Firearm-injury study authors call for suicide interventions tailored to rural men

Health promoters emphasize there is help and hope for those in crisis in the Haliburton Highlands and wider region

By Jenn Watt

Authors of a study on firearm-related injuries in Ontario are calling for suicide intervention strategies for men over 45 living in rural areas, after finding the rate of injuries for that population is much higher than in other parts of the province.

The paper, published in the Canadian Medical Association Journal in October, looked at statistics for Ontario residents who were injured or who died from firearms between 2002 and 2016 and found that 67.6 per cent of the approximately 2,700 deaths by firearm were attributed to “self-harm,” which in this field is the term used for suicide or intended suicide. When researchers looked at the rates of injuries, they found “Assault was the most common intent among those aged 15-34, whereas self-harm was the most common intent among those aged 45 or more.”

“Overall rates of firearm-related injuries and deaths were consistently higher in rural areas than in large urban areas,” the study reads. “The major driver of this difference was the higher rate of self-harm in rural versus large urban areas.”

The highest firearm injury rates attributed to self-harm were in 10 Census divisions with populations of less than 100,000.

One of the study’s authors, trauma surgeon Dr. David Gomez of St. Michael’s Hospital in Toronto, said the findings indicate more needs to be done on suicide prevention, specifically for men over 45 living in rural areas of Ontario.

“When you look at the distribution, you can see that 68 per cent of the self-harm injuries and deaths occurred in the 45-plus group, 96 per cent of them happened in men,” he said. “… The rate per every 100,000 people in rural areas is three compared to only 0.8 in urban areas, so the risk of suicide is significantly higher in rural areas compared to urban ones.”

Jack Veitch of the Canadian Mental Health Association Haliburton, Kawartha, Pine Ridge, said the report’s findings are similar to Canadian statistics and said there are a number of resources available regionally to help those who are having thoughts of suicide, as well as those who want to help.

“We’ve got intervention where we’re actively intervening and supporting a person,” said Veitch, who is the manager of community engagement and education. “So, the intervention support of ‘I’m actively experiencing thoughts of suicide, what do I do?’ There’s a 24-hour crisis line, call 24 hours a day, seven days a week to talk to a trained mental health professional for that support. And that’s toll-free, available to all residents of Haliburton County [1-866-995-9933].”

Crisis is self-defined, he said, so anyone feeling that calling the line would be of help is encouraged to do so. “It could be as simple as a family member [saying] ‘I’m just looking for advice or guidance’ [they] can call the crisis line and talk to that professional.”

The mental health association also works to improve mental health literacy in the community, he said, “providing courses and education surrounding how somebody can support a person experiencing thoughts of suicide.”

These Safe Talk courses were offered in the county once a year and provided a certification for those who took it. Due to the pandemic, in-person classes aren’t happening, but Veitch said those interested in acquiring those skills can take the Living Works Start program online for a small fee.

In addition, CMHA HKPR has a program called Assertive Outreach for Suicide Prevention, which is partnered with area hospitals such as Ross Memorial Hospital in Lindsay and Peterborough Regional Health Centre with service for the most high risk, vulnerable population.

The caseworker works with the person “with the sole goal of supporting mental health and keeping that person alive and well,” he said.

The programs available through CMHA HKPR have been “very successful,” Veitch said.

“Statistically speaking, it’s a very successful program. … The evidence is there that this has been a successful program at keeping people healthy, safe and alive,” he said.

Dearbhla Lynch, a health promoter with Haliburton, Kawartha, Pine Ridge District Health Unit, said it’s important to emphasize that suicide can be prevented.

“When people are thinking about suicide, they’re often in crisis and when we’re in crisis, we’re overwhelmed and often our usual problem-solving methods aren’t working. Maybe our regular coping strategies are unavailable – and this is something that’s happening during COVID. Maybe it’s more difficult than usual to connect with your supports, and when that happens, it upsets the balance between thoughts and feelings and behaviour. And in stressful situations, people often overestimate how bad things might get and underestimate how well they can cope,” Lynch said. “The crisis phase is temporary. So, somebody is in crisis, then providing that ask [about whether they’re thinking of suicide] and listen and linking to supports is really important.”

According to the Government of Canada webpage on suicide prevention, warning signs of suicide include thinking of or talking about suicide, and having a plan for suicide. Signs and behaviours that might suggest a person is at risk for suicide include withdrawing from family, friends and activities; feeling like they have no purpose or reason for living; increased substance use; feeling trapped or there’s no way out of a situation; feeling hopeless about the future; talking about being a burden or being in unbearable pain; and anxiety or significant mood changes such as anger, sadness or helplessness.

“Suicide is preventable,” Lynch said. “There is help and there is hope.”

For Gomez, the findings of the study are only a first step toward future research that will provide better information on firearm-related injuries and potential solutions. The study pointed out that there are higher rates of gun ownership in rural areas, which needs to be taken into account.

“Our findings highlight the need for suicide-prevention strategies in rural Ontario targeted at men aged 45 and older,” the study reads. “Restricting access to lethal methods by such means as safe-storage campaigns and reduction in firearm ownership must go hand in hand with depression screening and treatment.

When speaking with the Echo about the study, Gomez said no one intervention will provide the solution.

“We as a society need to accept that firearm suicide is a big problem and it will require societal change. And I by no means think that completely eliminating firearms is the only way to fix this. I think there are a lot of [things] that the average law abiding responsible gun owner can do to try to reduce risk,” he said.

Separating the firearm from the ammunition is one way to reduce risk. “Safe storage practices which include keeping your firearms locked, separate from your ammunition, are proven risk-reduction strategies,” Gomez said, as that provides time for introspection. “… We have to remember, it’s not the firearm on its own. It’s what’s happening to the person, and most likely what’s happening to men over the age of 45 living in rural areas. Do they have access to the mental health resources that they need and are the mental health resources available actually tailored for rural men? That is the crux of the problem. If somebody’s having a mental health crisis, do they have the resources to reach out? Do they trust those resources? And are there enough resources available in rural areas? And I think one of the key things that we highlight with this paper is that this is a very complex issue that requires many interventions at the mental health level, at the firearms level, and the societal level.”

In the Haliburton, Kawartha, Pine Ridge region, the 24-hour crisis line receives base funding from the government, providing it with long-term stability. However, the Assertive Outreach for Suicide Prevention program relies entirely on donations.

The program includes a caseworker to work one-on-one with a person at risk of suicide, as well as a family support worker who helps family and caregivers of the individual. Annual costs are about $145,000. Veitch said given the success of the program, he hopes that one day funding is provided through the government, but until that time it needs to come through donations.

Anyone wishing to donate can contact Veitch at or at 705-748-6687 ext. 1015.

If you are in crisis, and/or having thoughts of suicide, or want to speak to a mental health professional, call Four County Crisis at 1-866-995-9933.
Information on suicide prevention can be found at