Not Sell voluntary waiting period for gun sales to reduce suicide

A new study suggests many patients at risk for suicide would voluntarily place their name on a Do Not Sell list, prohibiting gun shops from immediately selling them a firearm.

The study, published today in Suicide and Life-Threatening Behavior, says nearly half of the 200 people surveyed would willingly place their name on such a list.

“There is evidence that suicide, in particular suicide-by-gun, is often impulsive — that once an individual decides to take their own life they are, in many cases, able to quickly obtain a firearm and use it,” said lead author Fredrick Vars, J.D., a professor in the School of Law at the University of Alabama. “The concept of a Do Not Sell list, similar to the national Do Not Call list, would be to eliminate such impulsive transactions. Restricting access to firearms, even temporarily, could save many lives.”

The authors report that previous studies of survivors of firearm suicide attempts found a majority had suicidal thoughts for less than a day, while another found that, of nearly lethal suicide attempts among people 13-34 years of age, about one-fourth of attempters spent less than five minutes between the decision to attempt suicide and the actual attempt.

Vars conducted the survey with investigators in the University of Alabama at Birmingham Department of Psychiatry in the School of Medicine.

“People with mental illness are more likely to commit suicide,” said Richard Shelton, M.D., vice chair of Research for the UAB Department of Psychiatry and a study co-author. "Studies indicate the vast majority of suicide attempt survivors end up eventually dying of something other than suicide, so a means of preventing someone from making future gun purchases during a suicidal crisis might reduce suicide rates.”

The researchers surveyed 200 patients at an inpatient psychiatric unit and two outpatient psychiatry clinics at UAB. The most commonly reported conditions of those surveyed were mood disorders, anxiety disorders, psychotic disorders or substance abuse.

The survey presented two options to study participants. In the first, respondents would voluntarily place their name on the Do Not Sell list, which would feature a seven-day waiting period following a request for removal from the list to avoid an impulse buy. The second option would require a judicial hearing to remove a name from the list and allow a gun sale. A total of 46 percent of respondents indicated willingness to participate in one of the two methods, with a slight preference for the seven-day waiting period.

“Nearly one-half of participants indicated they would like to be able to restrict their own future gun purchases,” Vars said. “This approach wouldn’t stop all suicides, but any dent we could make in the estimated 20,000 people who use a gun to commit suicide every year in the United States would be significant.”

“Waiting periods to purchase firearms have been shown to reduce gun suicide, most likely due to the impulsive nature of suicide attempts,” said Karen L. Cropsey, Psy.D., associate professor of psychiatry at UAB and a study co-author. “The Do Not Sell list is a new type of means restriction, and means restriction generally has been shown to be one of the most effective suicide prevention strategies.”

Cropsey says a Do Not Sell list would be a natural extension of current counseling practice.

“We regularly have conversations with patients who are having or have had suicidal thoughts about removing access to firearms in the home,” she said. “Taking a gun out of the home or, as in this case, creating a delay period that removes the ability to impulsively purchase a firearm are good strategies for suicide prevention.”

Vars, who has studied mental health and gun ownership for years, believes the concept of the Do Not Sell list is unique but could be implemented fairly easily.

“A waiting period — say seven, 10 or perhaps 15 days — would be fairly easy to establish and would involve primarily one-time set up costs rather than an ongoing expense,” Vars said. “The judicial review option would be more expensive. The largest hurdle would be in educating health care providers and the public that an option such as a Do Not Sell list exists.”

Vars would like to see the survey administered in other regions of the country to see if the results are similar.

“Alabama has a high rate of gun ownership and a strong consensus against gun regulation,” Vars said. “Sign-up rates could be different and possibly higher in regions with lower gun ownership rates.”