title: Effects of changes in permit-to-purchase handgun laws in Connecticut and Missouri on suicide rates.
abstract: OBJECTIVE
  In 2013, more than 40,000 individuals died from suicide in the United States. Restricting access to lethal means has the potential to prevent suicide, as suicidal thoughts are often transient. Permit-to-purchase (PTP) laws for handguns could potentially reduce suicides by making it more difficult for persons at risk of suicide to purchase a handgun.
  
  
  METHODS
  We used a quasi-experimental research design with annual, state-level suicide data to evaluate changes to PTP laws in Connecticut and Missouri. Data were analyzed for 1981-2012. We used synthetic control modeling as the primary method to estimate policy effects. This methodology provided better prediction of pre-PTP-law-change trends in the two states with PTP law changes than econometric models and is thus likely to provide more accurate estimates of policy effects.
  
  
  RESULTS
  The synthetic control model estimated a 15.4% reduction in firearm suicide rates associated with Connecticut's PTP law. Missouri's PTP law repeal was associated with a 16.1% increase in firearm suicide rates. Evidence that PTP laws were associated with non-firearm suicide rates was mixed in Connecticut and negative in Missouri.
  
  
  CONCLUSIONS
  The findings are consistent with prior research linking firearm availability to increased risk of suicide and lower suicide risks associated with PTP handgun laws.
authors.affiliation: Johns Hopkins Center for Gun Policy and Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: Cassandra K
authors.initials: CK
authors.lastname: Crifasi
authors.affiliation: Johns Hopkins Center for Gun Policy and Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: John Speed
authors.initials: JS
authors.lastname: Meyers
authors.affiliation: Johns Hopkins Center for Gun Policy and Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: Jon S
authors.initials: JS
authors.lastname: Vernick
authors.affiliation: Johns Hopkins Center for Gun Policy and Research, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States.
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Webster
mesh_terms: D000293:Adolescent; D000328:Adult; D003237:Connecticut; D005260:Female; D005389:Firearms / Q000331:legislation & jurisprudence*; D006801:Humans; D008297:Male; D008923:Missouri; D015233:Models, Statistical; D011640:Public Policy; D012307:Risk Factors; D013405:Suicide / Q000639:trends*; D055815:Young Adult; D000092864:Suicide Prevention
keywords: Evaluation; Firearms; Legislation; Suicide