When people think of gun violence, they typically think of a masked robber or a disturbed young man with an assault rifle and hundreds of rounds of ammunition.
In truth, the most common victim of fatal gun violence is a distraught man who, alone in a room, puts a gun to his head and pulls the trigger.
Far more people use guns to commit suicide than to kill someone else in Florida, according to state Department of Health records. The same is true nationally and in Central Florida.
In 2011, the most recent year for which state numbers are available, there were 1,474 firearm suicides in Florida compared with 827 firearm homicides.
In Central Florida, the numbers were 309 vs. 154.
Residents here shot themselves to death in public parks, parked cars, cemeteries, gun ranges, behind stores — but most often at home, a review of local medical-examiner records shows.
They had no trouble getting access to guns, even though an Orlando Sentinel review of 40 Central Florida cases showed nearly three out of every four had a history of mental illness, had been treated for mental illness, had attempted suicide previously or had talked about suicide.
Although she was under treatment for bipolar disorder and had been "Baker Acted" — temporarily placed in a mental hospital after making threats to commit suicide — 30-year-old Rebecca Sides of Oviedo was able to buy a shotgun. On Dec. 7, 2011, Sides used it to kill herself in her backyard.
Suicide by firearm is a public-health problem, said Dr. Matthew Miller, a physician and professor at the Harvard School of Public Health who has spent years researching the issue.
Suicide overall "kills more people under 30 than any other injury or disease," he said. "It kills more than motor vehicles. It kills more than poisonings. It kills more than drownings."
More than 100 lost daily
Suicides by any means — pills, suffocation, drowning — kill more than 100 Americans a day, according to Miller.
Suicide by gun killed 53 Americans a day in 2010, the most recent year for which national data are available. The overwhelming majority — 87 percent — were men.
"I see so much isolation and loneliness and heartache in my job that culminates in suicide. I find it a tragedy," said Dr. Jan Garavaglia, medical examiner for Orange and Osceola counties. "I think suicide is a public-health crisis."
But it's a crisis largely hidden from view. People typically avoid the subject. If a family member kills himself, relatives often hide that fact out of shame. And news organizations generally avoid the subject, often out of concern that it might prompt copycats.
"Most people don't know that there are more suicides than homicides," said Anara Guard, a suicide-prevention expert and executive with Education Development Center, a nonprofit Massachusetts company. "Homicides get a lot more news than suicides."
For every two people in the United States killed by criminals, three commit suicide, according to numbers from the Centers for Disease Control and Prevention.
Use of a gun dwarfs all other categories of suicide, according to state and national health statistics, and year by year, it's a problem that's getting worse.
Since 2007, homicides of all types have been on the decline across the country, but gun suicides have climbed. Across Central Florida, across the state and across the country, people are killing themselves with guns at a higher rate now than five years ago, data show.
Mental illness and gun access