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Utah Changed Its Approach To Suicide Prevention. It May Be a Model For Other States In The Suicide Belt

Utah Suicide Prevention Coalition PSA: "Gun Range"
Utah Suicide Prevention Coalition PSA: "Gun Range"

Utah state Rep. Steve Eliason had a jarring wake-up call to the suicide crisis in his state in 2012. Several of his son’s middle school classmates died by suicide that year.

“I ended up meeting with one of the parents, who tearfully pleaded with me to do something about this issue,” he said. “And so I started researching what could be done.”

Like many in the Mountain West, Eliason hadn’t grasped the scale of the problem.

“I was shocked to find out the suicide is the leading cause of death for ages 10 to 24 in the state of Utah,” he said.

Utah is in the Mountain West, America’s so-called Suicide Belt. It’s a swath of the Rocky Mountains whose natural beauty and bucket-list destinations belies some of the highest suicide rates in the nation — every state in the region has rates far above the national average.

But it’s a fact that seems to catch many residents by surprise. There has long been a stigma around suicide, but it can be especially tricky to talk about in a part of the country where guns are a part of life for many. That’s because firearms are by far the most common method of suicide, and experts say firearm safety is key to reducing the number of people who take their lives.

In Utah, Eliason and local suicide prevention experts have been working to make the conversation easier by specifically targeting gun owners in public health campaigns. It’s one of numerous strategies public health experts hope can stem the tide. And it seems to be working.

Bringing In Those With The Most to Lose

News of the tragedies at his son’s middle school was the beginning of a yearslong effort by Eliason that included the overhaul of Utah’s entire approach to suicide prevention.

Eliason, a Republican, represents the Salt Lake City suburbs. He’s also a gun owner and a staunch believer in firearm rights. He sees no conflict between those beliefs and efforts to curb gun suicides. Some of his closest collaborators have been firearms instructors and gun store owners.

That is one of the cruxes of Utah’s approach: Lean on those living with firearms, the group most at-risk for suicide.

Eliason’s first efforts began in 2014 when he successfully championed a bill that funded the creation of suicide prevention gun safety resources and encouraged safe storage by distributing trigger locks and offering rebates for gun safes.

Since then, Utah has completely revamped how it approaches suicide prevention. In a region with some of the highest suicide rates in the nation and uneven support for prevention and mental health care, experts have praised its methods.

Three things Utah has done: making suicide prevention a communitywide effort, particularly in reaching out to gun owners and Second Amendment activists; carefully crafting public service announcements that focus on positive outcomes rather than tragedy; and a centralized, comprehensive statewide approach that relies on constantly updated statistics, as opposed to the often-localized and disjointed efforts in some neighboring states.

And, slowly, the numbers have improved. At at 22.2 suicides per 100,000 people in 2018, the most recent year for which data is available, the states numbers are well above the national average of 14.2. A steady upward trajectory of the suicide rate has plateaued since 2015.

But it hasn’t been easy.

Pushback From Gun Groups

Eliason’s experience is an illustration of why tackling firearm suicide can be politically tricky. Anything that has to do with firearms can be a hard sell in conservative states these days.

As soon as Eliason’s 2014 bill came to light, the National Rifle Association  issued an “action alert” warning that the state was pillaging money from concealed carry permit fees for the program. The alert repeated falsehoods questioning the connection between firearm ownership and suicide.

Eliason got buy-in from the National Shooting Sports Foundation, the gun industry’s primary lobbying group, and he got his legislation through. He also enlisted the support of the Utah Shooting Sports Council, which helped him push back skeptics. He courted them as he does any gun enthusiast: by explaining that keeping guns locked away is a safety issue responsible gun owners have a duty to address. That’s been a cornerstone of his and the state’s strategy when it comes to pushing for firearms owners to be key players in suicide prevention.

“I haven’t met one person that, when the facts are laid before them regarding suicide statistics, they can’t see that the clear reason why we’re advocating for safe storage and awareness of the connection to suicide,” he said.

Cathy Barber, who studies guns and suicide at Harvard’s School Of Public Health’s Injury Research Center, praises Utah’s approach and says getting buy-in from gun owners and gun rights proponents is key to success.

“That’s because people who care about guns by and large care about safety and care about protecting lives,” she said.

Going Beyond Doom And Gloom

Kimberly Myers, suicide prevention coordinator for the Utah Division of Substance Abuse and Mental Health, has worked with Eliason from the beginning.

Myers helped the state develop its current approach to suicide, which is data-driven and aims to involve community members from gun store owners to high school sports coaches. It’s a shift that began in 2014, the year Eliason’s initial bill passed. Myers said the biggest problem with the state’s old approach — and that of some other states — was too much emphasis on just telling people there is a problem and not enough on taking action to actually prevent suicides.

“It’s not enough to be aware anymore,” she said.

That’s why the Utah Division Of Substance Abuse And Mental Health developed a series of PSAs that now air on TV and radio stations. In the ads, people in at-risk groups not only mention the problem of suicide, but also suggest solutions.

In one ad, teenagers look into the camera and ask parents to lock up their guns. They remind them that the leading cause of deaths for Utah teens is suicide and that nearly half of all suicide deaths involve firearms.

Another public service announcement from the campaign starts with a middle-aged man shooting a pistol at a gun range. He puts down the gun and turns toward the camera.

“Last year I was at my lowest, going through some pretty serious depression,” he says. “A couple of friends of mine stopped by the house and said they were worried about me. Said they would feel a lot better if they could hold onto my firearms until things turned around. I think they saved my life.”

Then he goes back to shooting as a narrator encourages viewers to talk to struggling loved ones about temporarily storing their firearms.

Barber called the spot “by far the single best PSA I’ve ever seen on suicide prevention.”

“Most suicide prevention PSAs stress a doom-and-gloom outlook and stress the tragedy of suicide,” she said. “And from my point of view, [that] may do more harm than good.”

Utah’s Division of Substance Abuse and Mental Health is constantly looking for clues on what might be driving suicides and what new programs or strategies might turn the tide. They collaborate with multiple agencies, like the state Office of the Medical Examiner and the Violence and Injury Prevention Program to track what’s driving suicides so the state can respond.

“But we want to also be really clear that behind every single data point that we share is a human life,” Myers said. “And sometimes that’s a human in recovery, somebody who had been in that dark space and made it through. And that is something worth celebrating every single time.”

Resources if you or someone you know is considering suicide:

National Suicide Prevention Lifeline: 1-800-273-8255 (TALK)

Options For Deaf + Hard of Hearing: 1-800-799-4889

En Español: 1-888-628-9454

Idaho Suicide Prevention Hotline: 208-398-4357

Colorado Crisis Services: 1-844-493-8255 (TALK)

Utah Suicide Prevention Coalition: 1-800-273-8255 (TALK)

Veterans Crisis Line & Military Crisis Line: 1-800-273-8255, Press 1

Crisis Text Line: 741-741

In emergency situations, call 911.

Guns & America’s Lisa Dunn contributed to this story.

The Guns & America series In Their Own Hands explores the complexity of gun suicides in the Mountain West, where gun ownership is often a way of life, and highlights communities addressing this persistent problem.

Copyright 2020 Guns and America. To see more, visit Guns and America.