Keith Carey is a gunsmith in Montrose, a town with a frontier flavor set amid the rocky mesas of western Colorado. He's a staunch, though soft-spoken, defender of the right to bear arms.
Yet now he's also a willing recruit in a fledgling effort to see if the gun community itself — sellers and owners of firearms, operators of shooting ranges — can help Colorado and a swath of other Western states reduce their highest-in-the-nation suicide rates.
"Suicide is a tragedy no matter how it's done," said Carey, whose adult daughter killed herself with a mix of alcohol and antidepressants a few years ago on the East Coast. However, he sees the logic in trying gun-specific prevention strategies in towns like Montrose, where guns are an integral part of daily life.
"It's very expedient for people to commit suicide by a firearm, without too much forethought," Carey said. "Unfortunately, it's generally effective."
So at the urging of a local police commander, Carey agreed last year to participate in the Gun Shop Project, a state-funded pilot program in which gun sellers and range operators in five western Colorado counties were invited to help raise awareness about suicide. It's a tentative but promising bid to open up a conversation on a topic that's been virtually taboo in these Western states: the intersection of guns and suicide.
The counter in Carey's tiny shop — where he repairs horns and woodwinds as well as guns — now displays wallet-sized cards with information about a suicide hotline. A poster by the door offers advice about ways to keep guns out of the hands of friends or relatives at risk of killing themselves.
"Consider offering to hold on to their guns or to help store their guns temporarily," the poster says. "You may save a life."
Carey says some of his customers take materials home, or ask a few questions. But the conversations tend to be brief.
"Suicide is one of those morose subjects that a lot of us don't want to talk about," he said. "But it's all too common. I believe any method of suicide prevention is worth a good hard try."
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Across the U.S., suicides account for nearly two-thirds of all gun deaths — far outnumbering gun homicides and accidental deaths. In 2014, according to federal data, there were 33,599 firearm deaths; 21,334 of them were suicides. That figure represents about half of all suicides that year; but in several western Colorado counties, and in some other Rocky Mountain states with high gun-ownership rates, more than 60 percent of suicides involve firearms.
A map of state suicide rates reveals a striking pattern. Along with Alaska, the states with the highest rates form a contiguous bloc of the interior West — Montana, Idaho, Wyoming, Nevada, Colorado, Utah and New Mexico. All have age-adjusted suicide rates at least 50 percent higher than the national rate of 12.93 suicides per 100,000 people; Montana's rate, 23.80, is the highest in the nation.
Between 2000 and 2014, gun suicides increased by more than 51 percent in those states, while rising by less than 30 percent nationwide.
Theories abound as to why residents of this Western region kill themselves at such high rates. Commonly cited factors include the isolation and economic hard times that are prevalent in rural areas of these states. A University of Utah psychiatrist, Perry Renshaw, contends that the lower oxygen levels of higher altitudes contribute to elevated suicide rates.
There's also widespread belief that a self-reliant frontier mindset — admirable in many circumstances — deters some Westerners from seeking help when depression sinks in.
"We embrace the cowboy mentality," says Jarrod Hindman, director of Colorado's Office of Suicide Prevention. "If you're suffering, suck it up, pick yourself up by your boot straps. But that doesn't work very well if you're suicidal."
Underlying all these explanations is the fact that firearms — the most effective of all the common means of suicide — are more ubiquitous in the West than in most other parts of the country.
Catherine Barber, a suicide prevention expert at the Harvard School of Public Health, says numerous studies show that residents of gun-owning homes are at substantially higher risk of suicide than other people — simply because a suicide attempt is more likely to involve a gun and thus prove fatal. According to federal estimates, suicide attempts involving firearms succeed 85 percent of the time, compared to less than 10 percent of attempts involving drug overdoses and several other methods that often allow a suicidal person to reverse course.
"It's not that gun owners are more suicidal," Barber argues. "It's that they're more likely to die in the event that they become suicidal, because they are using a gun."
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Colorado's Gun Shop Project is modeled largely after a program pioneered in New Hampshire a few years ago; it's now being tried in Nevada and a few other states. Barber helped design the initiative and hopes that constructive collaboration on firearm suicide prevention can spread nationwide.
"In the past, people shut up about this issue because they thought raising it meant raising the issue of gun control," she said. "It makes so much more sense to look at gun owners as part of the solution: Gun owner groups have a strong tradition of caring about safety."
The Colorado project is being expanded this year from five counties to nine, including San Miguel County, home to the Telluride ski resort and some of Colorado's most spectacular mountains. In a two-week span in late February to early March, the county of 8,000 people recorded three firearm suicides.
Hindman, who oversees the Colorado program, said that when he joined the state health department in 2004, talking about the role of firearms in suicide was discouraged. It's still a sensitive topic, he said, but some funding has materialized for gun-specific initiatives. One of Hindman's strategies is to emphasize the toll of firearm suicides, which run more than 5-to-1 higher than gun homicides in Colorado.
"Homicides and mass shootings are tragic," he said. "But the vast majority of gun deaths are suicides, and we don't have that conversation."
In Montrose, Police Commander Keith Caddy has been around guns since childhood as a hunter, lawman, firearms instructor and licensed gun seller. Now he's doing outreach for the Gun Shop Project — and most of the businesses he has visited agreed to display the suicide-awareness materials once they were assured it wasn't a gun-takeaway program in disguise.
"Is it doing any good or not? That's a tough thing to quantify," Caddy said. "It's my duty to protect the community I serve. If I can go out there and spend a little time talking to the gun shops, maybe the reward will be saving someone's life."
In Grand Junction, western Colorado's largest city with about 60,000 residents, the outreach was assigned to Dave Fishell, a local historian and author who knew most of the shop owners. He's a gun aficionado and collector who has made his own bullets.
Fishell says he has another important credential — for many years he battled serious depression, to the point where he contemplated suicide and three times put himself into a psychiatric ward.
"Maybe it's part of my mission in life," he said. "When people ask, 'Do you know what I'm going through?' I say I do."
During those episodes of severe depression, he placed his guns in a safe and gave the key to his wife — the kind of precaution he'd like to see more people consider. Yet he also remembers thinking that if he did kill himself, it should not be with a gun. He didn't want to contribute to giving gun owners a bad name.
At the gun shops he visited, several owners declined to display the materials and expressed skepticism about playing a role in suicide prevention.
"I can see that point of view," Fishell said. "But making people aware is a first step."
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Throughout the region, prevention efforts are fueled to a large degree by people who've lost loved ones to suicide, often involving firearms.
Cindy Haerle, a teacher and board member of the Grand Junction-based Western Colorado Suicide Prevention Foundation, grew up in "a real gun family" in Salida, Colorado, and had her own gun by the time she was 5. But she gave up shooting after her brother John, a high school football star and later a sniper in Vietnam, killed himself with a pistol in 1980 at age 29 after prolonged struggles with depression.
"Nothing is as final as a gunshot," said Haerle, who was 13 at the time.
Jim Doody, a former Grand Junction mayor and city councilor, serves on the foundation's advisory board. He talks movingly about the suicide of a close friend, Matt Townsend, in 1989 at the age of 33.
They'd met in 7th grade at a parochial school — "We drove the nuns crazy," said Doody — and stayed close through high school and thereafter. But adulthood proved challenging for Townsend, who took painkillers after a motorcycle injury. He told Doody at one point, "I think I'll blow my brains out someday."
Doody says Townsend called him late one night, drunk but seemingly in good spirits, just a day before killing himself with his brother's handgun. Even 27 years later, Doody feels some guilt for not picking up clues that his friend was on the brink of suicide.
Doody has joined in the recent appeals to gun owners to keep their weapons out of the reach of those at risk of suicide.
"Have we made a difference?" Doody wondered. "We won't ever know about a life we might have saved."
Andy Mills, who works for an energy company in the northwest Colorado town of Craig, lost his 15-year-old son, Austin, to suicide in 2010. Mills blames himself for not ensuring that Austin couldn't find the handgun that was kept in the house, and he now supports the Gun Shop Project's suicide prevention outreach.
Firearms remain a part of the family's life, however; Mills replaced the gun that Austin had used with a different model.
"My wife and daughter-in-law, we've all talked about it," he said. "They understood the need, as our protection and our right as gun owners, to still have a gun at home."
In Fruita, a few miles west of Grand Junction, high school teacher and gun-rights supporter Jami Jones talked about two people she knew who fatally shot themselves in recent years — a mechanic who had seemed devoted to his two young daughters, and a 15-year-old girl who was a classmate of Jones' own daughter.
The man used his own gun; the girl used a gun she found hidden in her mother's bedroom.
Jones depicted guns as a fact of life for western Colorado — she has a concealed-weapons permit and joins her husband in hunting and target shooting. But she says gun owners need to think about suicide prevention.
"What's your plan?" she said. "We've got to keep the children safe and the people who are mentally ill safe."
In a region of ruggedly beautiful peaks and canyons, the high suicide rates puzzle her.
"I don't really know why," she said. "You look around: We're in God's country."
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Suicide presents a distinctive challenge for shooting ranges: Occasionally, someone will rent a gun, then use it to commit suicide at the site.
At the Family Shooting Center at Denver's Cherry Creek State Park, there have been three such wrenching incidents, including two since Doug Hamilton began managing the range in 2004. One involved a young man upset by post-divorce problems; the other involved identical twin sisters from Australia who shot themselves with rented pistols — one died, the other survived.
Hamilton is open to letting his staff get some suicide-prevention training, though he's unsure it would help. Those who killed themselves at his range exhibited no signs of stress beforehand.
"How do we identify a bad apple who's about to go over the edge, and get them the help that they need?" Hamilton asked. "Suicide prevention brochures aren't something that anyone's going to pick up who has come out to our range to kill themselves."
In Grand Junction, a Gun Shop Project poster hangs on the bulletin board at the Rocky Mountain Gun Club, a state-of-the-art shooting range with sections for pistols, rifles and archery.
The general manager, Josh O'Neal, says safety is a high priority; there's a video system providing live views of all the ranges. Yet he's not confident of avoiding an onsite suicide attempt.
"We all feel in the back of our minds it's a question of when, not if," he said. "We're not psychologists. A lot of unstable people are good at hiding that."
The challenges facing shooting ranges are familiar to Dr. Michael Victoroff, a physician in the Denver area whose leisure-time passion is competitive shooting. He's a certified firearms instructor and was at the Family Shooting Center in Denver when one of the suicides occurred there.
"Nobody wants that," he said. "It's bad for your soul, it's bad for business, it's bad for the sport."
Due in part to that incident, Victoroff has become increasingly engaged in suicide prevention, and serves on a state working group seeking to raise awareness of the issue among primary-care doctors. He also has provided firearms instruction to Jarrod Hindman and other suicide-prevention specialists.
Differing from some gun enthusiasts, Victoroff asserts emphatically that the presence of a gun in a household is "an enabler of suicide."
"It's a myth that people would just choose some other means if they didn't have a gun," he said. "There's a particular attractiveness about suicide with a gun... It's by far the most effective means."
Victoroff belongs to the American Medical Association and the National Rifle Association, and has qualms about both.
"The medical community has been content not to know anything about gun culture and gun safety," said Victoroff, who offers presentations trying to bridge that knowledge gap. As for the NRA, he'd like to see suicide prevention highlighted in its training materials.
Over the years, firearm suicide has not been a high-profile issue for the NRA; it worries that the topic might be used to advance a gun-control agenda. Though the NRA has no position on Colorado's Gun Shop Project, it has endorsed a bill in Washington state encouraging gun dealers to participate in suicide prevention efforts, said spokeswoman Jennifer Baker.
The NRA views suicide as a mental health problem, she said. "The goal is to prevent it regardless of how people kill themselves."
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The intersection of gun culture and mental health is complicated. And it's personal for Ed Hagins in Montrose. Deputy director of a local mental health center and active with the county's suicide prevention coalition, he had a cousin who fatally shot himself.
Beyond that, Hagins says he has suffered from depression for much of his life, including instances as a teenager when he considered suicide. As an enthusiastic gun owner who enjoys target shooting, he's leery of proposals to deny gun rights to people diagnosed with mental illness.
"I meet that criteria," he said. "That's one of my biggest fears — legislation that I can't have a gun."
It's personal, too, for Ken Constantine, owner of Elk River Guns in Steamboat Springs.
"I don't want to sell a gun to someone to commit suicide," he said. "That happened once in this shop — it weighs on me."
He recalled the sale of a handgun to a woman several years ago: "She seemed completely normal. No telltale signs."
But he learned later from police that the woman, within a week of purchasing the gun, killed herself with it.
Having been through that experience, Constantine is troubled by the Gun Shop Project's offer of training for shop employees so they can better identify customers at risk of suicide.
"I won't assume the responsibility of a mental health professional," he said, suggesting instead that therapists in the area should get permission from their at-risk patients to temporarily place their names on a private list of people who shouldn't acquire guns.
But that approach has been tried and doesn't work, said Tom Gangel, director of a mental health center serving the area.
"We have asked patients who we think are really in danger, can we give their names to gun shops or they can self-report, but only one or two have done that," Gangel said. "In our area, not very many people want to give up the right to be able to go buy guns."
The local Gun Shop Project is coordinated by Meghan Francone, who constantly reassures gun owners and sellers that the outreach program poses no threat. She got involved after her 15-year-old brother-in-law, Austin Mills of Craig, fatally shot himself in 2010.
"Keep your guns. Keep a dozen. I don't care. But please make sure they are locked and out of the reach of someone who's in crisis," she said. "I'm not asking any gun shop owner to be a psychologist. I'm asking them to be their brother's keeper."
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