Gun safety management with patients at risk for suicide

Program in Psychiatry and Law, Georgetown University School of Medicine, Washington, DC, USA.
Suicide and Life-Threatening Behavior (Impact Factor: 1.4). 11/2007; 37(5):518-26. DOI: 10.1521/suli.2007.37.5.518
Source: PubMed

ABSTRACT Guns in the home are associated with a five-fold increase in suicide. All patients at risk for suicide must be asked if guns are available at home or easily accessible elsewhere, or if they have intent to buy or purchase a gun. Gun safety management requires a collaborative team approach including the clinician, patient, and designated person responsible for removing guns from the home. A call-back to the clinician from the designated person is required confirming that guns have been removed and secured according to plan. The principle of gun safety management applies to outpatients, inpatients, and emergency patients, although its implementation varies according to the clinical setting.

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    ABSTRACT: Firearms have been noted as a risk factor in youth suicide, but this has not necessarily translated effectively into the clinical setting. There is little information from the mental health field on firearm counseling interventions with parents of adolescents. The intent of this study was to uncover adolescent mental health clinicians' endorsements of specific messaging strategies on firearm access and safety counseling geared toward parents of depressed and suicidal adolescents. A total of 24 clinicians from a rural area took part in a focus group study. As part of the focus group, mental health counselors looked at six short paragraphs that phrased counseling parents on suicide and firearms. They were asked to identify three sentences across these paragraphs that they felt would be useful with parents of depressed or suicidal adolescents in counseling. Results found 66 responses that resulted in the recognition of 16 common statements across participants. The frequency of statements was examined, qualitatively analyzed and grouped according to messaging concept. The results indicated that the sentences the counselors identified fit into five concepts: Risk, Empathy, Impulsivity, Lethal Means Restriction Counseling, and Parental Responsibility. The present study provides insight into message strategies identified as helpful in engaging parents in discussions of firearms when the risk of adolescent suicide is present.
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