Certification change versus actual behavior change in teenage suicide rates, 1955-1979

National data on firearm suicides and accidental firearm deaths for persons aged 15-19 from 1955 to 1979 were examined to test hypotheses of increases in reported suicide rates as resulting from (1) improved accuracy in the determination and certification of suicide in equivocal firearm deaths; (2) actual increases in the rate of firearm suicides among teens; or (3) some combination of these factors. Data presented support the hypothesis of certification changes as the primary factor influencing suicide rates during the first 12-year segment, but suggest a period of actual growth combined with continued certification change from 1967 to 1979.