Lethal Impulse

BEATRICE, Neb. -- Two different teenagers. One common way to die.

Ryan Schramm was the popular freshman at Diller-Odell High School. Preston Keefover was the mischievous eighthgrader at Beatrice Middle School.

Ryan had good grades, athleticism, popularity. Preston had a team of counselors and educators trying to keep him from flunking.

Ryan became upset the morning of March 3, 2001. His dad had decided Ryan couldn't stay home alone while his parents were away.

Preston got mad the day of May 18, 2001. He found out that he had to go to summer school and that his mom had discovered he had been abusing amphetamines.

Ryan, 15, walked out to a shed on the family farm, scribbled a note on cardboard and shot himself with a hunting rifle.

Preston, 14, climbed up to the attic, scratched his final words into a section of drywall and shot himself with a shotgun.

Two months and 18 miles separated these deaths. The teens didn't know each other. It does not appear that Ryan's death led to Preston's. But the two teens had similarities. Each had deeper problems than the frustrations of his final day. And both -- when they felt the lethal impulse -- had easy access to guns.

Nearly six of every 10 teen suicides in the United States from 1994 to 2002 involved firearms. Outside the nation's metropolitan areas, two of every three involved firearms. Take the guns out of teens' hands, research shows, and more suicidal teens are bound to survive that impulse to kill themselves.

Sure, some depressed teens may find other means. But suicide rates are lower when teens have less access to firearms.

Restricting access is not that simple, though. Some families don't lock away their guns or hide the ammunition, because they want both handy for protection. Others want their children to learn to hunt and to respect guns, and feel it would be hypocritical to hide them.

Laws can help encourage gun safety in the home. But some lawmakers and suicide prevention experts fear the ramifications of trying to curtail a constitutional right many Americans hold dear.

"The mere implication that guns might be an issue nearly sank our first suicide prevention legislation six years ago, " said Christy Letsom, a suicide prevention coordinator in Virginia. "Since then, we've been very careful to avoid language that specifically addresses firearms."

There were 166 Nebraska teenagers who died by suicide in the state from 1994 to 2003, and 107 used firearms. The World-Herald interviewed 28 families that have lost children to firearm-related suicides since 1999 and found:

Twenty-five of the youngsters had easy access to the guns they used. Only three had to force open locked gun cabinets. One knew how to manipulate the lock. Another pried the hinges with a claw hammer. None of the guns had trigger locks on them.

Fourteen parents said their children had unfettered access to guns in the home, because they had succeeded at firearm safety training or had shown respect for guns.

Eight parents hid their guns separately from the ammunition, but their children knew the supposedly secret locations of both.

Three parents said they forgot that guns were in the home.

The problem with guns is they are among the most deadly and immediate means of suicide. Guns send children to their graves. Pills, hanging and other methods can be lethal, too, but state hospital records show that teens are much more likely to survive those kinds of attempts.

Nebraska hospitals in 2003 treated 553 children for selfinflicted injuries or suicide attempts. The hospitals discharged 386 children who swallowed pills or toxic substances, but only three who used guns.

"If we can get them to take pills instead of a gun, it is more likely to turn a suicide into a suicide attempt, " said Dr. David Grossman, a Seattle pediatrician whose research connects greater gun safety with lower teen suicide rates.

Grossman co-authored a study that was published this February in the Journal of the American Medical Association. It found that fewer safety measures were in place in 106 homes in which teens used guns to kill themselves compared with 480 randomly selected homes with gun owners and children. The researchers found out in each case whether guns were locked and unloaded, and whether the ammunition was stored separately.

Gun suicides are almost entirely the reason for the higher rate of teen suicides outside Nebraska's metropolitan areas. There is little difference between the metro and nonmetro rate among other types of suicides, but the nonmetro rate of firearm-related suicides is 46 percent higher.

Ryan and Preston are two of 10 teenagers from the Beatrice area who died by suicide between 1994 and 2003. Eight of those teenagers used firearms. Gage County, as a result, has one of the highest teen suicide rates in the nation for the past decade.

Ryan's father, Darrell Schramm, said his son might be alive today if the guns on their farm had been locked beyond his reach. But hunting had been part of Ryan's upbringing, and he had shown that he could safely handle firearms.

"It's kind of a way of life, " Schramm said. "I suppose if I wouldn't have ever owned a gun, he might be alive today. But the gun didn't kill the boy. The boy killed the boy."

Schramm's regret is that his son had been struggling with the aftereffects of a car accident five weeks earlier and that his family had been too busy to notice.

Ryan complained of blurred vision and headaches, and the Schramms would later learn of their son's strange behavior at school, such as drifting through the hallways during class time. He suffered dizzy spells and often couldn't see the blackboard.

Schramm believes the accident and the death are connected. He also carries the guilt of being a strict parent. His last words to his son were orders that he accompany the family to his brother's basketball tournament.

"I said, 'You're going with us, case closed, '" Schramm said, "and, see, I should have sat down and talked with him."

The permanent reminder is Ryan's suicide note, which stated he wasn't sure "how much longer" he could put up with his father. Schramm didn't show it to police and won't look at it anymore. It's too painful.

The end of the note, Schramm said, shows that his son didn't understand the finality of his actions.

"Bye for now, " the 15-year-old wrote, "but not for long. Love always."

By limiting access to guns, Grossman said, parents may delay their children until they have time to rethink their plans. The most effective means -- other than removing guns from the home -- is to lock them up and keep them unloaded, or to lock ammunition in a separate place.

Researchers at Johns Hopkins University in Baltimore reported last summer that firearm-related suicide is 11 percent less likely in states with laws requiring parents to restrict access to guns in the home.

"Child access" laws are opposed by the National Rifle Association. The organization says it supports gun safety, but believes judgments should be made by the owners and not mandated by laws. The group also worries that restrictions will make guns less available for home defense.

Preston Keefover's mother, Jane, had simply forgotten there was a gun in the house.

She had moved all of the family's hunting firearms to her father's house to keep them out of reach of her children. But her older son brought a gun back into the house because he had joined a trapshooting club.

When the season ended, the gun was stowed in Jane Keefover's closet. The ammunition was placed in a separate closet in the hallway.

"I'm surprised he could even load it, " she said.

Experts say limiting gun access might be particularly effective in lowering the suicide rate outside metropolitan areas, because a higher percentage of teen suicides involves guns.

Higher teen alcohol use in rural areas also contributes to risky and impulsive behaviors, but drunken teens are less likely to carry out complicated or difficult suicide plans. Guns, by comparison, are simple.

The experts caution, however, that locking away guns is only part of the solution. They say a greater need is to identify at-risk teens and give them timely and useful counseling and support.

One study in the year 2000 suggested that most parents won't remove guns from the home of a troubled teen. It found that only one in four families with clinically depressed children followed the advice of counselors and removed guns from their homes.

In Nebraska, after their teenagers' gun-related suicides, most of the 28 families interviewed removed all guns from their homes, purchased trigger locks or became more consistent about locking gun cabinets and concealing ammunition.

Getting rid of the gun was the easy part for Jane Keefover. Two of her children are on their own, but she still raises her youngest son, Spencer. That is tough. She questions every decision, every comment she makes to her son, worried that he will feel the same overwhelming pressure that Preston once felt.

The suicide note Preston put on drywall -- a simple "I ò U Guy's" -- has been cut out, framed and hung in the dining room.

"If Preston knew how much hurt he caused all of us, " Keefover said, "this isn't what he would have wanted."

Schramm still keeps about 25 guns in an open cabinet in his office on the farm, where he raises two of his children. He has fond memories of teaching his children to hunt, starting with lessons with BB guns when they were young.

Once in a while, Schramm wonders whether he should get rid of his guns. But then maybe the family shouldn't drive cars, either, given Ryan's car accident.

Parents can be too protective of their children, Schramm said: "You can't lock them up in the bedroom."


Stop reading and place a phone call.
Girls and Boys Town National Hotline, (800) 448-3000
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Did you know ...

SUICIDE is a leading cause of death until age 35. Nationwide, homicides and suicides each claim about 10, 000 young people a year. Only accidental deaths occur more often -- about 32, 000 a year.

SUICIDE is more prevalent outside U.S. metropolitan areas in general, although the disparity gets smaller as people age. In Nebraska, the rate of elderly suicide is higher inside metro areas.

SUICIDE has become less common at every age since the 1980s. Some experts link the drop to a growing use of antidepressant medications.

SUICIDE is most common among people age 65 and older. Most geriatric suicides occur within weeks of a doctor's visit, suggesting bad health news and physical pain are factors.

SUICIDE is widely believed to be underreported by authorities. Without evidence such as a suicide note, some suicides are ruled accidental.


Show teens you care

Suicidal teens feel hopeless and isolated. Change their view. If you are worried someone is suicidal:

Tell him: "I am concerned about how you are acting and the things you are saying.'' There are no magic words. Show patience and caring. Avoid arguing and lecturing.

Ask her: "Are you thinking about suicide?'' Talking about it does not make someone suicidal. It shows you care and will listen to their troubles.

Get help: "This is serious. I'm going to get you help.'' Call the teen's parents, another trusted adult or an emergency number.


Know facts, avoid myths

Common misconceptions, from Suicide Awareness Voices of Education (SAVE):

"People who talk about suicide won't really do it.''
Not True. Almost everyone who kills himself or attempts suicide has given clues. Do not ignore suicide threats. No matter how casually or jokingly spoken, they may indicate serious suicidal feelings.

"Anyone who tries to kill himself must be crazy.''
Not True. Most suicidal people are not psychotic or insane. They are upset, grief-stricken, despairing or depressed. Extreme distress and emotional pain are not always signs of mental illness.

"If a person wants to die, nothing will stop him.''
Not True. Even the most severely depressed person wavers. Most suicidal people do not want death; they want the pain to stop. The lethal impulse, especially among teenagers, does not last forever.

"People who die by suicide were unwilling to seek help.''
Not True. Studies of suicide victims show that most sought medical help within six months before their deaths.


Where to find free gun locks

Try your local law enforcement agency. The Beatrice Police Department, for example, keeps a box in its 24-hour front lobby.

Contact the Nebraska Sheriffs Association, which helped coordinate last year's giveaway of 135, 000 locks across the state. (800) 775-2469.

In Iowa, contact Al Overbaugh at the U.S. Attorney's Office for Iowa's Southern District in Des Moines. (515) 284-6283.

Project ChildSafe, a national firearms safety program, will bring an additional 100, 000 free locks to Nebraska in August.

Visit Omaha.com for a link to the group's Web site.


Deadly choice

Most youth suicides in Nebraska are done with guns.

1994 to 2003

Gun related: 107 (64%)
Hanging, strangulation, suffocation: 40 (24%)
Poisoning: 13 (8%)
Jumping or lying beneath a moving object: 4 (2%)
Drowning: 1 (1%)
Unspecified: 1 (1%)


Uncommon choice

Nonfatal attempts treated in Nebraska rarely involve guns.

1996 to 2003

Gun related: 24 (1%)
Hanging, suffocation: 5 (1%)
Poisoning: 2, 806 (73%)
Cut/pierce: 724 (19%)
Other/unknown: 258 (7%)

Sources: Study of death certificate and hospital discharge data from the Nebraska Health and Human Services System

Gun toll worse outside metro areas

Other types of suicide occur at about the same rate inside and outside the metropolitan areas.

Annual suicides, ages 10 to 19 per 100, 000


Gun: 2.66
Non-gun: 2.13

Gun: 4.4
Non-gun: 2.15


Gun: 3.62
Non-gun: 2.49

Gun: 5.3
Non-gun: 2.2


Gun: 3.30
Non-gun: 3.20

Gun: 4.97
Non-gun: 2.43

SOURCE: Study of data from the national Centers for Disease Control and Prevention, 1994 to 2002


Home alone

Compared with the nation, Nebraska has a higher rate of children raised by a single working parent or by two parents who work.

Metro areas: 64%
Midsize areas: 68%
Small town/rural areas: 66%

Metro areas: 73%
Midsize areas: 76%
Small town/rural areas: 78%

Only four of the 37 Nebraska families with teens who killed themselves included a parent who stayed home with their children.

SOURCE: World-Herald interviews; 2000 Census


Safe gun storage can save lives

Researchers say some suicides will be prevented if impulsive teens don’t have easy access to guns.

Trigger lock
Blocks trigger but does not prevent loading. Should never be used on loaded gun, which might fire in spite of lock.

Lockbox or gun safe
Effective if key or combination is kept secure; large safes or vaults can store rifles and handguns.

Simple, inexpensive; can lock gun to a fixed object. Cable should pass through firing chamber, not around trigger.

Not possible with all guns; user must know correct procedure.

Barrel lock
Keeps gun from being loaded or fired. Must be proper size.

Other considerations
When practical, keep guns and ammo stored separately.

Teach children to respect the danger of handling guns.

SOURCES: Smith & Wesson/Masterlock, SafTLock, Colt, National Shooting Sports Foundation, Knight Ridder Tribune