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IMPORTANCEUnderstanding mental health and substance use treatment seeking and suicidality among suicide decedents is important to determine prevention efforts. OBJECTIVE To evaluate differences in treatment seeking and suicidality between suicide decedents who died by firearms and those who died by other methods. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional data were collected on 234 652 suicide decedents from 2003 to 2018. Participant information was reported by their state of residence to

Objective To identify and verify classes of firearm owners that exist within the United States and determine the sources that classes deemed credible to discuss firearm safety for suicide prevention. Methods The study is composed of two parts. Part 1 (N = 1018) utilizes a nationally representative sample of firearm owners. Part 2 (N = 1064) consists of firearm owners from Mississippi, Minnesota, and New Jersey. Results Four unique classes were identified in Sample 1: multiple firearms class, single handgun class, few firearms class, and long‐gun class. A three‐class solution was found for sample 2. Two of the classes from sample 1 replicated: multiple firearms class and single handgun class. Although many of the classes differed in the ranking of credible sources, a combination of The American Foundation for Suicide Prevention, law enforcement officers, and family members was ranked as credible sources among all classes. Conclusions Findings provide evidence of the heterogenous nature of firearm owners and can be utilized to better understand the subgroups of firearm owners. Additionally, the findings from the credible sources analyses can be leveraged to create more effective safe firearm storage messaging which may increase adherence with safe storage suggestions and ultimately reduce suicide rates.

Objective/Background: Poor sleep has been shown to have multiple negative outcomes during adolescence, in both academic and mental health domains. Several studies have identified the association between poor sleep and suicide risk in adolescents. However, onset of and engagement in nonsuicidal self-injury (NSSI) is also common in this age group, but this behavior has rarely been studied in association with sleep in adolescent samples. In the current study, it was expected that poorer sleep and more symptoms of insomnia would associate with a greater likelihood of recent NSSI engagement and greater NSSI severity.Participants: Data were collected from 387 community adolescents (mean age = 14.19, SD=1.08), 9% of whom reported NSSI in the past 6 months. The gender breakdown was about even (52% female) and the majority of the sample was White (88.5%).Methods: Adolescent participants were recruited from middle and high schools for a study on mental health and risk behaviors. Researchers visited schools and administered self-report questionnaires to students in large groups. Measures assessed NSSI engagement and severity features, overall sleep quality, and insomnia symptoms.Results: Results indicated that greater insomnia symptoms, but not overall sleep quality, significantly associated with greater likelihood of recent NSSI engagement. Sleep variables were not significantly associated with NSSI severity among adolescents with recent NSSI.Conclusions: Insomnia symptoms seem to be associated with recent engagement in NSSI. Adolescents who report symptoms of insomnia should also be assessed for self-harm behavior.

IMPORTANCEFirearm access is associated with risk for suicide, and, since early 2020, the US has experienced an unprecedented surge in firearm sales. OBJECTIVE To assess frequency of suicidal ideation among individuals who purchased firearms during the surge period (surge purchasers), other firearm owners, and non-firearm owners. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional online survey data were collected from January to June 2021. Participants were recruited via quota sampling through Qualtrics Panels. Within Minnesota, zip codes from Minneapolis and St Paul were oversampled. Participants included 6404 US adults recruited from 3 states: New Jersey (n = 3197), Minnesota (n = 1789), and Mississippi(n = 1418). Participants identified as becoming a first-time firearm owner during the surge period, being an established firearm owner who purchased a firearm during the surge period, being a firearm owner who did not buy firearms during the surge period, and not owning firearms. MAIN OUTCOMES AND MEASURESThe primary outcomes were lifetime, past year, and past month suicidal ideation as measured by the Self-injurious Thoughts and Behaviors Interview-Revised. RESULTSThe mean (SD) age within the full sample was 44.81 (18.45) years, with 3132 males (48.8%), 4706 White adults (73.4%), 2674 reporting annual household income less than $50 000 (41.7%), and 1546 (24.1%) reporting current firearm ownership. In the full sample, individuals who purchased firearms during the surge period were more likely than were non-firearm owners to report lifetime suicidal ideation (odds ratio [OR], 2.21; 95% CI, 1.82-2.68), past-year suicidal ideation (OR, 2.10; 95% CI, 1.72-2.55), and past-month suicidal ideation (OR, 1.80; 95% CI, 1.41-2.29). In addition, among individuals who purchased firearms during the surge period, first-time owners were more likely than established firearm owners to report lifetime suicidal ideation (OR, 2.12; 95% CI, 1. 43-3.14) and past-year suicidal ideation (OR, 2.37; 95% CI, 1.59-3.53). Results were largely consistent across states. CONCLUSIONS AND RELEVANCEIn this survey study, results highlighted that individuals who acquired firearms during the purchasing surge were more likely than other firearm owners and non-firearm owners to have experienced suicidal thoughts. This is particularly true for individuals who purchased a firearm for the first time during the surge period. This illustrates the need to implement policies and interventions that increase safety among firearm purchasers (eg, safe firearm storage) as well as those that promote the acquisition of alternative forms of protection (eg, home alarm systems).

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