Firearms constitute an environmental risk factor for suicide among all age groups. Although other professions have been urged to assess firearm availability and advocate for the removal of firearms of their clients, little is known about the practices and the techniques within the social work profession. The present study surveyed a random sample (N = 697) of Ohio licensed social workers (requiring a BSW) and Ohio licensed independent social workers (requiring an MSW and 3,000 hours of post-master's practice experience) on their attitudes, knowledge, and behaviors regarding client firearm assessment and safety counseling. Findings indicated that the majority of social workers in this study did not report assessing for firearms or counseling on firearm safety on a routine basis. Barriers included lack of training on risks, lack of risk awareness, discomfort with the topic, not social work responsibility, lack of time, and more important topics to discuss. The most influential variable positively related to firearm assessment and counseling behaviors among these social workers was reporting previous firearm safety training. Other variables included influential media, depressed client, and suicidal client.
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"A statewide (Ohio) survey of licensed social workers (n = 697, 28% response rate) resulted in two articles from this sample. The initial article reported that 34% of the respondents routinely assessed firearm ownership and access in their clients and 15% routinely counseled their clients on firearm safety (Slovak et al. 2008). In addition, only 24% of the social workers reported receiving training for firearm safety counseling. "
[Show abstract][Hide abstract]ABSTRACT: Firearm violence is a significant cause of morbidity and premature mortality in the United States. The majority of suicides and homicides are committed with firearms. Considerable debate has occurred regarding firearm violence and mentally ill people. Mental health professionals can play a central role in research, practice, and advocacy regarding firearm violence prevention through a number of avenues. However, little is known about mental health professionals' perceptions and practices regarding firearm safety counseling in the mentally ill. Thus, the purposes of this investigation are to summarize the literature on firearm violence by the mentally ill and to conduct a rigorous review of the available scientific literature on mental health professionals' views and practices on firearm violence prevention. A total of nine studies were found that dealt with mental health professionals' attitudes and practices on firearm violence prevention. Findings have been summarized in the following categories: mental health professionals training, screening for the presence of firearms, engagement in firearm safety counseling, and perceptions regarding firearm violence in the United States. Mental health professionals need more training regarding firearm issues if they are going to play a role in reducing firearm trauma by the mentally ill. Their impact will be primarily on firearm suicides.
Full-text · Article · Jun 2016 · Violence and Gender
"had easy access to it, emphasizing an opportunity for lethal means counseling and enhanced home safety. Future areas for exploration include gender differences in choice of method— including whether easy access to a home firearm makes a woman more likely to choose it over another method— and in likelihood of and response to lethal means counseling.  A primary study limitation is that the chart review abstraction form asked about assessment of " means to complete suicide (e.g., firearms or presence of medications ), " without separation of assessment of access to different kinds of means. Thus we cannot, from these data, know what proportion of suicidal ED patients had firearm-speci"
[Show abstract][Hide abstract]ABSTRACT: Background:
Reducing access to lethal means (especially firearms) might prevent suicide, but counseling of at-risk individuals about this strategy may not be routine. Among emergency department (ED) patients with suicidal ideation or attempts (SI/SA), we sought to describe home firearm access and examine ED provider assessment of access to lethal means.
This secondary analysis used data from the Emergency Department Safety Assessment and Follow-up Evaluation, a three-phase, eight-center study of adult ED patients with SI/SA (2010-2013). Research staff surveyed participants about suicide-related factors (including home firearms) and later reviewed the ED chart (including documented assessment of lethal means access).
Among 1,358 patients with SI/SA, 11% (95% CI: 10-13%) reported ≥1 firearm at home; rates varied across sites (range: 6-26%) but not over time. On chart review, 50% (95% CI: 47-52%) of patients had documentation of lethal means access assessment. Frequency of documented assessment increased over study phases (40-60%, P < .001) but was not associated with state firearm ownership rates. Among the 337 (25%, 95% CI: 23-27%) patients discharged to home, 55% (95% CI: 49-60%) had no documentation of lethal means assessment; of these, 13% (95% CI: 8-19%; n = 24) actually had ≥1 firearm at home. Among all those reporting ≥1 home firearm to study staff, only half (50%, 95% CI: 42-59%) had provider documentation of assessment of lethal means access.
Among these ED patients with SI/SA, many did not have documented assessment of home access to lethal means, including patients who were discharged home and had ≥1 firearm at home.
Full-text · Article · Mar 2016 · Depression and Anxiety
"In a survey of emergency department nurses, only 28% reported engaging in means restriction counseling and only 18% reported working on units where means restriction counseling was standard practice (Grossman, Dontes, Kruesi, Pennington, & Fendrich, 2003). A survey of social workers showed that only 22% believed that means restriction counseling was important (Slovak et al., 2008). "
[Show abstract][Hide abstract]ABSTRACT: The restriction of potentially lethal means during periods of high risk has been identified as one of the more promising suicide prevention strategies. The purpose of this paper is to introduce clinicians to means restriction counseling and to describe a Motivational Interviewing (MI) based approach for use with ambivalent or challenging patients. This paper examines empirical support behind legislative efforts for means restriction along with the limitations. It explains the need for means restriction counseling with adults and requisite challenges. For patients who are reluctant, it describes an MI-based approach to means restriction counseling and provides a case example. By the end of the paper, readers should be aware of the potential importance of means restriction counseling and the possible use of an MI-based approach with challenging patients. Means restriction counseling is a promising clinical intervention for suicidal patients and research on MI-based and other approaches is sorely needed.
Full-text · Article · Oct 2014 · Cognitive and Behavioral Practice