I gave my 100th training on suicide last month at Bergen County Community College to an audience of over 100 counselors, educators, advocates, leaders and law enforcement officers. That was a fairly diverse audience both demographically and professionally.

More than half of those talks were delivered to the Army, police or union workers. Not a diverse group; not really.

48,824 people died in 2024 in the United States by suicide. That number has increased steadily, with some fluctuations, since 2000 and has outpaced the increase in population over that time. Men kill themselves at about four times more than women. Whites take their lives at a much higher rate than Blacks, Asians, Hispanics and people of mixed race.¹ Whenever I show the chart on race, I state that it is one of the only public health statistics I know is to where minorities have better outcomes than Whites². Of working age adults, people aged 45-54, solidly in middle age, die by suicide at the highest rate. They are sandwiched by the next highest groups on either end of them, 55-64 and 35-44.³

To review, the data tells us that the group that kills themselves the most are white, middle-aged men. When I look at an audience of soldiers, cops or union workers, I ask, “Sound like anyone you know?”

According to a CDC study that I have used for years,⁴ the most common specific life stressor for someone who dies by suicide is a romantic relationship problem. After that, the other most common crises include mental health concerns, substance misuse, financial problems and occupational distress. This tracks exactly with my clinical work over the last ten years.

I suspect that almost everyone reading this will agree that romance, mental health issues, finance, job problems and alcohol misuse are familiar to us or those around us. And yet, despite those common stressors, most people don’t think about, attempt or actually take their own lives.

Access to firearms is a huge risk factor. In 2024, there were 48,824 deaths by suicide in the United States. Of those, 27,593 were by a self-inflicted gunshot. That means that 56% of suicides in the United States in 2024 were from firearms.

I’ve been using an incredible chart published by the New York Times in 2017 for my speeches and classes when talking about suicide. Last month, someone asked me why I haven’t updated it. I told him that I hadn’t seen a new chart like that, but that it wasn’t an excuse. I pulled the latest numbers off of the SPRC website and had ChatGPT put this new graphic together.

Mass shootings are horrifying. The sheer number of incidents provokes anxiety and outrage. Any of us in the United States could seemingly die in the next mass shooting. And yet, it only accounts for 1.1% of firearm deaths. The professional media, social media and the charlatans that occupy the strange, online outrage space all spend way more time on mass shootings than they do firearm suicides. If media attention was proportionally parcelled out according to types of gun deaths, I wouldn’t feel the need to write this article and I believe that there would be a significant conversation about the firearm suicide relationship.

According to a national survey cited by the SPRC, about 14.3 million American adults had a serious suicidal thought in 2024. About 2.2 million, or one in seven, actually attempted suicide. Very few people that attempted suicide actually died by suicide. One can argue whether or not it was a suicidal gesture or a deeply deliberate attempt; I will not do that here. What I want you to consider is this: about 85 to 90% of attempted firearm suicides resulted in death. It is the most lethal way to kill oneself. If more people of the 2.2 million attempters had access to guns, there would be even more deaths by suicide.

If someone tries to overdose on drugs, ingest poison or turn on their car in the garage, they are more likely to be discovered in time to contact emergency services and get them treatment. Most suicidal crises are temporary; an attempt with a firearm is usually permanent.

I want to bring up one more chart that a LLM put together from data I pulled off the Institute for Health Metrics and Evaluation.

The United States has the highest firearm suicide rate among these 12 countries I selected for this chart. In fact, it has the second highest firearm suicide rate in the world⁵, and we accounted for about 35% of the world suicide by firearm deaths in 2016.

Canada and the European countries have drastically lower firearm suicide rates. Japan and Korea have almost no firearm suicide rates.

Mexico, Brazil and Colombia have much higher firearm homicide rates than the United States but still have much lower firearm suicide rates. I can’t explain why. All I can write is that the firearm suicide rate has been a uniquely American problem for a long time.

I do not want pro-gun people to take this as an attack on the Second Amendment. Nor do I want gun control people to use this data as a reason for banning all guns. I am an Army Veteran and I work closely with the New York State Police and other law enforcement agencies. I am a gun owner. I take gun ownership incredibly seriously and they are locked in safes. I would rather not have to write this paragraph, but the gun issue in America has been such an emotional button for so many people for over three decades that I felt the need to include it.

The United States has an alarmingly high suicide rate, especially when compared against the other industrial Western democracies.

To bring it back to where I started, the people in the United States who die by suicide the most are white, male, middle aged, have some kind of relationship/financial/job/substance stress and have access to guns.

Sound like anyone we know?

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1. Native Americans die by suicide at a rate at or more than whites. They make up about 1-2% of the population. In states like Alaska and New Mexico, local and state health officials should strive to address suicidality specifically in that population. ↩︎
2. Asian Americans live longer. ↩︎
3. According to the Suicide Prevention Resource Center (SPRC), people 85 and older kill themselves at the highest rate of any age group. It includes individuals with chronic pain and terminal diagnoses who take their lives without a medical provider. I don’t view that in the same way as reported suicides in other age groups. You are allowed to disagree with my view. ↩︎
4. It is a 27-state data set from 2015 that was published in 2018. I hate the idea of a 27-state data set instead of 50, as it feels like cherry picked data. But I accept it because I know that there are a number of states that do a less than stellar job at data collection. ↩︎
5. Greenland has a higher firearm suicide rate than the US, but their total population is 56,500. They obviously deserve to remain an independent country. Insane times that I feel the need to write that. I don’t want someone to minimize the US firearm suicide problem by saying “Greenland is #1.” ↩︎

Back in 2014, I wrote an article that stated universities around the country should shut fraternities down because they were bastions of sexual assault, hazed pledges and were often involved in cheating scandals. I opened the article with details about the death of a 19-year-old female Rutgers sophomore who died from acute alcohol poisoning after attending “a small gathering” at Delta Kappa Epsilon.

I had only been writing on my website for three months and the article got about 30,000 views in the first week. It had touched a nerve, yet many of the people who reached out to me were members of Greek life from around the country who were furious with me. As a result, I decided to pay special attention to fraternity stories.

Two months later, I wrote about “Rape Haven” at Princeton and shared news reports of other sexual assaults and alcohol deaths on other campuses that had happened just that fall. It was not written well, but I was angry that campus officials weren’t doing enough and politicians weren’t jumping all over the issue.

In the fall of 2015, a Rutgers football captain was arrested for allegedly assaulting “a woman he was romantically involved with by picking her up and slamming her down on a concrete surface.” I wrote about that case and other horrific incidents around the country involving college football players and how their universities didn’t do enough to address it. I concluded the article with how Professor William Dowling explained schools typically handled scandals:

1) college officials express shock
2) an investigative committee is established
3) a version of the following statement is issued: “the scandal does not truly represent this esteemed university”
4) there is an announcement that “nothing like this will ever happen again”

A month later, the woman who had bruises on her from the alleged assault dropped the charges so the case was dismissed. The football player was reinstated to the team and was taken in the third round of the NFL draft the following spring. While this football story has nothing to do with fraternities, it does have everything to do with university scandals and their lack of holding privileged males accountable when serious allegations of violence against women arise.

In May of 2017, I went after the fraternities again, this time following the death of a 19-year-old sophomore at Penn State who was from Hunterdon County. I offered up the beginning of a plan for universities to dismantle fraternities:

1. Do not let them use any university facilities for their purposes. They cannot hold meetings or events on campus.
2. Do not let them advertise any events on campus billboards and encourage the student newspapers to reject advertisements from the fraternities.
3. Engage in a constant, blistering, fact-filled education campaign where students and their parents are told about the problems of fraternities and the high rates of cheating, drunkenness, drug abuse, hazing, rape and death. This should be conducted by college officials and students. Social norming ads should be aired on college TV and radio. Put up warning billboards that are similar to anti-smoking ads.

I stand by this, but it is obvious that the strong fact-filled education campaign should be ubiquitous on social media.

I stopped writing about these stories because it felt like another version of school shootings. It would make the news, parents would be sad, some students would be outraged, universities would launch an investigation and then eventually, almost everyone would move on and the status quo would be restored. I’ve added a fifth step to Dowling’s description of the college playbook for handling scandals: 5) they count on people forgetting.

Now, here we are again, nine and a half years after I last wrote about it. Because of what happened at Cornell. Once again, this has touched a nerve. This feels bigger, and yet, I fear that after the outrage and investigations, this will ultimately just result in people forgetting.

I hope this isn’t the case. And I know most of you feel the same way.

I still think a good plan incorporates some version of all three aspects of my 2017 plan. But I’ll add a fourth:

4) Fraternity houses, both on-campus and off, should be regularly patrolled the same way police deal with documented high-risk locations: noise, intoxication, medical emergencies, hazing, assaults, and large parties. Those in danger get medical transport, those who commit crimes get arrested and those who obstruct aid or conceal emergencies are held accountable.

There is a path here. I do think that if the outrage of this moment is properly harnessed and enough pressure is put upon college presidents and elected officials, some movement might actually take place. Call your state senators. Call your congressmen. Call your governor. Email campus officials. Protest in front of their offices. Don’t let up. Dismantle the fraternities.

I don’t want to revisit this after some terrible incident at Yale or Emory or USC in 2035.

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Illustration generated with AI.