Reduce Access to Means

​Reduce access to means of suicide

• One important way to reduce the risk of death by suicide is to prevent individuals in suicidal crisis from obtaining and using lethal methods of self-harm.
• Examples of actions to reduce access to lethal means include educating the families of those in crisis about safely storing medications and firearms, distributing gun safety locks, changing medication packaging, and installing barriers on bridges.

Provider actions

• Understand that lethal means are objects (e.g., medications, inhalants, firearms, sharp instruments, bridges, tall buildings, motor vehicles) that can be used to inflict self-directed violence.
• Share - Lethal Means Safety (LMS) is an intentional, voluntary practice to reduce one’s suicide risk by limiting access to those lethal means.
• Share statistics - 90% of the national and Veteran population who attempted suicide using a firearm will actually die from that result.
• 5% of the combined mortality of all other suicide attempts nationally result in death.
• The suicide risk factors between those who do and do not live with firearms are essentially the same. Access to a firearm and the lethality of the firearm is what make the difference.
• Suicidal crisis is often very brief - about 25% of survivors said that they decided to harm themselves and acted within five minutes.
• Any action that can put time and distance between someone in crisis and seriously thinking of self-harm is key to helping the person survive the immediate crisis.
• Complete a risk assessment,  Patient Health Questionnaire-9 (PHQ-9), Columbia-Suicide Severity Rating Scale (C-SSRS), and Comprehensive Suicide Risk evaluation (CSRE).
• Provide education on current programs to reduce access such as distribution of gun locks, limiting medications in packages, erecting barriers at bridges/high risk-areas, removing items that can be used such as ligatures, and creating partnerships with other organizations such as organizations that support gun ownership.

Actions in practice

• The Myth: A common myth in suicide prevention is that individuals who want to die will always find a way to do so.
• The Facts: This is not the case. Increasing the time and distance between someone with suicidal intent and lethal means can reduce suicide risk.
  
• Counseling to Reduce Access to Lethal Means (CALM):
  
• Online modules for primary care providers, addressing communication skills with patients who are difficult to engage around firearm safety; brochure for patients and providers, research brief. 
• Firearm safety suicide prevention.