Counseling on Access to Lethal Means

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"If you save a life in the short run, you likely save a life in the long run."
Dr. Matthew Miller, Harvard Injury Control Research Center (bit.ly/gunsuicidetoll)
© 2015 Unified Community Solutions. All Rights Reserved. Updated 06/05/2015.
Permission granted for non-commercial use: UCS logo and copyright must be included.
Download free at bit.ly/lethalreduce. Contact UCS at bit.ly/homeucs
REDUCING ACCESS TO LETHAL MEANS
LETHAL MEANS COUNSELING IS VITAL
• Some suicides are planned and deliberate, but many are a reaction to a
short-term crisis. Decreasing access to lethal means:
• Helps people in danger think through their options
• Makes it possible for others to intervene
• According to a study of suicide attempt survivors: For two out of three of
them, less than an hour elapsed between the decision to end their life and
the attempt; and for one in four, only five minutes elapsed.
• Studies also show that 90% or more of attempt survivors do not later die
by suicide.
• Most people who kill themselves die on their first attempt (and many have
not sought treatment for suicidal feelings).
COUNSELING TIPS
Clients’ Family and Loved Ones:
• Explain that you're concerned that their loved one is at risk for suicide.
• Ask if there are firearms at home and explain why you're asking (presence
of a gun increases the chance that a suicide attempt will be fatal).
• Ask all adults in the home (the mother, for example, may not know
whether her male partner has a firearm at home).
• Ask about all firearms (if there is one gun, there are often others).
• Ask regarding each relevant household (if, for example, parents have joint
custody, ask about both homes).
• Advocate for the safest option: Not having firearms in the home until the
situation improves.
• Encourage monitoring alcohol/drug use (to avoid increasing impulsivity)
Adult Clients:
• Review the same information as above.
• Express concerns about their safety and your wish to keep them safe.
• Ask if you can enlist help from family members or other concerned parties.
• Help the client understand that risk can escalate rapidly (because of
anger, inebriation, etc.) and not having lethal means at hand reduces
lethal outcomes in fragile or volatile situations.
• Assess client's compliance:
• Being collaborative might demonstrate a client’s desire to stay safe.
• Refusal to remove guns or medications might indicate real danger.

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REMOVAL OF LETHAL MEANS
Firearms
• Take a non-controversial stance focused on lethal-means counseling as a
way to reduce danger for people who might be die by suicide (i.e., avoid
political arguments for or against legal rights related to guns).
• Sympathize with gun owners who object to not having a firearm at home,
even temporarily. Don't minimize the tough sacrifice, but advocate for the
safest option, which is removing a suicidal person’s access to guns.
• Safe storage options include the home of a trusted friend or relative and
contacting local law enforcement (call first to learn about local laws)
• Hiding unlocked guns is insufficient (“secret” hiding places are not secure).
• Get more information from the National Shooting Sports Foundation:
• Where to get free gun locks: bit.ly/gunlockmap
• Firearm safety in the home: bit.ly/gunsinhomes
Medications
• Give clear, direct advise (and help) to clients and families to ensure that:
• Only non-lethal quantitities of meds are prescribed or purchased
(more information is available from the Poison Control Hotline 1-
300-222-1222)
• Lethal doses of medications are removed (see bit.ly/ disposemeds)
• All medications and poisons are stored in a safe, secure place
OTHER MEANS
• If a person’s thoughts about suicide inlcude the following, it is important to
remove access to them (even an at-risk person can replace them):
• Ligatures (belts, ropes, etc.)
• Razor blades, knives, and other sharp objects
• Poisons, including household products
• Vehicles (removing or monitoring access to keys, etc.)
• High places
FINAL CHECKLIST
• Document what you have advised the client and/or family.
• Follow agency policies regarding interventions to remove lethal means.
• Ask about suicidal thoughts and plans on an ongoing basis.
• Removing lethal means naturally provides opportunties to enlist partners
LEARN MORE
• Free Online Course: Counseling on Access to Lethal Means (CALM) —
training.sprc.org
• Resources & Information: Means Matter — bit.ly/meansmatter