MIRECC / CoE
18: Lethal Means Safety
Other Management Modalities » opulation & Community-based Interventions
18: Lethal Means Safety
We suggest reducing access to lethal means to decrease suicide rates at the population level.
Grades and Definitions
- Strong for
- or "We recommend offering this option …"
- Weak for
- or "We suggest offering this option …"
- No recommendation
- or "There is insufficient evidence …"
- Weak against
- or "We suggest not offering this option …"
- Strong against
- or "We recommend against offering this option …"
Categories and Definitions
|Evidence Reviewed*||Recommendation Category*||Definition*|
|Reviewed||New-added||New recommendation following review of the evidence|
|New-replaced||Recommendation from previous CPG that has been carried over to the updated CPG that has been changed following review of the evidence|
|Not changed||Recommendation from previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed but the recommendation is not changed|
|Amended||Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has been reviewed and a minor amendment has been made|
|Deleted||Recommendation from the previous CPG that has been removed based on review of the evidence|
|Not reviewed||Not changed||Recommendation from previous CPG that has been carried forward to the updated CPG, but for which the evidence has not been reviewed|
|Amended||Recommendation from the previous CPG that has been carried forward to the updated CPG where the evidence has not been reviewed and a minor amendment has been made|
|Deleted||Recommendation from the previous CPG that has been removed because it was deemed out of scope for the updated CPG|
|*Adapted from the NICE guideline manual (2012): The guidelines manual. London: National Institute for Health and Care Excellence;2012. and Martinez Garcia L, McFarlane E, Barnes S, Sanabria AJ, Alonso-Coello P, Alderson P. Updated recommendations: An assessment of NICE clinical guidelines. Implement Sci. 2014;9:72.|
Lethal means are objects (e.g., medications, firearms, sharp instruments) that can be used to inflict self-directed violence (SDV). Lethal Means Safety (LMS) is an intentional, voluntary practice to reduce one's suicide risk by limiting access to those lethal means.
This section includes links to recommended webinars about Lethal Means Safety.
- Perspectives on Firearm-Related Conversations in Clinical Settings Presented by Dr. Joseph Simonetti
- Community Prevention Progress: A Look at Governor's Challenge Efforts to Educate Communities on Lethal Means Safety Presented by Cicely Burrows-McElwain, Colonel Wanda Wright & Nicole Gore
- Partnering with Firearm Retailers to Promote Temporary Out-of-Home Firearm Storage Presented by Gala True, PhD, Caleb Morse, and Joseph Constans, PhD
This section includes links to recommended podcasts about Population & Community-based Interventions.
- Short Takes on Suicide Prevention
- Why We Need to Talk Firearm Safety When We Talk about Suicide Prevention with Dr. Michael Anestis
- Talking to Patients about Firearm Safety with Dr. Marian (Emmy) Betz
- Promoting Lethal Means Safety to Prevent Veteran Suicide with Dr. Joseph Simonetti
This section includes examples of recommended websites with Lethal Means Safety information.
- Lethal Means Safety Resources at VISN 19 MIRECC The VA Rocky Mountain MIRECC for Veteran Suicide Prevention developed a Lethal Means Safety website, which contains information regarding the evidence for LMS, tips on Lethal Means Safety Counseling, LMS recommendations, and associated resources.
- Means Matter Harvard's T.H. Chan School of Public Health developed the Means Matter website, which is another excellent source of information regarding LMS.
This section includes visual abstracts related to Lethal Means Safety.
- Firearm Safety as a Suicide Prevention Strategy Within Health Care Systems
Firearm Safety as a Suicide Prevention Strategy Within
Health care systems face several challenges in implementing firearm-related lethal means safety suicide prevention interventions
- Refining Interventions
- Risk Perceptions
- Managing Sensitive Data
Develop a comprehensive and individualized set of evidence-informed lethal means safety training materials for clinical staff
Prioritize creation and implementation of firearm safety interventions tailored to diverse clinical settings and patient-risk groups
Support research that improves understanding of firearm-related risk perceptions to inform messaging and communication strategies
Managing Sensitive Data
Establish and disseminate a plan outlining firearm-related data collection and management procedures
Develop infrastructure to facilitate stakeholder engagement to increases cultural competency and focus on patient needs
Support continued partnerships with firearm owners, gun shops, shooting ranges, and firearm advocacy organizations which could provide invaluable information for training and clinical materials
Simonetti, J., & Brenner L. (2019) Promoting firearm safety as a suicide preventions strategy within health care systems: challenges and recommendations. Psychiatry Online. https://doi.org/10.1176/appi.ps.201900286
- What are firearm storage practices among a nationally representative sample of US Veterans?
What are firearm storage practices among a nationally representative sample of US Veterans?
n=561 Veteran Firearm Owners
2015 National Firearms Survey
22.5% store all firearms unloaded & locked
33.3% store at least one firearm loaded & unlocked
Strongly Agree/Agree that taking time to load or unlock gun is no good for self-protection
Unloaded & locked: 13.7%
Loaded & unlocked: 48.5%
Simonetti e al. (2018) American Journal of Preventative Medicine dot: 10.1016/j.amepre.2018.04.014