This work was orally presented at the 2012 American Public Health Association Annual Meeting (October 2012).
Prevention and Treatment
LETHAL MEANS RESTRICTION FOR SUICIDE PREVENTION: BELIEFS AND BEHAVIORS OF EMERGENCY DEPARTMENT PROVIDERS
Article first published online: 14 MAR 2013
© 2013 Wiley Periodicals, Inc.
Depression and Anxiety
Volume 30, Issue 10, pages 1013–1020, October 2013
How to Cite
Betz, M. E., Miller, M., Barber, C., Miller, I., Sullivan, A. F., Camargo, C. A., Boudreaux, E. D. and on behalf of the ED-SAFE Investigators (2013), LETHAL MEANS RESTRICTION FOR SUICIDE PREVENTION: BELIEFS AND BEHAVIORS OF EMERGENCY DEPARTMENT PROVIDERS. Depress. Anxiety, 30: 1013–1020. doi: 10.1002/da.22075
Contract grant sponsor: National Institute of Mental Health; Contract grant number: U01MH088278; Contract grant sponsor: American Foundation for Suicide Prevention; Contract grant sponsor: Joyce and Bohnett Foundations.
- Issue published online: 7 OCT 2013
- Article first published online: 14 MAR 2013
- Manuscript Accepted: 21 JAN 2013
- Manuscript Revised: 27 DEC 2012
- Manuscript Received: 23 OCT 2012
- National Institute of Mental Health. Grant Number: U01MH088278
- American Foundation for Suicide Prevention
- Joyce and Bohnett Foundations
- hospital care;
- emergency psychiatry;
We sought to examine the beliefs and behaviors of emergency department (ED) providers related to preventing suicide by reducing suicidal patients’ access to lethal methods (means restriction) and identify characteristics associated with asking patients about firearm access.
Physicians and nurses at eight EDs completed a confidential, voluntary survey.
The response rate was 79% (n = 631); 57% of respondents were females and 49% were nurses. Less than half believed, “most” or “all” suicides are preventable. More nurses (67%) than physicians (44%) thought “most” or “all” firearm suicide decedents would have died by another method had a firearm been unavailable (P < .001). The proportion of providers who reported they “almost always” ask suicidal patients about firearm access varied across five patient scenarios: suicidal with firearm suicide plan (64%), suicidal with no suicide plan (22%), suicidal with nonfirearm plan (21%), suicidal in past month but not today (16%), and overdosed but no longer suicidal (9%). In multivariable logistic regression, physicians were more likely than nurses to “almost always” or “often” ask about a firearm across all five scenarios, as were older providers and those who believed their own provider type was responsible for assessing firearm access.
Many ED providers are skeptical about the preventability of suicide and the effectiveness of means restriction, and most do not assess suicidal patients’ firearm access except when a patient has a firearm suicide plan. These findings suggest the need for targeted staff education concerning means restriction for suicide prevention.