Gun suicide is astonishingly lethal: Of all suicide attempts not involving guns, 94% fail, and most of those people do not try again, Everytown reports. Of all suicide attempts that do involve guns, 90% succeed. That's one reason that gun ownership correlates with the youth suicide rate, state by state. A study last year found that for each 10 percent increase in household gun ownership in a state, the suicide rate for 10- to 19-year-olds increases by more than 25 percent.

And, the presence of guns is another community risk factor that has increased during the pandemic: From March to July 2020, Everytown reports, gun sales doubled compared with the year before.

Carrson Everett, 17, says when he himself attempted suicide, the fact that his parents kept their guns safely locked away and out of reach most likely helped save his life. He says that during the pandemic, "Teenagers are already having the effect of isolation, staying at home and everything. And now there's all these new firearms in their homes and, you know, we can't tell who's safely storing their guns and who isn't. And it's very dangerous."

Everett has started his senior year of high school in Kingsport, Tenn., on a hybrid schedule. On the days that he's home, he says he wonders what he's missing out on at school. "Everyone feels isolated, and it's been very tough for everybody."

He says these past few months have been especially hard for him because he has depression and anxiety. Plus, he says he's been bullied for years for being gay, including over video chat during distance learning.

Everett is a volunteer for Students Demand Action, an anti-gun violence group that is part of Everytown. He said he's learned that gun violence isn't just a matter of crime or mass shootings, but also suicide. "I wrote an op-ed about a kid that was my age over in Cookeville, Tennessee, that had taken his own life with a firearm because he had been outed [as gay] at school. So, you know, it's very relatable for me."

Damour, the teen psychologist, explains that not having guns in the home, or keeping them safely locked away, is important especially for adolescents because "teens are impulsive."

What parents can do

She says parents need to know that suicide is preventable. A red flag is when sadness is more than a passing mood. Caregivers need to check in regularly — which can be unexpectedly complicated when the whole family is spending so much time at home.

A common pattern, she notes, is parents trying to work during the day, and teenagers staying up late at night to have time to themselves. This isn't inherently a problem, Damour says, but "there's a difference between allowing privacy and allowing a teenager to hole up in their room for days at a time."

If a teen talks about harming themselves or wanting to disappear, a parent should ask directly, "Is that something you think you might really do or you think about doing? Or are you just letting me know that you're very upset right now?" And, she adds, hear them out without dismissing what they're saying.

She also says parents should look out for anger: "In teenagers, uniquely, depression can take the form of irritability. That depression in teenagers sometimes looks like a prickly porcupine. Everybody rubs them the wrong way. And that is easy to miss because sometimes we'll just dismiss that as being a snarky teenager."

If school is all-virtual, she says, parents should look for safe sports, work or volunteer opportunities that allow teens to have social time and contact with other caring adults.

Finally, Damour says she sees one bright spot: During the pandemic, she and other clinicians are finding that telemedicine — therapy over video chat — is working surprisingly well with adolescents.

"The teenagers that I see are often talking to me from their bedrooms, sometimes flopped over in their beds," she says. "There's something unguarded about it that's very different than having them sit in my office."

And, virtual therapy can lower barriers to access for families who might have had to travel to get accessible mental health care.

If you or someone you know is having suicidal thoughts, reach out for help. The National Suicide Prevention Lifeline is open 24 hours a day at 800-273-8255.

Copyright NPR 2021.