Relative to control, both lethal means counseling and provision of cable locks resulted in greater adoption of storage methods at six month follow-up; cable locks resulted in greater adoption at three months. The combination of counseling and cable locks did not outperform either strategy alone.
Strikingly, firearm suicides account for approximately half of all suicide deaths each year in the United States (U.S.). Certain segments of the U.S. population, such as military service members, demonstrate firearm suicide rates higher than that of the general population. One approach that clinicians use to mitigate risk of firearm suicide is lethal means safety counseling. Lethal means safety counseling refers to discussions between clinicians and their patients regarding ways to decrease access to firearms during at-risk periods, such as through storing a firearm unloaded and locked. Although lethal means safety counseling is considered a best practice for firearm suicide prevention (and suicide prevention more broadly), research on its acceptability and utility is remarkably underdeveloped.
Michael Anestis, Ph.D., Associate Professor of Psychology at the University of Southern Mississippi (USM), is about to change that through a study funded by the Department of Defense (DoD), through the Military Suicide Research Consortium (MSRC). Anestis and his colleagues recently launched a randomized clinical trial (RCT) of Project Safe Guard. Project Safe Guard is testing the acceptability and utility of multiple approaches to lethal means safety counseling among National Guard personnel. This study, Anestis says, will provide first-ever data regarding firearm lethal means safety counseling among U.S. military service members.
Participants for this study will include National Guard personnel, a group with a suicide rate that is substantially higher than both the general population and the active duty component of the U.S. military. The prototypical National Guard suicide decedent appears to be a young male firearm owner not currently deployed who dies using his own gun. Thus, testing lethal means safety counseling among this at-risk group prior to the onset of suicidal symptoms may present rich opportunities for suicide prevention. A preventative approach to firearm suicide prevention, Anestis says, is immensely important to thwart the trajectory toward suicide.
The actual ingredients of Project Safe Guard are quite simple, yet powerful. National Guard personnel will be randomly assigned to one of four groups. In the first group, participants will receive a 20-minute counseling session regarding firearm safety and also receive cable locks to secure each of their firearms. In the second group, participants will receive a 20-minute counseling session covering general physical/mental health education (e.g., sleep, diet); this group will also receive cable locks to secure each of their firearms. The third and fourth groups will receive the same 20-minute counseling sessions regarding firearm safety and general physical/mental health, respectively, but neither of these groups will receive cables locks to secure their firearms. In this regard, Anestis and his team will be able to examine (1) whether firearm lethal means safety counseling works; and (2) if it works because its recipients received firearm cable locks to facilitate safekeeping. Participants in this study will be followed up for 6 months to determine the extent to which each group changes their firearm storage practices.
Study results, Anestis says, will help inform future directions for firearm suicide prevention within the U.S. military. Although lethal means safety counseling is generally delivered by a clinician, Anestis also recognizes that research shows military service members underutilize mental health resources. Thus, non-traditional approaches to the delivery of lethal means safety counseling may be needed. Accordingly, moving forward, Anestis envisions testing Project Safe Guard within a peer-to-peer frameworkâservice members helping fellow service members to increase firearm safety practices as a way to decrease suicide risk.