Reading about death and suicidality can be distressing. Please read this in a moment where you feel safest and ready to do so.

For Jess Hegstrom, suicide prevention coordinator for Lewis and Clark County, Montana,  the greatest gifts we can give to people struggling with suicide are time and space between their thoughts and their firearms. Suicide is often an impulsive decision, she says, but with guns, “you can’t call a bullet back.” When you’re in a dark place and don’t have access to highly lethal means such as a firearm, you’re less likely to die, she says.

The public health worker has personal experience with suicide and how scary it can be. Hegstrom is a suicide survivor herself and lost her father to suicide in 1999. She has Bipolar II disorder and says that during rough patches, she asks her friends to hold on to her medications so that she will not try to overdose. “It’s about slowing things down and making sure we don’t turn impulsive decisions into permanent ones,” she says.

But pills are a lot less lethal than firearms, and research shows that guns are the majority of the problem in Mountain states such as Montana, Wyoming, Colorado, Arizona, Idaho and Utah. Gun suicide rates make up 86 percent of all firearm deaths in Wyoming, 82 percent of those in Montana and 76 percent of those in Colorado.

These are the quiet deaths that we don’t often hear about in a nation where mass shootings draw most of the attention. According to the Harvard T. H. Chan School of Public Health’s Means Matter Campaign, a group that tries to reduce access to lethal methods that can lead to suicide,, scientists have found that guns are by far the most lethal means of attempting suicide, with an 85 percent fatality rate, compared with other methods that have a rate of around 5 percent.  Though mental illnesses such as depression contribute to the risk, according an October 2021 study published in the journal Injury Epidemiology, ready access to lethal means is a key risk factor for suicide.

“People use what’s available,” says Paul Nestadt, a psychiatrist who specializes in the epidemiology of suicide at Johns Hopkins University. “If it’s a bottle of Tylenol on your bedside table, that only has a 2 percent fatality rate. But if it’s a firearm, the likelihood of death is much higher.” Unlike other modes of suicide, if you use a gun, there’s no in-between.

Many people decide against taking the fatal step using other means than firearms and may end up getting help. Catherine Barber, a senior researcher at the Harvard T. H. Chan School of Public Health’s Injury Research Center and founder of Means Matter, calls this the “oh, shit moment”: the time when people realize that they don’t want to die and they seek help. Either the mind changes and tries to save itself, or the body fights back by, for example, vomiting up drugs. Nine out of 10 people who attempt suicide and survive will not go on to die by suicide later. But interrupting an attempt that involves a firearm is much more fraught.

That’s part of the reason why Marian Betz, an emergency room physician and deputy director of the Injury & Violence Prevention Center at Colorado School of Public Health, began working on off-site gun storage. This is a place, she says, where both gun rights and gun control advocates can come together to save lives.

Colorado has one of the most robust programs when it comes to off-site gun storage. This program includes the Colorado Gun Storage Map, which lists shooting ranges, gun shops and police departments that are willing to temporarily store guns for individuals who may be experiencing a mental health crisis. This means having a number of sites agree to store firearms so that people have places to quickly turn to when they’re in crisis. Another aspect of the program is the Gun Shop Project, a public health campaign in which gun shop owners are educated on the risk of those with suicidal tendencies having access to lethal means. Similar online map tools have been established in Washington State and Wisconsin. With the help of Hegstrom and other suicide prevention advocates, Montana is currently laying the groundwork for storing more firearms off-site through public health campaigns to convince gun owners to do so when needed. This effort will require buy-in from residents of a state where 66 percent of adults own guns. In Mountain states such as Montana and others, the steps that could be taken could also mean something as simple as helping a friend in need by offering to temporarily store their guns when you see them struggling, Hegstrom says.

The idea is catching on among gun rights advocates. A study published in  Injury Epidemiology in March found that a quarter of participants in Colorado and Washington State had stored their guns away from home in the past five years. “The key thing to remember is that this is about voluntary and temporary gun storage,” Betz says. “We’re not talking about confiscating anyone’s gun’s here.”

Jacqueline Clark is co-owner of Bristlecone Shooting, Training, & Retail Center in Lakewood, Colo. Her facility offers two different types of off-site gun storage. Customers must first sign an affidavit stating that they are the rightful owner of their guns. And within the document, they must list any guns to be stored, including their make, model and serial number. The guns are then out of the control of the person who wanted them stored until that individual goes through another background check to get them back, the same process that a gun buyer goes through. Clark says that Bristlecone also offers a simpler method of providing gun lockers to customers, who then have the key and do not have to go through a background check to get their guns back.

Clark says she’s seen firsthand how off-site gun storage can help someone in pain. She remembers one customer in particular, the mother of a veteran who came in to store her son’s guns because he was experiencing mental distress, and she was nervous about what he would do with the firearms in their home. “We brought all the paperwork out to him in the parking lot because she feared the inside of the store would be a trigger,” Clark says.

Off-site gun storage is used for a variety of reasons that may pertain to mental distress but could also include more benign situations such as the arrival of one’s grandkids, travel or a recent move. Clark says that she and her colleagues at Bristlecone don’t want to know the reasons why customers utilize their off-site storage resources because that would open them up to more liability. “We don’t ask a lot of questions,” she says. Clark has trained her staff to look for warning signs of people who could be mentally unstable or a so-called straw purchaser, a person who buys a gun for someone else who couldn’t pass a background check.

For the most part, Clark says, “our staff are not mental health professionals who should be responsible for making a decision about whether or not a person can have their gun back.” She says that liability protection laws in Colorado need to better insulate businesses and individuals if something goes terribly wrong—for example, if a gun shop, shooting range or friend returns a gun to a person who, unbeknownst to them, is still in mental distress. “God forbid if we give a gun back to somebody, and then they do something bad with it,” she says.

Recent research has shown that civil liability is a key hindrance for those who would otherwise consider storing guns for someone else. Betz published a study in the August 2022 issue of the journal Suicide and Life-Threatening Behavior that interviewed potential storage providers and found that they supported voluntary storage programs but “cited civil liability, regulatory and legal concerns” associated with storing and returning firearms, especially when people had previously admitted to mental health issues.

Montana recently passed a law that would protect people and businesses who temporarily store the firearms of someone going through a mental health emergency. The new law, Montana Senate Bill 423, states that “no cause of action may arise against an individual or a private entity for returning a firearm to the firearm owner at the termination of a firearm hold agreement.” Clark says that similar protections would make things a lot easier in Colorado.

Secure gun storage appears to save lives. According to research from Everytown for Gun Safety, the eight states with the strongest gun safety laws—including laws on storing firearms safely to prevent children from accessing them—saw a 4 percent decrease in gun suicides from 1999 to 2022.  Additionally, in homes that locked both firearms and ammunition, there was 78 percent lower risk of self-inflicted gun injuries.

These measures are about reducing suicides, Barber says, not taking away guns, and they are “low-hanging fruit” when it comes to prevention. It’s important, she explains, to have gun shops, firing ranges and progun individuals on board because they are the right messengers to reach out to gun owners who may be skeptical about giving up their firearms.

Moments matter when someone is in a state of crisis, she says. “If you put the guns in the safe and change the code with the gun owner’s permission, you’re not taking away their self-agency,” Barber adds—but you could be saving their life.

IF YOU NEED HELP

If you or someone you know is struggling or having thoughts of suicide, help is available. Call or text the 988 Suicide & Crisis Lifeline at 988 or use the online Lifeline Chat.