Katherine M. Keyes and Ava Hamilton are with the Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Katherine M. Keyes is also with the Society and Health Research Center, Facultad de Humanidades, Universidad Mayor, Santiago, Chile, and is a Guest Editor for this supplement issue. Jeffrey Swanson is with Psychiatry and Behavioral Sciences, Social and Community Psychiatry, School of Medicine, Duke University, Durham, NC. Melissa Tracy is with the Department of Epidemiology and Biostatistics, University at Albany School of Public Health, State University of New York, Rensselaer, NY. Magdalena Cerdá is with the Department of Emergency Medicine, University of California, Davis, Sacramento, and the Department of Population Health, New York University School of Medicine, New York.
Am J Public Health. 2019 Jun;109(S3):S236-S243. doi: 10.2105/AJPH.2019.305041.
To estimate the number of lives saved from firearms suicide with expansions of gun restrictions based on mental health compared with the number who would be unnecessarily restricted. Agent-based models simulated effects on suicide mortality resulting from 5-year ownership disqualifications in New York City for individuals with any psychiatric hospitalization and, more broadly, anyone receiving psychiatric treatment. Restrictions based on New York State Office of Mental Health-identified psychiatric hospitalizations reduced suicide among those hospitalized by 85.1% (95% credible interval = 36.5%, 100.0%). Disqualifications for anyone receiving psychiatric treatment reduced firearm suicide rates among those affected and in the population; however, 244 820 people were prohibited from firearm ownership who would not have died from firearm suicide even without the policy. In this simulation, denying firearm access to individuals in psychiatric treatment reduces firearm suicide among those groups but largely will not affect population rates. Broad and unfeasible disqualification criteria would needlessly restrict millions at low risk, with potential consequences for civil rights, increased stigma, and discouraged help seeking.
估计枪支限制扩张后，因心理健康原因而减少的枪支自杀人数，与不必要的限制人数。基于代理的模型模拟了纽约市对任何精神科住院患者和更广泛的任何接受精神科治疗的人进行为期 5 年的所有权取消对自杀死亡率的影响。基于纽约州心理健康办公室确定的精神科住院治疗的限制将住院患者的自杀率降低了 85.1%（95%可信区间 = 36.5%，100.0%）。任何接受精神科治疗的人的取消资格都降低了受影响人群和总人口中的枪支自杀率；然而，有 244820 人被禁止拥有枪支，即使没有这项政策，他们也不会死于枪支自杀。在这种模拟中，拒绝让接受精神科治疗的人获得枪支会减少这些群体的枪支自杀率，但在很大程度上不会影响人口比率。广泛且不切实际的取消资格标准将不必要地限制低风险人群，这可能会对公民权利、增加污名化和阻碍寻求帮助产生潜在影响。
