Could the mental health system have saved the life of Missouri gubernatorial candidate Tom Schweich? His tragic death last month was apparently the result of a single self-administered gunshot wound to the head. He left behind a grieving family and friends, as well as members of the media, who have speculated about what may have driven him to suicide. Was it the result of bullying? Was he a martyr in a fight against anti-Semitism or dirty politics?
We don't have definitive answers to these questions, and maybe we never will. What we know for certain is that Tom Schweich, like dozens of people in America each day, was a victim of gun violence. If he and 10% of others who attempt suicide by a firearm instead attempted it by taking an overdose of pills, we would have 1,900 fewer suicide fatalities each year.
When we think about gun violence, we don't think of suicide as readily as homicide. But in 2013, more than 20,000 people died from a self-inflicted firearm injury, compared to 11,000 who died from firearm-related homicide.
The idea of suicide conjures up thoughts of mental health problems such as major depressive disorder or substance use problems. This is reasonable, because between 60% and 90% of individuals worldwide who succeed in their suicide attempt are thought to have a psychiatric disorder; major depression, bipolar disorder and substance abuse are the leading conditions associated with suicide.
However, simply focusing on mental illness ignores other contextual issues that connect the thought of suicide to its completion. As many as 40% of people who attempt suicide do so impulsively, research shows. But while many individuals who attempt suicide have a discernible psychiatric condition, some, particularly those engaged in an impulsive suicide attempt, do not. Instead, it is typical that they have been subjected to high levels of stress before the suicide event: intense emotional states that may have been brought about by interpersonal conflict.