Suicide among discharged psychiatric inpatients in the Department of Veterans Affairs.

Objective: The objective of this study was to explore correlates of the use of firearms to commit suicide. Methods: A national sample of psychiatric patients discharged from Department of Veterans Affairs medical centers was followed from the time of discharge until December 1999. The study explores state-level measures as correlates of overall suicide and suicide by firearm, controlling for individual sociodemographic characteristics and psychiatric diagnosis. The outcomes of interest were completed suicide and suicide by firearm. Results: Patients who were male, Caucasian, and who had a diagnosis of substance abuse or post-traumatic stress disorder were significantly more likely to use a firearm than another means to commit suicide. Multivariable models indicated that veterans living in states with lower rates of gun ownership, more restrictive gun laws, and higher social capital were less likely to commit suicide with a firearm. Conclusions: Gun ownership rates, legislation, and levels of community cohesiveness are significantly associated with the likelihood of psychiatric patients committing suicide with a gun.