AJPH study shows that permit to purchase laws are a promising avenue to reduce suicides in young adults

In 2020, suicide ranked as the third leading cause of death for adults aged 18 to 20 years in the United States.  Firearms were implicated in approximately half of these cases, and by 2017, they had surpassed motor vehicles as the leading cause of death in this age group. While ongoing debates on gun violence and mental health have increased public support for restricted firearm access, not much is known about the impact of gun control policies on young adults.

To fill this knowledge gap, a recent study published in the August issue of the American Journal of Public Health on July 03, 2024, investigated the correlation between state firearm legislation and suicides in young adults aged 18 to 20 years. The study was led by Assistant Professor Emma E. Fridel who expresses her concern by saying, “Currently, there are no federal restrictions on buying long guns from private sellers or owning ammunition. [Also, no study] has examined how state minimum age laws affect the incidence of young adult suicide based on background check legislation.”

The study explains that state laws that impose minimum age restrictions primarily focus on regulating firearm purchases from private sellers. These restrictions are typically enforced through either universal background checks or permit to purchase (PTP) laws. PTP laws mandate that individuals must personally apply for a firearm permit before buying, involving local or state law enforcement agencies in the process. The authors analyzed the collective and individual effects of these firearm regulations across all 50 US states, from the year 1991 to 2020.

Looking at the individual impact of various laws, the study showed that state laws increasing the minimum handgun purchase age to 21 were associated with a 12% reduction in firearm suicides in people aged 18 to 20 years, without significantly affecting the overall suicide rate. In contrast, state PTP laws were associated with a significant reduction, with a 39% decrease in firearm suicides and a 14% decrease in the overall suicide rate among this age group.

However, the effects of minimum age restrictions were more pronounced in conjunction with other laws. In states with PTP laws, minimum age restrictions decreased firearm suicide by 33%, whereas in states without PTP laws, these restrictions had a negligible effect. This underscores the dependency of the protective effects of minimum age laws on the presence of the state PTP laws.

Interestingly, the results also indicated that states adopting both policies (minimum age restrictions and PTP laws) averaged fewer than 10 young adult firearm suicides per year. In contrast, states with only minimum age laws averaged 14 firearm suicides annually, and those without either policy averaged 16.

There are multiple reasons that PTP laws are particularly effective, and may even be lifesaving, for at-risk young adults. “Interacting face-to-face with law enforcement during the permitting process likely discourages underage buyers and increases the perceived risks for straw purchasers. Similarly, licensing fees and mandatory firearm safety–training classes may be cost prohibitive for unemployed or in-school young adults,” Dr. Fridel notes.

The PTP vetting procedures are also time-consuming, thus reducing the chances of impulsive suicide attempts. Dr. Fridel states “Approximately half of survivors of near-lethal suicide attempts deliberate for less than 10 minutes before acting, and some previous [research] suggests that younger individuals are more likely to impulsively attempt suicide.”

While age-based handgun restrictions may have minimal impact on young adult suicides, broader laws restricting overall firearm access could make a bigger difference. PTP laws are particularly vital in curbing access to lethal means for vulnerable young adults. With strong support from over three-quarters of Americans, PTP laws are poised as an effective, feasible policy to reduce firearm suicides based on evidence and public opinion.

In a nutshell, implementing comprehensive firearm access laws can greatly contribute to reducing suicides among young adults.