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If you or someone you know is in crisis, call or text 9-8-8 for help.
HELENA, Montana – At his home, Mike Hossfeld unlocked a heavy black steel door to his gun safe room, unveiling both modern and collectable firearms from the early 1900s.
"Most of this is mine. There are a few weapons in here that belong to other folks." he says.
Hossfeld regularly stores firearms for others who are going through a crisis or simply a rough period in life. That puts time and space between them and their guns, which can significantly reduce suicide risk.
Hossfeld first stored a firearm for his National Guard commander in the 1980s after he talked about suicide.
"We carried our sidearms in a shoulder holster. So I just walked over and took the strap off, and said I was going to store his weapon for him in my toolbox," Hossfeld recalls.
His commander recovered and was very happy to get his weapon back, Hossfeld says. And that's the whole premise, Hossfeld says, of a Montana law passed earlier this year: to make it easier to help a friend get through a mental health crisis and alleviate the immediate risk of suicide until someone gets better.
Montana lawmakers passed legislation to protect those that store firearms for others from legal liabilities in case someone subsequently harms themselves after picking up their gun.
Public health officials hope that will encourage more people like Hossfeld to store firearms for family and friends. They also want to encourage gun shops and shooting ranges to offer storage for the public.
Some Montana public health officials are building a map identifying locations that are willing to store firearms. Similar maps have cropped up around the country in recent years.
Montana has the second highest suicide rate across the country next to Wyoming, according to the federal Centers for Disease Control and Prevention. Nearly nine out of 10 of Montana's gun deaths are suicides, according to state data. That's much higher compared to the national average of 60%.
Tough conversations
At a local gun show this spring, Lewis and Clark County Suicide Prevention Coordinator Jess Hegstrom set up a booth as she tried to blend into a sea of camo and folks wearing pro-gun t-shirts shopping for guns and accessories.
"I have like little guns on my earrings. I'm cool, I'm friendly. I'm not here to waggle my finger at you," she says.
Instead, Hegstrom talks to people about how to bring up tough topics with friends and family, like suicide and safe storage of firearms for anyone at risk.
"Sometimes it's really well received because people do worry about this topic, and they don't always know what they can do," she said.
Othersshy away from the conversation, which Hegstrom says is a sign there's still a lot of work to do to normalize conversations about firearms and suicide.
Hegstrom is currently working on a local "safe storage map" identifying gun shops and other locations willing to store guns for the public. The map will be local at first. She hopes it will become a statewide resource and a tool for suicide hotline operators.
"So we're just trying to make sure that there's a wealth of options for people to safe store, especially if you can't do it on that one-to-one basis. There's multiple locations, multiple possibilities," she said.
Colorado, Washington State, Utah, Louisiana, and other states around the country have implemented some version of a safe firearm storage map or public messaging campaign encouraging people to store firearms outside of the home while at increased risk for suicide.
Legal barriers
However, there are perceived and real legal barriers to making both public safe storage maps and getting people to store firearms for others to become commonplace.
"I'm not really sure that firearms dealers doing hold agreements is really the best idea," says Ed Beal, owner of Capital Sports in Helena, Montana.
Hegstrom asked Beal to participate in the safe storage map for Lewis and Clark County, but Beal said he has a lot of questions about what is legally required under federal law when it comes to storing firearms temporarily, particularly about background checks.
Gun shops in other states have begun to navigate this complex legal landscape.
On the safe storage map for Colorado, you can find Hammer Down Firearms, a gun shop outside Denver.
The idea of storing guns for the public is fine in theory, says co-owner Chris Jandro. However, he says only two people have ever used the service.
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Many customers back out once they hear that they'll need to pass a background check when they come back to get their gun, said Jandro.
And the background check includes questions about mental health treatment.
Getting treatment doesn't necessarily disqualify someone from getting the gun back, but the questions are confusing, especially for someone in crisis that is unsure about what mental health treatment they may seek out.
He says all gun dealers want to help "stop this madness," that is driving suicide rates up. "You can tell, people are more depressed than they've ever been," says Jandro. "I mean, we see it." But he thinks friends and family are in a better position than gun store owners to hold firearms for people who are suicidal.
In 2021, The Biden administration announced its support for the creation of more safe storage maps. It also reminded gun dealers that they still had to do background checks.
NPR and KFF Health News requested an interview with the Bureau of Alcohol, Tobacco and Firearms, which regulates gun shops, but did not receive a response.
Federal law doesn't prohibit people from storing guns for each other on a personal basis.
But in some places, like New York and Massachusetts, state laws can make it almost impossible, according to Harvard's Cathy Barber.
"In New York state, you might be a licensed gun owner, but you're still not supposed to hold onto somebody's guns because you're supposed to register each individual gun," she explained.
The only way around it is for both people to go to a gun shop together and do the paperwork for an ownership transfer. They'd need to repeat that process again when the original owner wants the gun back. In places like New York, that includes filing additional paperwork with the state to get approval for a license specific to each gun.
Other states do allow immediate family members like a spouse or adult children to hold onto guns without transfer paperwork, but they prohibit extended family members or friends from doing so.
That can make it hard to find someone outside of the home that's legally able to store guns.
Overall, these legal hurdles just take too long during a psychiatric crisis, said Boulder, Colorado ER physician and University of Colorado professor Dr. Emmy Betz, who helped set up the Colorado's safe storage map.
"It is a great idea for transfer laws or background check laws to have that clause that allows transfers for prevention of suicide... So it would make it easier to give your gun to your cousin for example," she said.
That's what lawmakers did In Washington State. Before, only immediate family members could hold onto guns. But a recent law change now allows friends and extended family members to hold a gun — if suicide is a risk.
Harborview Injury Prevention and Research Center founder Dr. Fred Rivara supported the new law, but said it only helps families in his state.
"I think that's part of the problem because these laws are different in all 50 states..., and a lot of states are silent on this whole issue of temporary storage of firearms," he said.
Support from public health officials and gun enthusiasts
The number suicides involving firearms pushed the national suicide rate to an all-time high in 2022, according to an KFF analysis of preliminary mortality data.
It will take time to address these legal barriers. That shouldn't stop health officials from continuing to engage gun owners and the gun industry about safe storage, says Betz.
"What we really want for long-term optimal health is to help the at-risk person be building their own set of skills to get through things themselves, with help, but for them to be the one to do it," she says.
That's why these voluntary efforts are key rather than only relying on legal restrictions surrounding guns to remove access to firearms for those at risk of suicide.
However, Betz says there is still a space for red flag or extreme risk laws that allow courts to legally seize firearms from someone that poses a risk to themselves or others.
She said that approach should be a last resort.
Gun-rights advocates are coming around to the idea of voluntary safe storage. Jason Swant is the head of Prickly Pear Sportsman's Association, which operates a shooting range in Helena, Montana.
Swant said his group was reluctant at first to work with public health officials because he was afraid of a slippery slope that could eventually lead to legal restrictions — such as red flag laws.
Swant started working with Lewis and Clark County health officials because he came to understand that safe storage holds real promise for reducing suicides.
"We've had a few people let us know that somebody asked and held my firearm and that made a difference," he said.
Swant hopes the effort in Montana — and similar programs in states like Washington and Colorado — will eventually prove to be more effective at stopping suicide than red flag laws.
However, there isn't a lot of data on how often people use public safe storage options or ask friends of family to hold onto their guns to reduce suicide risk.
According to one survey of Colorado and Washington State gun owners, a little over a quarter of respondents had stored a firearm away from home in the last five years. However, they could have been storing guns for reasons beyond suicide risk, like long vacations or having grandchildren in the house.
Researchers in Colorado are planning a study that will examine how often people in four states are storing guns outside of their homes specifically to prevent a suicide.
A public awareness campaign in Utah also plans to survey state residents about whether its tv commercials and other PSAs are changing how people think about reducing access to firearms during a crisis.
Making it normal to ask for help
It's going to take long-term and broad messaging campaigns to truly change people's behavior on a large scale, says Harvard researcher Cathy Barber.
"You need the kind of message saturation that we've got with designated drivers and 'friends don't let friends drive drunk,' where you're seeing it in TV shows, on movies, you're seeing it in PSAs," she said.
There are some anecdotal stories that suggest a larger shift inside the firearm community could be happening.
"I have in my telephone a list of my top people and when things start going dark, they're always available for me to reach out," said Peter Wakem, a North Carolina-based custom gun case designer.
Wakem said he has periodically gone into crisis over the years, and when that happens, his friends take his firearms and change the code for the safe at his shop. He started talking about that on various gun-oriented podcasts to promote the idea and show that asking for help is normal.
He even keeps a note inside his gun safe to remind himself.
"Time to reach out, things will get better, you're not weak. You're doing the right thing. Make the phone call. Signed, Future Pete," the note reads.
This story comes from NPR's health reporting partnership with KQED and KFF Health News.