On May 18th, 2003, Switzerland in a referendum approved a reform of their army, which accounted for the changed security situation in Central Europe. With the reform (called Army XXI), especially a significant reduction in troop strength was connected. In 2003, Switzerland had approximately 400,000 soldiers, after the reform, their number halved to 200,000. The soldiers went into retirement earlier than before (at the age of 33 instead of 43 years), the number of recruits decreased, and the price of the weapon for which the soldiers traditionally could buy their weapon after their retirement increased. In addition, a firearms license was required. The reform had the consequence of a significant reduction in the number of available firearms in Switzerland.
Thomas Reisch from the Psychiatric University Hospital in Bern, Switzerland, and colleagues now report in The American Journal of Psychiatry on their investigation of the change in suicide rates in Switzerland after the army reform (Reisch et al., Am J Psychiatry 2013; 170:977-984). The authors compared the suicide rates in the group of 18-43 year old men before the reform with that after the reform. Women from the same age and men in the age group 44-53 years were used as control groups.
The authors found a significant reduction in suicide rates after the army reform. Both the overall suicide rate and the suicide rate by firearms decreased significantly. The decrease of suicide by firearms was compensated by other methods only to a small extent. Only the number of suicides by jumping in front of a train increased. The authors calculate a decrease in the number of suicides by 2.16 per 100,000 inhabitants per year. The number of suicides by firearms decreased by 2.64 per 100,000 inhabitants per year. Calculated on the total population, 36.7 fewer suicides per year were observed after the reform of the army. The rate of suicide by other methods (especially jump in front of a train) increased by 0.48 per 100,000 inhabitants per year, which corresponds to a total of 6.7 suicides. Thus, about 30 young men per year were rescued in total since 2004 in Switzerland due to the restriction of availability of firearms. In the control groups, no significant changes were observed.
For countries with very strict access to firearms such as Germany, where suicides with firearms play only a minor role, the study may have limited significance. In an accompanying editorial, however, John Mann and Robert Gibbons (New York and Chicago) calculate the consequences for the United States (Mann und Gibbons, Am J Psychiatry 2013; 170: 939-941). In 2010 incredible 31,672 people died from firearms in the United States, of which 61.2% were due to suicide and 35% were due to homicide. 58% of all suicides are committed by firearms in the United States. 34 million of Americans have about 195.000 million weapons, and about 35% of all households have at least one weapon available. For every case of use of firearms for self-defense, there are 37 suicides by firearms. People who live in a household that have a gun, have a five times higher risk of dying by suicide by a gun than people who live in a weapon-free household.
Man and Gibbons conclude their editorial with very specific numbers: „If the effect seen in Switzerland, where the rate of firearm suicide in 18- to 43- year-old men decreased from 9.9 per 100,000 per year to 7.26 per 100,000 per year (a 27% decrease), were to apply to the United States, where in 2010 the rate of firearm suicides was 11.06 per 100,000 in this demographic group (6,045 suicides, in a population of 54,639,456), the rate would decrease to 8.07 per 100,000 per year, saving 1,636 lives per year on average.” (Mann und Gibbons, 2013).
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