Partnering with the Gun Lobby to Enact Suicide Prevention Laws in Utah 

The first time Utah state Rep. Steve Eliason was asked what he was going to do about a rash of youth suicides in his suburban Salt Lake County neighborhood, he didn’t know what to say. 

Some of the people asking were parents whose children had taken their lives. Others were friends and classmates of the deceased.  

“There was a kid in my scout troop whose dad was incarcerated, and [the youth] came to me and said, ‘Steve, there’s kids at my school that are dying, and nobody’s talking about it, and I don’t like it,’” he said. “I can remember feeling wholly inadequate. Like ‘I’m a CPA. I don’t know about this stuff,’” he said. 

Eliason immersed himself in learning more about suicide and suicide prevention. He reached out to researchers and Greg Hudnell, a former Utah high school principal who founded the Hope Squad, a nationally recognized suicide prevention program that trains students to guide distressed peers to adult professionals who can help them. 

Eliason, a 2023-24 Milbank Fellow and Republican serving his 14^th year in the Utah House of Representatives, also sought input from the state’s leading gun owners’ rights lobbyist and proceeded to become Utah’s leading legislator on suicide prevention and related issues. Over the last 10 years, Eliason has become adept at navigating Utah’s political landscape. He has sponsored nearly 60 successful pieces of legislation, many impacting gun owners, in a state with a culture of gun ownership. Additionally, he has successfully sponsored multiple other bills related to homelessness and mental health access, as well as mental health screening in Utah public schools. The vast majority of his legislation has passed unanimously.  

 In the Suicide Belt 

Eliason’s first step was a deep dive into public health data and literature. He learned that Utah is part of the “suicide belt,” a region of the western United States where the suicide rate is particularly high compared to the rest of the nation.

Experts say social isolation, a culture of self-reliance, a lack of access to mental health care, and ready access to firearms contribute to suicide rates in the Mountain West states that far exceed those of most other states. Researchers are also working to better understand the correlation between high suicide rates and altitude and whether antidepressant medications are less effective at high elevations.

In Utah, adults ages 45 to 54 have the highest rates of suicide in the state, 49 per 100,000 population for men and 18.1 per 100,000 population for women. For Utahns ages 10 to 17 and 18 to 24, suicide is the leading cause of death according to Utah Department of Health and Human Services data. 

A 2018 study by researchers with Harvard’s T.H. Chan School of Public Health found Utah’s youth suicide rate was similar to its neighbors but significantly higher than the nation’s. The study also determined 91% of firearm suicides among Utahns under age 18 occurred at their homes and the majority of the guns used in youth suicides were obtained from the youths’ homes. 

Data suggest a higher percentage of Utahns own guns compared to the national average. According to in-state public opinion polling, about half of Utahns say they have a gun in their homes compared to about 4 in 10 nationally.  

Eliason said he also learned how safe storage of firearms can help prevent death by suicide, particularly among youths. 

“Teenagers are impulsive,” Eliason said. “The part of their brains that regulates emotion and judgment is not fully developed until their mid-20s. It is normal for them to swing from emotional highs and lows. It’s normal for them to not think things through. It’s up to us as parents and those of us who are lawmakers to allow them to develop as safely as possible.”  

Navigating Legislation That Impact Gun Owners 

For Eliason, suicide prevention is personal. Four of his extended family members have died by suicide. Three of them died using another family member’s gun, he said. 

In a state considered among the reddest of the red, firearms are such a part of the state’s fabric that the Utah Legislature, in 2011, voted to designate the John M. Browning-designed M1911 automatic pistol as the state firearm. 

Clark Aposhian, chairman of the Utah Shooting Sports Council and a gun rights lobbyist, says Utah’s propensity for gun ownership stems from its culture of self-reliance.

“Utah has a huge history, even before we were a state, of relying on ourselves and our own personal responsibility rather than asking for help from the government,” he said in the 2019 documentary “Wake Up:  Stories from the Frontlines of Suicide Prevention.” 

Eliason said he knew that to pass legislation to encourage the use of gun locks and gun safes and require suicide prevention training of people with concealed firearms permits, he’d need to work with the state’s gun rights lobby. 

In advance of the 2019 legislative session, Eliason asked Aposhian to meet with him to review data he had collected about gun deaths in Utah. “He gave me some numbers and some things to look up and I was very skeptical because the numbers that he was telling me just were not what I’d heard before,” Aposhian said. “We had 572 gun deaths in that year, but when we found out that 86% of those were suicides, that hit me.”  

Still, Aposhian did not accept the numbers out of hand, he said. So, Aposhian conducted his own research. “Try as I might, everything he said was accurate from multiple sources,” he said. After that, he agreed to collaborate with Eliason in areas of common interest. 

With input from Aposhian, suicide researchers, and safety advocates, Eliason crafted legislation that required people who renew concealed firearms permits in Utah to complete an online training module about suicide prevention. 

House Bill 17, passed in 2019, also required state mental health and criminal identification officials to implement and manage a firearm safety program and suicide prevention course. The legislation offered Utah residents who filed applications for concealed firearm permits to receive coupons for gun safes. It also required federal firearms dealers to provide cable-style gun locks provided by Utah’s Division of Substance Abuse and Mental Health to individuals purchasing certain firearms. 

Expanding into Behavioral Health 

Today, Eliason is considered the Utah Legislature’s go-to lawmaker on issues of suicide prevention, mental health, and homelessness. He frequently speaks at national conferences, sometimes teaming with Aposhian to share how they found common ground on their shared goal of reducing suicide deaths by firearms. 

Earlier this year, Eliason teamed up with Utah Senate Majority Leader Evan Vickers on legislation to create the Utah Behavioral Health Commission. The commission is the central authority for coordinating behavioral health initiatives among state and local governments, health systems, and other interested parties to ensure that the state’s behavioral health systems are “comprehensive, aligned, effective, and efficient.” 

The commission must include one individual with lived experience with a substance use disorder, another with lived experience with mental illness and another to represent families of individuals with behavioral health issues. 

Vickers said Eliason brought his vast knowledge about suicide prevention and behavioral health to the table. “I’m kind of a novice in that area. I certainly don’t know anyone here who knows as much as he does about it, so I really rely on his expertise,” said Vickers, R-Cedar City, who is a pharmacist. 

During the same legislative session, Eliason introduced legislation to better address the needs of patients at the Utah State Hospital, some of whom had been discharged into homelessness. The bill authorized the state hospital to enter contracts with other entities to help the patients receive step-down services. 

To learn more about the psychological factors behind suicides, the state legislature passed a bill sponsored by Eliason in 2017 that created a position in the State Medical Examiner’s Office to perform “psychological autopsies” on people who die by suicide. 

He passed legislation and secured funding to expand the number of mental health care providers by requesting funding to increase the number of psychiatric residences at the University of Utah Spencer F. Eccles School of Medicine. And in 2016, the Utah Legislature passed legislation sponsored by Eliason that created three refundable tax credits for psychiatrists and psychiatric advanced practice registered nurses who open a new practice or to any practitioner who cares for underserved populations. 

To improve crisis services, Eliason partnered with Utah state Sen. Daniel Thatcher, R-West Valley City, on legislation that brought about the SafeUT smartphone app that provides real-time crisis intervention for students, parents/guardians, and educators through live chat with licensed counselors and a confidential tip line. More than 885,500 students K-12 and those enrolled in college or post-secondary education have access to the app. A 2023 report attributes 536 lifesaving interventions to the SafeUT app.  

There are encouraging signs that this legislative work is paying off, although Eliason cautioned that much work remains to further reduce the rate. According to the Office of the Medical Examiner, the 10-year average number of youth suicide deaths is 36. In 2023, the most recent year, there were 25 deaths, which represents a 31.3% decrease from the moving 10-year average, a period in which youth suicide reached peak levels. 

A Legislative Champion 

Utah’s inaugural psychological autopsy examiner Michael Staley said Eliason keeps in frequent contact with him to stay informed of the latest suicide statistics and data trends. 

According to Staley, Eliason is “one of the most fierce advocates that we’ve had in our state ever when it comes to preventing suicide.” Among state lawmakers nationwide, he says that “there really isn’t any parallel or equivalent of Steve.” 

When Staley and his colleagues travel to conferences out of state and share the suicide prevention work that Utah’s state and local governments are doing such as improving crisis services, data collection, and efforts to increase the mental health provider pipeline, peers from other states inevitably ask, “How did you do that?” 

Staley says he explains that Utah has a legislative champion.  

During one recent debate on a gun safety bill in the Utah House of Representatives, the normally buzzing legislative chamber grew still as Eliason wrapped up his presentation. He noted that the bill had the support of state and national shooting sports federations as well as the Utah Suicide Prevention Coalition.  

“If you have ever received a phone call that a family member has just died by suicide and that family member was a child, it changes your world,” he said. 

To illustrate the point of the bill, Eliason demonstrated a locked gun safe that permitted nearly instantaneous access to a user and displayed a cardboard box of helpful resources for people who have just experienced the death of loved one by suicide.  

“This is a biometric safe for individuals wanting ready access to their firearm, but also want to protect their family. It is only opened by your fingerprint. This box is distributed to families who have lost a family member to suicide…With more of these (safes), for which this bill would supply a coupon to help offset the cost, we would have to give out far fewer of these boxes.” 

The bill passed by a vote of 66-4 in the House of Representatives and by a vote of 26-0 in the Utah Senate.