Charting a Course Through the Ineffable and the Inflammatory: Studying Youth Firearm Suicide

The United States' epidemic of youth firearm suicide represents both a clinical challenge and an existential crisis, with firearm suicide rates increasing yearly. Efforts to mount effective responses, however, are thwarted by cultural, social, and political barriers that affect our ability to understand youth firearm practices, develop risk-reduction strategies, and communicate those strategies to families. The psychological autopsy, a methodology wherein researchers interview the family members and associates of youth firearm suicide decedents, offers tremendous potential for reconstructing the lived experience of children and adolescents lost to suicide. Since its introduction in the 1950s, however, the psychological autopsy has largely developed into a tool that filters lived experience through the lens of clinical scales and validated batteries to facilitate quantitative analysis of suicide risk factors. I argue that we cannot build a deep or actionable understanding of the cultural, sociological, and historical circumstances that subtend youth firearm suicide if we rely solely upon analytical models rooted in the quantitative analysis of clinical constructs. To attain an actional understanding of this tragic epidemic, we must develop practices that apply psychological autopsy methodologies in the service of generating thick descriptions of youth firearm practice and suicide. Several disciplinary traditions, including anthropological ethnography and oral history practice, offer insights that can help us realize psychological autopsy's potential to generate new knowledge, develop interventions to stem the rising tide of youth firearm suicide, and communicate these interventions in an increasingly polarized political environment.