Predicting Risk of Suicide Among Individuals Who are Members of Higher-Risk Populations: Finding THE Needle in a Stack of Needles!

  • Eric D. Caine

The study by Swanson et al. sought to assess the implied premise of the Department of Veteran Affairs (VA) policy that automatically registering Veterans who require a fiduciary into the National Instant Criminal Background Check System (NICS) will lead to a reduction in suicides or harmful violence. Registration in NICS is intended to prohibit purchase of a firearm. This policy raises an ultimate key question: Does such registration save lives? It is in this context that the authors seek to approximate an answer, mindful of many limitations they acknowledge and some that they do not mention.

I am writing this commentary based on four professional perspectives—(1) as a person trained in psychiatry who was an inpatient clinician for many years treating acutely suicidal individuals and who also treated many outpatients who were suicidal; (2) as a former chair of a department of psychiatry for more than two decades, where I saw persons in consultation who were suicidal or reviewed cases...



Dr. Caine is supported in part by grant R49 CE002093 from the Centers of Disease Control and Prevention. None of the opinions expressed are those of the funder.


  1. Franklin, J. C., Ribeiro, J. D., Fox, K. R., Bentley, K. H., Kleiman, E. M., Huang, X.,... Nock, M. K. (2017). Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 143(2), 187–232. Scholar

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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Injury Control Research Center for Suicide Prevention, Department of PsychiatryUniversity of Rochester Medical CenterRochesterUSA

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