A gun show might not be the first place you would expect to talk about suicide prevention — especially in a place like rural northeast Utah, where firearms are deeply embedded in the local culture.
But one Friday at the Vernal Gun & Knife Show, four women stood behind a folding table for the Northeastern Counseling Center with exactly that in mind.
Amid a maze of tables displaying brightly varnished rifle stocks, shotguns and the occasional AR-15 assault-style rifle, they waited, ready to talk with show attendees.
"Lethal access to lethal means makes a difference. Suicide attempts by any other means are less lethal," says one of the women, Robin Hatch, a prevention coordinator with Northeastern Counseling for nearly 23 years.
Utah has one of the highest rates of death by suicide in the U.S. And 85% of firearm deaths in the state are suicides. According to Utah's health department, suicide rates can vary widely depending on where you are. For example, the suicide rate in northeast Utah is 58% higher than the rest of the state.
Suicide by gun is a particular problem: The rate in rural areas is double that in urban areas, according to state officials.
A major factor is the easy access to firearms in Utah — and the grim fact that suicide attempts involving guns have a higher mortality rate than by other means.
This was the first time Hatch and her colleagues at Northeastern Counseling were doing outreach at a gun show.
As the auditorium filled with firearm sellers and hunters, the counselors stacked their folding tables with neat piles of free cable locks that thread into a gun to prevent rounds from being loaded, and water-resistant gun socks screen-printed on the outside with the National Suicide Prevention Lifeline number.
The idea behind distributing both devices is to slow a person down during a moment of crisis. "Anything that we can do to get people off track a little bit, thinking something different," Hatch explains. "We believe that will help make a difference in our suicide rates."
Unpredictable employment adds stress
The northeast corner of Utah is home to oil and gas fields, cattle ranches and the Uintah and Ouray Reservation.
Health experts say factors contributing to the high suicide rates in the area include limited access to mental health services in rural communities and the unpredictability of the ranching and oil and gas industries. The boom-bust cycles, along with physical and mental stress, take a toll on workers.
"Injuries and accidents, keeping your job, having a job tomorrow. It's so up and down," says Val Middleton, a former oil and gas safety instructor at Uintah Basin Technical College in Vernal. "The guys don't eat right typically. No exercise, hard work, long hours, no sleep. That's what adds up. The divorce rate is high, really high. The family life is low."
Add high gun ownership and the risks are increased.
Dee Cairoli is a pastor at Roosevelt Christian Assembly in a neighboring town. He also works part time as an NRA concealed-carry handgun instructor. When hosting classes, Cairoli explains how gun owners can intervene if another gun owner shows signs of a mental health crisis.
"I've done it a couple of times as a pastor where I've gone to somebody's house and said, 'Look, maybe you need to listen to me for a minute. I know what I'm talking about. I promise I'll keep it in my [gun] safe, but let me have your gun.' "
Cairoli speaks with authority. When he was 15, his father killed himself with a gun.
"It was very tragic, but I never hated the gun. I never blamed the gun. I knew that it was just his desperate moment and that he had just chosen that," Cairoli says.
He believes that personal tragedy, along with the credibility he brings as a gun user and local pastor, allows people in crisis to trust him.
Not Just A Rural Issue
How to talk about suicide with guns isn't just an issue in rural parts of Utah. It's a topic that state Rep. Steve Eliason of Sandy, a suburban city near Salt Lake, also tackles. Eliason has sponsored legislation focused on firearms, suicide prevention and mental health services. It is personal for him, too.
"I've lost three extended family members to suicide. All firearm suicides. Young men," Eliason says.
This year, he worked on bills to fund firearm safety and suicide prevention programs, supply gun locks, create new mental health treatment programs and expand crisis response in rural Utah.
Eliason describes these issues as nonpartisan, but with Utah's proud gun culture, he's also careful with his approach. He describes advice he got from a politically liberal friend in public health about how to bring together opposing perspectives about firearms.
"Obviously, there's kind of two schools of thought on firearms," he says. "Those two schools of thought, if they were circles, they would overlap into a small oval — that oval is the culture of safety. And she says, 'I would recommend that you dwell within that oval.' That's what I've tried to do."
That perspective led to the Utah legislature appropriating money to fund a study from the Harvard T.H. Chan School of Public Health, in consultation with the Utah Shooting Sports Council. That study spurred discussions about the problem of firearms and suicide and formed the basis of at least one of Eliason's 2019 bills, to expand access to gun locks.
Like Eliason's work at the state policy level, Hatch's suicide prevention work in her community depends on relationships and trust.
Hatch's table at the gun show was less busy than others. But the women gave out hundreds of gun locks and gun socks over the course of the day. And attendees said having them there was a fitting way to bring up the subject of suicide and firearms.
"You need to know your community, and you need to address it in a way that your community will accept it," Hatch says.
DAVID GREENE, HOST:
Utah has one of the highest rates of suicide in the country. Erik Neumann at member station KUER in Salt Lake City set out to learn how people work to prevent suicide in a state with a strong gun culture.
ERIK NEUMANN, BYLINE: The town of Vernal sits in the high desert of northeast Utah. The land is windy and dry, dotted with oil and gas fields and cattle ranches. Walking into the Vernal Knife and Gun Show (ph), you can hear pops from a corner where people are shooting pellet guns for a self-defense course. The tables are covered with shotguns, hunting rifles and a few assault-style rifles. At one booth, four women are giving out free gun locks - cables that thread through guns to prevent bullets from being loaded.
ROBIN HATCH: This is for a rifle right here. It is. And it's yours.
NEUMANN: Robin Hatch is here with Northeastern Counseling Center. The giveaways are a way to start a conversation about suicide.
HATCH: Our tricounty area is leading the state for suicide. Most of them are by firearm.
NEUMANN: It's the first time Hatch has done this at a gun show. She's also giving out free gun socks, which are fabric sleeves you slide over a gun. Hers are printed with a number for a suicide hotline.
HATCH: So could I interest you in a gun sock?
UNIDENTIFIED PERSON: Sure.
HATCH: Would you like a pistol or a rifle?
UNIDENTIFIED PERSON: Let's do rifle.
HATCH: What color would you like?
UNIDENTIFIED PERSON: Blue?
HATCH: Blue. Thank you.
UNIDENTIFIED PERSON: Thank you.
NEUMANN: Health experts say reasons for northeast Utah's high suicide rate include limited access to mental health services and the unpredictability of working in ranching or oil and gas and the stress of those jobs. Val Middleton taught oil and gas safety at a nearby technical college.
VAL MIDDLETON: Injuries and accidents and keeping a job and having a job tomorrow - and it's so up and down.
NEUMANN: Add to that - high rates of gun ownership. Dee Cairoli is a pastor in a nearby town. He also works part time as an instructor for the NRA. In his classes, he explains how gun owners can intervene for each other during a mental health crisis.
DEE CAIROLI: I've done it a couple of times as a pastor, where I've gone to somebody's house and said look - maybe you need to listen to me for a minute. I know what I'm talking about. Please, I promise I'll keep it in my safe, but let me have your gun.
NEUMANN: When Cairoli was 15, his father killed himself with a gun.
CAIROLI: It was very tragic, but, you know, I never hated the gun. I knew that it was just his desperate moment and that he had just chosen, you know, that.
NEUMANN: Cairoli can draw on this tragedy to connect with people who are in crisis. Someone else who has a similar approach is Republican state Representative Steve Eliason.
STEVE ELIASON: I've lost three extended family members to suicide - all firearm suicides, young men.
NEUMANN: Eliason has sponsored bills dealing with firearms, suicide prevention and mental health services in Utah. He calls these issues nonpartisan, but he's also careful with his strategy. He describes advice he got from a politically liberal friend in Public Health about how to bridge the gap on guns.
ELIASON: There's kind of two schools of thought on firearms. And those two schools of thought, if they were circles, they would overlap into a small oval, and that oval is a culture of safety. And she says, I would recommend that you dwell within that oval. And that's what I've tried to do.
NEUMANN: It's a strategy that also works for Robin Hatch. Along with her co-workers, she's also a gun owner, but that doesn't stop her from trying to reduce suicides.
HATCH: You need to know your community, and you need to address it in a way that your community will accept it.
NEUMANN: Compared to others at the gun show, their table was less busy. Still, they gave out lots of gun locks and gun socks with the hope that somewhere, someday those tools will help someone pause for a moment and instead ask for help.
For NPR News, I'm Erik Neumann in Salt Lake City, Utah.
GREENE: Erik's story comes to us through a partnership with NPR, KUER and Kaiser Health News. Suicide can be prevented. If you're in crisis or know someone who is, please call the National Suicide Prevention Lifeline at 1-800-273-TALK. Transcript provided by NPR, Copyright NPR.