Khary Penebaker was 18 when he first learned the truth about his mother's death.

He was rummaging through his dad's stuff one day — just a teenager satisfying his curiosity — when he found a box stacked with 100 copies of her death certificate.

And for the first time, he read the words that would shape the rest of his life — 'self inflicted gunshot wound'.

"Seeing that death certificate really screwed me up. I took a week off high school and I was in a panic. It just hit me," he says of that day in 1996.

It was a moment that would eventually lead to his future as a fierce advocate for common-sense gun reforms. He was elected in June 2017 as a representative from Wisconsin to the Democratic National Committee, where he has pushed for universal background checks for gun sales.

But first he had to suffer through years of trauma.

"I've been a gun violence survivor 38 out of my 40 years on Earth and I have never known what my own mom's feel and touch is like," Penebaker says. "I don't know what it's like to hear her tell me she loves me or how proud of me she is. I spent most of my life with a horrible amount of self-worth because I thought if my own mom can do this to me, then anybody can leave me. I must not be worth a whole lot. It's taken me a very long time to forgive her."

Mass shootings in America have become so frequent now that guns have become inextricably linked in people's imaginations to the idea of public massacres. But the truth is that the people who are most at risk from guns are those who own them.

According to the Centers for Disease Control and Prevention, of the 36,252 people who lost their lives to firearms in 2015, 22,018 — or roughly 60 percent — were suicides. Gun owners are far more in danger of taking their own lives than of turning their guns upon the rest of the world.

Mark Kaplan, a professor of social welfare at the University of California, Los Angeles, and one of only a few hundred suicidologists in the country, calls gun suicides a "hidden epidemic" in America.

"By hidden epidemic," he says, "I mean suicide by gun gets a very limited coverage in the media and by policymakers, yet it accounts for most of the firearm deaths in the United States. It is woefully understudied, woefully under-resourced, woefully underfunded by the federal government, and there's a whole lot that we don't know. But from evidence and research produced so far, we know that there is definitely a connection between availability of guns both at home as well as in communities and the likelihood of dying by gun suicides."

"And that's true across the country. Wherever there are fewer guns, there are proportionally fewer gun suicides."

Below are two heat maps of the United States, one that ranks states by gun ownership rate and the other by suicide rate (measured per 100,000 population). The darker the color of a state, the higher its suicide rate or gun ownership rate. Move the green slider button below the picture to see the overlap.

A comparison of the two maps shows that the link between the two is strong, if inexact. Six of the top 10 states with the highest rate of household gun ownership are also among the top 10 with the highest rate of suicide.

And this is before we account for poverty, population density and crime, all of which influence both the suicide and the gun ownership rates. When researchers behind a study published in the New England Journal of Medicine used this data and controlled for rates of poverty, urbanization, unemployment, mental illness and drug and alcohol dependence and abuse, they found an even more definitive link between the household gun ownership of states and the rates of suicide.

Simply put, the states with the most guns have the most suicides.

In fact, this deadly connection transcends national boundaries.

Below is a chart of the 10 countries with the highest rates of gun suicides in the world, based on data collated by GunPolicy.org. Click on a flag to see where that country ranks globally. A ranking of 6 in gun suicide rate, for example, means that the country has the sixth-highest rate of gun suicides in the world.

The chart shows what most suicidologists have been pointing out: The United States has both the largest number of guns and the highest rate of gun suicides in the world.

The overlap isn't just limited to geography. Broken down along racial and ethnic lines, they still reflect the same link. Hispanic and black populations have a far lower suicide rate than do non-Hispanic whites, a group that has the highest gun ownership rate.

Gender lines reflect this link too.

A 2017 survey conducted by the Pew Research Center found that 22 percent of women own a gun in America, far lower than the proportion of men — 40 percent. Moreover, male gun owners are more likely than female gun owners to have a gun loaded and easily accessible to them at home.

And perhaps because they have greater access to guns — or because, as Kaplan of UCLA suggests, "men often lean toward the more lethal, the more violent methods of suicide" — studies by the National Institutes of Health have found that when it comes to choosing the instrument to take their own lives, men tend to reach for guns, whereas women tend to reach for pharmacological drugs. Is it any surprise, then, that the suicide rate of men is consistently higher than that of women?

Many question the rationale behind focusing so much of the blame on guns. After all, they point out, there are other methods people could choose.

Brandy Lidbeck, author of The Gift of Second: Healing from the Impact of Suicide (2016), says that although her own mother shot herself when she was 10 years old, she doesn't believe that firearms are the real problem.

"Guns do not always equal suicide," she says. "When people are in that desperately hopeless place, it would be obviously helpful if they did not have access to guns. Unfortunately, I also fear they would find a different means. They are not always thinking straight when they are in that frame of mind."

But Liza H. Gold, a clinical professor of psychiatry at the Georgetown University School of Medicine and editor of Gun Violence and Mental Illness (2015), says that's a common fallacy.

"Many people will say incorrectly, 'Oh, well, if they want to commit suicide, they'll just find another way to do it.' That's called 'means substitution.' It's not true and we have research that demonstrates this," Gold says. "Even when there is an increase in use of other means, suicide rates still overall go down."

The reason for that, she says, is simple: Guns are devastatingly effective.

"Almost 85 out of 100 people who try to kill themselves by firearms are successful and they're successful immediately," Gold says. "There's no chance to change your mind. If people take an overdose, there's so much time involved in taking the overdose to actually dying from a variety of variables that the lethality rate of overdoses is something like 2 percent. And one of the next highest rates is suffocation or hanging, which is around 60 percent. So there's really nothing as lethal as firearms."

What this means, Gold says, is that it makes guns a permanent solution to what is often a temporary problem: "People may have been thinking about suicide for a long time but the decision to actually go through with it tends to be very impulsive, often fueled by drugs or alcohol or extreme emotional states or all of them."

Research has found that for most people who attempt suicide, the act is part of only a short-term crisis. According to a literature review of 90 studies published in the British Journal of Psychiatry, seven of 10 people who attempt suicide and survive never make another attempt.

And this, Khary Penebaker says, is what makes the finality of suicide by firearm particularly tragic for people like his mother.

"I get this all the time: 'If your mom didn't have access to a gun, she would have tried something else.' Well, my mom did try something else. She tried to use pills twice and she lived through those. But you don't really get a second chance from a bullet."

These days, when 46-year-old Christen McGinnes enters Inova Fairfax Hospital in Northern Virginia, she is recognized instantly.

That's not just because McGinnes has spent the better part of a decade in and out of surgery at the hospital, as doctors work to restore her mangled face and jaw. It's also because now, eight years after she shot herself in the head, she volunteers at the hospital that saved her life and counsels trauma patients and anyone who has attempted suicide.

It has been a hard road for her. McGinnes remembers that one fateful morning in 2010 vividly — waking up to a feeling of utter despair after a long year of loss and depression, picking up the .357 revolver that an ex-boyfriend had given her for protection, tidying her apartment, going out to the balcony, pulling the trigger and somehow being able to hear her roommate scream and call 911 until the ambulance came.

"And I remember that someone, a fireman maybe, put his hands on my shoulder and said, 'I've got you. You're going to be OK.' And somehow I lived."

McGinnes has since had to undergo 49 surgeries to her face. The bullet had shattered the right side of her face, including much of her jaw, her cheek, her teeth and her tongue. Her right eye was totally gone and was replaced with a prosthetic. For two years, she couldn't talk and she couldn't eat — she was fed through a tube. Even now, as McGinnes speaks to me over the phone from Virginia, she slurs her words and speaks slowly and haltingly, trying to distract herself from the pain in her jaw that flared up the previous night.

Partly in an effort to help her distract herself, I ask her what the cover photo on her Facebook profile signifies. It's a picture of Jean Grey, aka Phoenix, a superhero from Marvel Comics' series "The X-Men" who shares McGinnes' red hair. What else do they share?

Her voice lightens for the first time on the phone, and she says, "Everyone that knows me says that I am a superhero and that I am this woman who has survived unimaginable odds. That's why I connect with her."

Despite all she has gone through, McGinnes tells me over and over again how lucky she feels to get a second lease on life. And she tries her best to repay this chance by giving others the mental health help they need — the help that she herself never received and that, she says, may have kept her from trying to kill herself.

Experts usually caution against framing suicide as primarily a mental health issue, because it may stigmatize people with mental illness. But even if suicidal individuals do recognize that they need mental health help and seek it, it's often harder for them to navigate through the tortuous web of American healthcare than to just get a firearm.

"Here in Wisconsin, you can get the gun the same day you attempt to purchase one so long as you pass the background check, but it'll take you a month to get your first mental health care appointment," Khary Penebaker says.

His mother, who was struggling with suicidal thoughts for many years and had made multiple attempts to kill herself, should never have been able to have access to a gun, he says.

"If you think about it, would we allow in a civilized society a situation where someone tells you, 'I'm an alcoholic,' and then you say, 'Well, I'm going to have open intoxicants all around the house'? Would anybody do that? The answer clearly is no. If someone says, 'I'm not OK, I may be a risk to myself,' is it a good idea to leave pills around them or razors — or anything? Of course not. Then why a gun?"

One morning in March 1998, a Connecticut Lottery accountant named Matthew Beck went on a rampage at his workplace, stabbing and gunning down four of his bosses and then shooting himself in the head.

When investigators began piecing together the events, it wasn't long before they found that Beck had struggled with mental health issues for years before his attack — and everyone knew. He was always angry at his bosses and had frequently vented to his colleagues. Beck was struggling with depression, he had tried to kill himself at least once before, and there were reports of police being called to his apartment once because he held a knife to his throat. In the months leading up to the attack, he had even taken time off from work for "stress-related problems."

In short, Matthew Beck's life was littered with red flags.

And yet, when his anger and pain finally boiled over, all he had to do was reach over and pick up his 9mm Glock.

That proved to be a defining moment for Connecticut's firearm policies. State legislators set about crafting the nation's first "red flag law," which would enable people to alert authorities about someone they saw having mental health issues who had access to a firearm. Such statutes allow law enforcement to temporarily take away the firearm after getting permission from a judge.

Some version of these red flag laws — officially known as gun violence restraining orders or extreme risk protection orders or ERPOs — have since been enacted in Indiana, California, Washington and Oregon. After the massacre at a school in Parkland, Florida, in February this year, interest in such laws surged.

But experts and advocates say that ERPOs have even more value as a tool to prevent suicides.

A 2016 study by Duke University researchers found that Connecticut's law had prevented at least 70 suicides over a 14-year period.

"If we were to look at this as a way to help our family members work themselves through or navigate through when those dark moments come, when that wave of depression hits you, and allow them to have a separation between those and a gun, we can help save their lives," Khary Penebaker says.

One of the organizations working to advocate for the passage of ERPO policies across the country is the Coalition to Stop Gun Violence in Washington, D.C.

Adelyn Allchin, the organization's director of public health research, says that after the Sandy Hook shooting in Connecticut in December 2012, the coalition's sister organization, the Ed Fund, brought together a group of leading researchers, practitioners, and advocates in gun violence prevention and mental health to look at the intersection of mental illness and gun violence.

Together, they began to work toward developing more red flag laws.

"We focus on developing policies that will temporarily remove firearms from individuals at risk of harming themselves, and we work on applying them to the rest of the country," Allchin says. "Currently, 30 states are enacting and working towards some form of these risk protection policies."

While ERPOs work as a stopgap when lives are in immediate danger, Allchin says, her organization also advocates for measures that work in the long term.

"We released a report in September 2017 about lethal means safety counseling," she says. "It's absolutely critical for healthcare providers to be trained in talking to their patients about access to lethal means that they might have, especially if they are at risk for suicide, and ways to reduce access to those means. If they're firearm owners, it's important that healthcare providers talk to them about safe storage."

Marilyn Koenig, founder and president of the non-profit Friends for Survival in Sacramento, California, says that no one was really aware about safe storage of guns in the '70s, when her 17-year-old son, Steven, shot himself.

"They didn't tell us to lock our guns up in those days," she says. "We had a pistol and it was in a drawer in our master bedroom, and we never ever heard about or had any such conversations about keeping it secure ever."

Koenig says she doesn't think access to the gun was a condition of Steven's suicide because unlike most attempters, he didn't act impulsively. He planned his suicide for days. He left seven notes.

But she does believe that informing people about the danger of having guns in the house could have saved many other lives. And that's why she now warns those she finds at risk to stay away from firearms. "We do know from research since then that if people who are at risk of suicide have guns in the house, that house is more likely to have a suicide than not," Koenig says. "And I think that's a very telling thing."

"So if somebody's at risk of suicide, don't have guns even if they're locked up. Get rid of them. I'm sorry, but it's just not worth it. It's not worth somebody's life to have guns in the house."