ORLANDO, Fla. — When people think of gun violence, they typically think of a masked robber or a disturbed young man with an assault rifle and hundreds of rounds of ammunition.
In truth, the most common victim of fatal gun violence is a distraught man who, alone in a room, puts a gun to his head and pulls the trigger.
Far more people use guns to commit suicide than to kill someone else in Florida, according to state Department of Health records. The same is true nationally and in Central Florida.
In 2011, the most recent year for which state numbers are available, there were 1,474 firearm suicides in Florida compared with 827 firearm homicides.
In Central Florida, the numbers were 309 vs. 154.
Residents here shot themselves to death in public parks, parked cars, cemeteries, gun ranges, behind stores — but most often at home, a review of local medical-examiner records shows.
They had no trouble getting access to guns, even though an Orlando Sentinel review of 40 Central Florida cases showed nearly three out of every four had a history of mental illness, had been treated for mental illness, had attempted suicide previously or had talked about suicide.
Although she was under treatment for bipolar disorder and had been “Baker Acted” — temporarily placed in a mental hospital after making threats to commit suicide — 30-year-old Rebecca Sides of Oviedo was able to buy a shotgun. On Dec. 7, 2011, Sides used it to kill herself in her backyard.
Suicide by firearm is a public-health problem, said Dr. Matthew Miller, a physician and professor at the Harvard School of Public Health who has spent years researching the issue.
Suicide overall “kills more people under 30 than any other injury or disease,” he said. “It kills more than motor vehicles. It kills more than poisonings. It kills more than drownings.”
Suicides by any means — pills, suffocation, drowning — kill more than 100 Americans a day, according to Miller.
Suicide by gun killed 53 Americans a day in 2010, the most recent year for which national data are available. The overwhelming majority — 87 percent — were men.
“I see so much isolation and loneliness and heartache in my job that culminates in suicide. I find it a tragedy,” said Dr. Jan Garavaglia, medical examiner for Orange and Osceola counties. “I think suicide is a public-health crisis.”
But it’s a crisis largely hidden from view. People typically avoid the subject. If a family member kills himself, relatives often hide that fact out of shame. And news organizations generally avoid the subject, often out of concern that it might prompt copycats.
“Most people don’t know that there are more suicides than homicides,” said Anara Guard, a suicide-prevention expert and executive with Education Development Center, a nonprofit Massachusetts company. “Homicides get a lot more news than suicides.”
For every two people in the United States killed by criminals, three commit suicide, according to numbers from the Centers for Disease Control and Prevention.
Use of a gun dwarfs all other categories of suicide, according to state and national health statistics, and year by year, it’s a problem that’s getting worse.
Since 2007, homicides of all types have been on the decline across the country, but gun suicides have climbed. Across Central Florida, across the state and across the country, people are killing themselves with guns at a higher rate now than five years ago, data show.
One out of every four people who committed suicide with a gun in 2010 was under treatment for a mental illness at the time, according to the National Violent Death Reporting System, a databank for 16 states — not including Florida — that publishes its findings through the CDC.
Federal and Florida gun laws do not bar the overwhelming majority of the mentally ill from purchasing guns. They only screen out two very narrow sets of them: those who have been committed to a mental institution and those found by a judge or government agency to be a danger to themselves or others.
Rebecca Sides, the bipolar Oviedo woman who shot herself in 2011, had been under treatment for years, according to her mother, Shelly Olson.
Sides broke no law when she bought the shotgun that she used to kill herself. In fact, it was not her first gun purchase. She bought a handgun and in 2006 got a Florida concealed-weapons permit, Olson said.
That gun was taken away by police on Dec. 11, 2010, because Sides became suicidal and was “Baker Acted,” temporarily placed in a mental health facility while she was evaluated to determine whether she was a threat to herself or others, her mother said.
Sides was released and four months later bought a 12-gauge shotgun at an Orlando pawnshop, records show. Eight months after that, on a day when she was fired from her job and involved in a minor traffic accident that resulted in a confrontation with police, she used that shotgun to kill herself.
“She was mentally impaired. That was the end of the world right there,” Olson said. “There’s no way my daughter should have been able to buy this gun.”
Public debate about guns and gun control was reignited in December, when 20-year-old Adam Lanza gunned down 20 first-graders and six adults at Sandy Hook Elementary School in Newtown, Conn., then killed himself.
Current Florida law does not prohibit gun sales to the tens of thousands of residents each year who, like Sides, are locked up for 72 hours under the state’s Baker Act — because that is considered a period of observation, not a legal commitment to a mental-health facility.
However, if someone is involuntarily committed to a mental hospital after being Baker Acted, he is prohibited from buying a gun. The Florida House and Senate passed a bill last month that would marginally expand that to also prohibit guns sales to those voluntarily committed after being Baker Acted.
Gov. Rick Scott has not signed it.
It’s impossible to tell from state and federal data the circumstances surrounding individual gun suicides. But through a variety of public records — from police documents to autopsy reports — the Orlando Sentinel looked at 40 gun-suicide cases in Central Florida from 2010 to 2012.
In 30 of those cases, the person was under treatment for a mental illness, had a history of mental illness or had talked about or attempted suicide. The most common afflictions: depression, bipolar disorder and anxiety.
That review also shows that in seven of 10 cases in which authorities could identify who owned the gun used in a suicide, it was the victim.
“Having a gun in the home raises the risk for everyone in the home,” said Miller, the Harvard physician and researcher.
A Tavares teenager who had talked about suicide for months shot himself in the head the day after his 18th birthday. His girlfriend told deputies his brother had given him the gun as a birthday present.
An out-of-work Davenport sales trainer who shot himself in the head with a 9 mm Luger was found with a gun receipt in his wallet. He had ordered the weapon 10 days earlier.
A 43-year-old Orlando woman who shot herself with a 9 mm semiautomatic pistol because she was upset about a breakup with her girlfriend had bought it a few weeks earlier.
The National Rifle Association would not comment for this story. Neither would Marion Hammer, its former national president and the organization’s chief lobbyist in Tallahassee.
Eileen Reig, owner of Reig’s Gun Shop and Range on South Orange Blossom Trail in Orlando, said selling weapons to people with a history of mental illness is a complicated issue.
Often people who suffer a bout of mental illness — for example, women with postpartum depression — improve. It makes no sense that they should be forever barred from buying a gun, she said.
Miller, the Harvard researcher, said the number of firearm suicides can be cut dramatically without any changes in the law. The issue “is not pro-gun or anti-gun,” he said. “The suicide issue really has to do with helping people remove guns when someone who’s living there is high-risk.”
Dr. Deborah Day, a Winter Park psychologist, said family members and caregivers can do things to help.
“Anytime I have somebody who’s unstable, I ask about weapons, not only guns but all weapons and access to pills,” Day said. “I’ve actually had a patient show up with a weapon on them or in the car, so we walk out to the car together, and we get that weapon.”
(Orlando Sentinel staff writer Scott Powers contributed to this report.)
©2013 The Orlando Sentinel (Orlando, Fla.)
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