WILLIAM BRANGHAM: This is Suicide Prevention and Awareness Month, and it seems we need both more than ever, because last year in this country, over 49,000 people died by suicide.

That is an all time high.

We know that firearms are involved in more than half of U.S. suicides.

A recent analysis by Johns Hopkins University found that the gun suicide rate also reached an all time high, and that for the first time, the rate of suicides by gun were higher among black kids and teens than white ones.

For more on this distressing trend, we turn again to Dr. Emmy Betz.

She's the director of the University of Colorado's Firearm Injury Prevention Initiative, and she's also an emergency physician.

Dr. Betz, very good to have you back on the program.

Before we get into those specific data points, what do you make of this overall trend of increasing rate of suicides in America?

DR. EMMY BETZ, Director, Firearm Injury Prevention Initiative: Well, it's certainly not, I think, what were hoping for.

We saw a decrease in suicide rates from about 2019 to 2020, and I think many of us hoped that maybe things were improving, and so now we're seeing rates go up again.

You know, I think an important take home, though, is that there's a lot we can be doing that these deaths are preventable.

So it's important we not give up hope.

WILLIAM BRANGHAM: I mean, guns, as I mentioned, are used in over half of suicides in America.

And I know that you and a lot of researchers have argued that we need to talk about that connection between firearms and suicides more overtly.

What are the things that you think people ought to know about that connection?

EMMY BETZ: Yeah, absolutely.

I think the first thing to know is it's not that the gun somehow causes the suicide.

So we know from lots of studies that having a gun in the home, for example, doesn't make someone more suicidal.

It's that a gun is uniquely lethal in a suicide attempt.

If someone uses a firearm, unfortunately, about 90 percent of the time, that person will die.

So there's no chance for them to perhaps regret what they've done and call for help or for someone to find them and get them to a hospital for treatment.

So in the emergency department, we very rarely see people with firearms suicide attempts because, unfortunately, they've died at home.

And so when we think about the connection between firearms and suicide, it's really two things.

So one that I just mentioned that it's that firearms are so lethal.

And the second is that suicide attempts usually occur after a pretty brief period of deliberation, you know, when someone is in a place that feels so dark, they don't see a way out, and they may reach for something to try to hurt themselves or to try to kill themselves.

And if that object is a gun, they are likely to die.

But we know that things get better.

We know there are effective treatments for mental health, for mental illness like depression.

We know that the social stressors we all face, those things often look better the next morning or there's a way out.

So that's why when we talk about firearms and suicide, it's really about just making sure someone in that dark moment can't reach for a gun.

WILLIAM BRANGHAM: Because -- I mean the cliche that you always hear is that if someone is distressed, they will find a way no matter what.

And it seems like you're arguing that, no, the means by which they choose to harm themselves matters.

EMMY BETZ: Absolutely.

And in fact, we know from a lot of research that suicide is not inevitable in that if someone is considering suicide and let's say they can't get into the gun safe, most of the time, that person won't just find another way.

So that's sort of a myth.

But also, even if they did, even if they attempt with something else, they're much less likely to die.

Because medications, for example, there are antidotes often or other things that we can do to help stabilize people, which is why suicide is preventable and there are ways to get people through those dark moments.

But if it's a gun that they've attempted with, usually there's not second chance.

WILLIAM BRANGHAM: So what are some of the proven prevention strategies with regards to firearms that can save lives?

EMMY BETZ: When we talk about firearms and suicide, it's often like a designated driver, right?

So it's when your friend is perhaps not at their best or perhaps impaired from alcohol, you help them get home safely.

Same thing.

If someone is going through a rough patch, we want to make sure that they don't have access to firearms at home.

So that could mean changing the storage so that they can't get into the gun safe.

It might mean temporarily moving guns out of the home to store it with a range or a retailer family member, depending on what's legal in your state.

A lot of times people ask, say, well, are you just talking about red flag laws and confiscation?

And that is an option.

But I see that as sort of the last resort.

What we want to be doing first is engaging firearm owners, their families, in recognizing that during tough times, it's just not a good idea to have access to a gun.

And so it's about voluntary and often temporary changes in access, making sure things are locked up.

WILLIAM BRANGHAM: We also know that the suicide rate and this is by any means amongst older adults went up last year.

People aged 45 to 64 saw a nearly 7 percent increase.

Those 65 and up saw over an 8 percent rise.

I mean, I know where you live and work, the mountain, rural west.

It's particularly a hotspot, if that's the right term for firearm suicide.

And it's often older white males.

Do you have a sense as to why older Americans are particularly vulnerable here?

EMMY BETZ: I think, you know, as a nation, as communities, we need to think about how we look at aging, how we portray aging.

I think that's often a very negative view of people being feeble or just being dependent on others and not having value in society anymore.

And it's so wrong.

So how do we really help everyone age in a healthy way?

Meaning staying socially connected, feeling like they have purpose, feeling like they're giving back to their community, feeling like they're connected to their community.

As we age, we all develop various kinds of physical impairments.

That's just a normal part of the process.

But we need to make it okay for people to adapt and accept those, but also to reach out for help.

I think there's still a lot of stigma, particularly among men, about sort of what it means to be a man or that you don't need help, that you have to be physically strong and so forth.

And I think we really need to be working to adapt our model of what it means to be an aging person and particularly an aging man in our country.

WILLIAM BRANGHAM: All right.

Dr. Emmy Betz, University of Colorado Medical School.

So good to see you.

Thank you very much.

BETZ: Thank you so much.

WILLIAM BRANGHAM: And if you or someone you know is struggling with depression or thinking about suicide, you can call nine eight to access the national Suicide and Crisis Lifeline, or online at nine eight lifeline.org.