“I’m not depressed, I’m just not sleeping”

"Just insomnia" in a stoical, isolated man is frequently depression — and farmers/men with firearms access are a recognised high-suicide-risk group, so the reluctance itself is the warning. The non-negotiable task is an EXPLICIT suicide-risk assessment (thoughts of being better off dead, ideation, plan, intent, means, preparatory acts) including direct enquiry about FIREARM ACCESS — asking does not increase risk. With high lethal-means access plus hopelessness, lethal-means safety (the guns and ammunition leaving his control today — a registered firearms dealer, another certificate holder or the police; a cabinet he holds the key to is not enough) is central to the safety plan, and the GP must know the firearms duty: a genuine safety risk can justify informing the police/firearms licensing department in the public interest (GMC Confidentiality 2017; Home Office statutory guidance on firearms licensing), done proportionately and, wherever possible, with the patient. Treat the depression per NICE NG222 (CBT with an antidepressant for more severe depression; review within 1 week when there is suicide risk), with same-day crisis team assessment for a plan involving a firearm. The examinable hidden agenda is shame-laden (a failing farm and a marriage ending) and a man testing whether anyone notices his despair. Overcome stigma with warmth so he engages, treat the depression and alcohol, surface the social drivers and signpost practical help, handle the confidentiality/firearms conversation honestly, and safety-net with crisis routes and early follow-up.