{"id":1979,"date":"2019-09-05T09:24:24","date_gmt":"2019-09-05T08:24:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/injury-prevention\/?p=1979"},"modified":"2019-09-05T09:24:24","modified_gmt":"2019-09-05T08:24:24","slug":"lock-to-live-for-firearm-safety-a-tool-for-patient-centered-injury-prevention","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/injury-prevention\/2019\/09\/05\/lock-to-live-for-firearm-safety-a-tool-for-patient-centered-injury-prevention\/","title":{"rendered":"\u201cLock to Live\u201d for firearm safety: A tool for patient-centered injury prevention"},"content":{"rendered":"

 <\/p>\n

\"\"<\/p>\n

As part of the firearms special issue, author Emmy Betz, MD, MPH (Twitter: @EmmyBetz<\/a>) has contributed this blog post that articulates with her original article “Lock to Live”: Development of a firearm storage decision aid to enhance lethal means counseling and prevent suicide<\/em><\/a><\/span><\/p>\n

 <\/p>\n

\u201cAre there usually firearms in or near your home?<\/em>\u201d This question is a critical one for individuals at risk of suicide, yet it\u2019s one that healthcare providers may feel uncomfortable asking. There is strong evidence<\/a> that access to \u201clethal means\u201d \u2013firearms, medications, hanging supplies, high bridges, etc. \u2013 can increase the likelihood that a suicide attempt will be fatal. Firearms have the highest case fatality rate of any method of suicide and are widely available in the US, but they are also a highly politicized issue. Studies<\/a> have shown that many healthcare providers don\u2019t routinely ask suicidal patients about firearms, likely in part because of the sensitivity of the topic. Providers can also be uncertain what to do if the patient says \u201cyes\u201d \u2013 what are the recommended options for reducing lethal means access during times of risk? What are the best messages<\/a> and messengers for delivering \u201clethal means counseling<\/a>\u201d on how to reduce access to firearms and other lethal means?<\/p>\n

In patient-centered healthcare<\/a>, providers partner with patients in identifying needs and health goals, and providers \u201ctreat patients not only from a clinical perspective, but also from an emotional, mental, spiritual, social, and financial perspective.\u201d Firearm safety counseling is a new realm of \u201ccultural competency<\/a>\u201d for providers, and a collaborative, empathetic, respectful approach should be the basis of patient-centered injury prevention<\/a>. There are multiple ways to reduce firearm access<\/a> in times of suicide risk, ranging from locking devices to storage with firearm retailers, and tailored counseling is more likely to be effective than a one-size-fits-all approach.<\/p>\n

But how else can we support patients in making decisions about safety? Decision aids<\/a> have been developed and used for conditions ranging from acne to weight control. By addressing decisional needs (knowledge, values clarification, understanding of options and risk and benefits of each), these tools help individuals find the decision that is right for them. This, in turn, makes behavior change more likely \u2026 suggesting that, if providers can help patients choose the firearm storage option that works best for their situation, the patients may be more likely to go home and make those changes, resulting in a lower risk of suicide death.<\/p>\n

We developed \u201cLock to Live<\/a>\u201d to fill this need. It\u2019s an online decision aid<\/a> intended to support \u2013 not replace \u2013 counseling by healthcare providers or public health professionals. It incorporates the views and perspectives of stakeholders, including firearm owners and retailers, individuals with lived experience of suicide ideation or attempts, and healthcare providers. We\u2019ve just finished a small feasibility trial and are thrilled to be working with researchers in Washington and Colorado<\/a> in larger studies.<\/p>\n

Looking forward, many questions other remain, with new ones arising daily. What\u2019s the best way to disseminate lethal means safety messages to at-risk communities, and how do those messages need to be tailored (or not) for different groups? How can we best partner with firearm retailers<\/a> and instructors? How can we influence everyday firearm storage norms and encourage engagement of friends and families, similar to successful \u201cfriends don\u2019t let friends drive drunk\u201d campaigns? To answer these \u2013 and myriad other questions \u2013 we\u2019ll need funding. Foundations like the American Foundation for Firearm Injury Reduction in Medicine (AFFIRM<\/a>), Kaiser Permanente<\/a>, the National Collaborative on Gun Violence Research<\/a> and others are a key source of current support, but what is needed is appropriate levels of federal funding through the NIH and the CDC<\/a>. There are no easy answers, but working together \u2013 and using a public health approach \u2013 we can save lives.<\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

  As part of the firearms special issue, author Emmy Betz, MD, MPH (Twitter: @EmmyBetz) has contributed this blog post that articulates with her original article “Lock to Live”: Development of a firearm storage decision aid to enhance lethal means counseling and prevent suicide   \u201cAre there usually firearms in or near your home?\u201d This […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[2731],"tags":[],"class_list":["post-1979","post","type-post","status-publish","format-standard","hentry","category-gun-violence"],"yoast_head":"\n\u201cLock to Live\u201d for firearm safety: A tool for patient-centered injury prevention - Injury Prevention: Editor's Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/injury-prevention\/2019\/09\/05\/lock-to-live-for-firearm-safety-a-tool-for-patient-centered-injury-prevention\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"\u201cLock to Live\u201d for firearm safety: A tool for patient-centered injury prevention - 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