Brief Training Increases Discussions between VA Providers and Veterans on Firearm Safety to Reduce Suicide
An important risk factor in Veterans’ suicide rates is firearms ownership. Having firearms in the home is strongly correlated with suicide by firearms, and firearms carry the highest mortality rate among the most common means for attempting suicide. Other countries have successfully reduced suicide rates through lethal means restriction, but such measures are not as effective in the US; therefore, there is a need to focus on firearm safety rather than restriction. Firearm safety, as an approach/intervention, does not focus on banning lethal means; rather, it involves making firearms less accessible to individuals, whether by using a gun safe or storing firearms outside the home. The suicidal crisis is typically brief, with some who attempted suicide reporting less than 10 minutes between the first thought of suicide and the attempt, indicating that delays in this time period can save lives. This study evaluated the impact of a one-hour educational seminar for clinicians on lethal means safety. “A Public Health Approach to Talking About Firearms and Death by Suicide” was offered by the South Central Mental Illness Research, Education, Clinical Center (MIRECC) as a virtual Community-Based Outpatient Clinic Mental Health Grand Rounds session. The first evaluation of this virtual session was completed by 190 VA clinicians, including social workers (53%), psychologists (24%), nurses (8%), physicians (5%), and counselors (1%). All participants also were invited to participate in a four-month evaluation on the impact of the training on their practice, which was completed by 70 participants.
- This webinar was effective in providing clinicians with the skills to talk with Veterans about firearm safety, and it continued to impact their practice four months after training.
- After the training, participants reported that they felt that it was very important to speak to all Veterans about firearm safety and believed that harm reduction was important in reducing death by suicide. Importantly, they felt more confident in their ability to have the discussion after the webinar.
- In the four-month evaluation, participants responded that they had been successful with speaking with Veterans about firearm safety, with 71% percent of respondents reporting being moderately to very successful. On average, clinicians asked more than half of Veterans they had treated about firearm safety.
- Clinicians felt it was important to let others know that Veterans were open to talking about firearm safety. One clinician stated, “Veterans are very open to talking about [firearm safety] when it is approached in a non-judgmental way.”
- Results indicate that brief educational experiences can empower clinicians to discuss difficult topics such as firearm safety with Veterans – and that these discussions have the potential to reduce the rate of suicide by firearms among Veterans. The webinar is available for free here.
This study was partly funded by HSR&D. Drs. Bryan and Asghar-Ali are part of HSR&D’s Center for Innovations in Quality, Effectiveness and Safety (IQuESt) in Houston, TX.
Bryan J, Chen R, Moon A, and Asghar-Ali A. A High-Need, High-Impact Educational Session on Firearms and Death by Suicide. Suicide and Life-Threatening Behavior. July 1, 2021. Online ahead of print.