Veterans Open to Discussing Firearms Storage Safety in Primary Care Setting if Topic is Approached Appropriately
Veterans are significantly more likely to use firearms as a means of suicide than the general population, and reducing access to such lethal means is one of the few empirically supported approaches for lowering suicide rates. VA is investing in efforts to move suicide prevention efforts “upstream” – to populations not necessarily viewed as high risk. As one upstream approach, primary care teams could encourage patients to take steps to improve household safety and reduce risk for suicide by putting distance between their firearms and themselves, particularly during times of emotional distress. This quality improvement project – part of a larger study to develop a training program on firearms storage safety (FSS) for VA primary care teams – describes Veterans’ perspectives on discussing FSS during primary care visits. In late 2018 and early 2019, investigators conducted focus groups and interviews with 68 Veterans to assess acceptance of FSS discussions during primary care visits, identify facilitators and barriers to conducting FSS discussions, and identify strategies for primary care teams to use to effectively conduct these discussions with Veterans.
- Most Veterans agreed that primary care is an acceptable setting for FSS discussions, but staff need to build rapport and trust by using a personal, caring, and non-judgmental approach.
- Veterans noted concerns about the legal consequences of disclosing firearm ownership and most did not support direct questioning about this, e.g., “Do you own a firearm?,” which may trigger fears of having firearms being taken away or limitations being placed on access to firearms.
- Veterans also noted the need to provide a clear reason for why a discussion on FSS was happening, such as promoting mental health or concern for household safety and wellbeing.
- Discussing FSS with Veterans in primary care settings is a promising upstream approach that can complement other suicide prevention efforts but must be conducted in a Veteran-centric manner.
- This study relied solely on qualitative interviews. Because investigators were unable to draw definitive conclusions, findings should be used as a starting point for more deductive exploration.
- Study participants lived in a large West coast urban area (Portland, OR), which may not reflect perspectives of Veterans residing in rural locations or in other parts of the country.
This project was funded by the Office of Mental Health and Suicide Prevention. Drs. Dobscha, Clark, and Newell are part of HSR&D’s Center to Improve Veteran Involvement in Care (CIVIC), Portland, OR.
Dobscha S, Clark K, Newell S, et al. Strategies for Discussing Firearms Storage Safety in Primary Care: Veteran Perspectives. Journal of General Internal Medicine. January 26, 2021; online ahead of print.