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Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms
Objective This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home...
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| Published in: | Suicide & life-threatening behavior 2020-10, Vol.50 (5), p.1054-1064 |
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| Main Authors: | , , , , , , , , , |
| Format: | Article |
| Language: | English |
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| cited_by | cdi_FETCH-LOGICAL-c4489-96d8902764e5f86ec74cb29f8aec05219a265ce36bc46e4dc2db30508bcedf483 |
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| cites | cdi_FETCH-LOGICAL-c4489-96d8902764e5f86ec74cb29f8aec05219a265ce36bc46e4dc2db30508bcedf483 |
| container_end_page | 1064 |
| container_issue | 5 |
| container_start_page | 1054 |
| container_title | Suicide & life-threatening behavior |
| container_volume | 50 |
| creator | Diurba, Sofiya Johnson, Rachel L. Siry, Bonnie J. Knoepke, Christopher E. Suresh, Krithika Simpson, Scott A. Azrael, Deborah Ranney, Megan L. Wintemute, Garen J Betz, Marian E. |
| description | Objective
This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home.
Methods
Emergency department providers (physicians and mid‐level practitioners) and behavioral health (BH) providers at four Colorado EDs completed an anonymous, web‐based survey.
Results
Fewer ED providers (35%) than BH providers (81%) felt confident in their ability to counsel patients about lethal means (p |
| doi_str_mv | 10.1111/sltb.12649 |
| format | article |
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This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home.
Methods
Emergency department providers (physicians and mid‐level practitioners) and behavioral health (BH) providers at four Colorado EDs completed an anonymous, web‐based survey.
Results
Fewer ED providers (35%) than BH providers (81%) felt confident in their ability to counsel patients about lethal means (p < .001). In multivariable analysis, the only clinical or provider factor associated with often or almost always asking patients about firearm access was provider type, with BH providers more likely than ED providers to ask in all scenarios (OR: 5.58, 95% CI 1.68–18.6). Behaviors and attitudes about lethal means counseling did not vary by whether the provider had firearms at home. Almost all providers said that additional training and protocols about how to help patients make firearm storage decisions would be helpful.
Conclusions
Gaps in ED‐delivered lethal means counseling persist, highlighting directions for future provider education and protocol development.</description><identifier>ISSN: 0363-0234</identifier><identifier>EISSN: 1943-278X</identifier><identifier>DOI: 10.1111/sltb.12649</identifier><identifier>PMID: 32598076</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Behavior ; Colorado ; Counseling ; Departments ; Emergency Service, Hospital ; Firearms ; Humans ; Patients ; Suicidal Ideation ; Suicide - prevention & control ; Weapons</subject><ispartof>Suicide & life-threatening behavior, 2020-10, Vol.50 (5), p.1054-1064</ispartof><rights>2020 The American Association of Suicidology</rights><rights>2020 The American Association of Suicidology.</rights><rights>Copyright © 2020 The American Association of Suicidology</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4489-96d8902764e5f86ec74cb29f8aec05219a265ce36bc46e4dc2db30508bcedf483</citedby><cites>FETCH-LOGICAL-c4489-96d8902764e5f86ec74cb29f8aec05219a265ce36bc46e4dc2db30508bcedf483</cites><orcidid>0000-0003-1643-6565</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,780,784,885,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32598076$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Diurba, Sofiya</creatorcontrib><creatorcontrib>Johnson, Rachel L.</creatorcontrib><creatorcontrib>Siry, Bonnie J.</creatorcontrib><creatorcontrib>Knoepke, Christopher E.</creatorcontrib><creatorcontrib>Suresh, Krithika</creatorcontrib><creatorcontrib>Simpson, Scott A.</creatorcontrib><creatorcontrib>Azrael, Deborah</creatorcontrib><creatorcontrib>Ranney, Megan L.</creatorcontrib><creatorcontrib>Wintemute, Garen J</creatorcontrib><creatorcontrib>Betz, Marian E.</creatorcontrib><title>Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms</title><title>Suicide & life-threatening behavior</title><addtitle>Suicide Life Threat Behav</addtitle><description>Objective
This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home.
Methods
Emergency department providers (physicians and mid‐level practitioners) and behavioral health (BH) providers at four Colorado EDs completed an anonymous, web‐based survey.
Results
Fewer ED providers (35%) than BH providers (81%) felt confident in their ability to counsel patients about lethal means (p < .001). In multivariable analysis, the only clinical or provider factor associated with often or almost always asking patients about firearm access was provider type, with BH providers more likely than ED providers to ask in all scenarios (OR: 5.58, 95% CI 1.68–18.6). Behaviors and attitudes about lethal means counseling did not vary by whether the provider had firearms at home. Almost all providers said that additional training and protocols about how to help patients make firearm storage decisions would be helpful.
Conclusions
Gaps in ED‐delivered lethal means counseling persist, highlighting directions for future provider education and protocol development.</description><subject>Behavior</subject><subject>Colorado</subject><subject>Counseling</subject><subject>Departments</subject><subject>Emergency Service, Hospital</subject><subject>Firearms</subject><subject>Humans</subject><subject>Patients</subject><subject>Suicidal Ideation</subject><subject>Suicide - prevention & control</subject><subject>Weapons</subject><issn>0363-0234</issn><issn>1943-278X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kU9rFDEYh4Modq1e_AAS8CLC1PybTMaDULetFVYsuIK3kMm8s5syk6zJTGXwy5vt1qIefC-B5OHJL_kh9JySE5rnTerH5oQyKeoHaEFrwQtWqW8P0YJwyQvCuDhCT1K6JnkYIY_REWdlrUglF-jnCsat6fEnMD7h05QgpQH8iI1v8TJMPkHv_AY7j8ct4PMB4ga8nfEZ7Ewc9-hbfOa6DmLehoSbGV_FcONaiHg97-BWdAUxBZ-vuQwD4AsXwcQhPUWPOtMneHa3HqOvF-fr5WWx-vzh4_J0VVghVF3UslU1YZUUUHZKgq2EbVjdKQOWlIzWhsnSApeNFRJEa1nbcFIS1VhoO6H4MXp38O6mZoDW5szR9HoX3WDirINx-u8T77Z6E250VTFGS5IFr-4EMXyfII16cMlC3xsPYUqaCaqq_OecZ_TlP-h1mGJ--p4qGaeSlTJTrw-UjSGlCN19GEr0vlO971TfdprhF3_Gv0d_l5gBegB-uB7m_6j0l9X6_UH6C_i5roU</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Diurba, Sofiya</creator><creator>Johnson, Rachel L.</creator><creator>Siry, Bonnie J.</creator><creator>Knoepke, Christopher E.</creator><creator>Suresh, Krithika</creator><creator>Simpson, Scott A.</creator><creator>Azrael, Deborah</creator><creator>Ranney, Megan L.</creator><creator>Wintemute, Garen J</creator><creator>Betz, Marian E.</creator><general>Blackwell Publishing Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K7.</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-1643-6565</orcidid></search><sort><creationdate>202010</creationdate><title>Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms</title><author>Diurba, Sofiya ; Johnson, Rachel L. ; Siry, Bonnie J. ; Knoepke, Christopher E. ; Suresh, Krithika ; Simpson, Scott A. ; Azrael, Deborah ; Ranney, Megan L. ; Wintemute, Garen J ; Betz, Marian E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4489-96d8902764e5f86ec74cb29f8aec05219a265ce36bc46e4dc2db30508bcedf483</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Behavior</topic><topic>Colorado</topic><topic>Counseling</topic><topic>Departments</topic><topic>Emergency Service, Hospital</topic><topic>Firearms</topic><topic>Humans</topic><topic>Patients</topic><topic>Suicidal Ideation</topic><topic>Suicide - prevention & control</topic><topic>Weapons</topic><toplevel>online_resources</toplevel><creatorcontrib>Diurba, Sofiya</creatorcontrib><creatorcontrib>Johnson, Rachel L.</creatorcontrib><creatorcontrib>Siry, Bonnie J.</creatorcontrib><creatorcontrib>Knoepke, Christopher E.</creatorcontrib><creatorcontrib>Suresh, Krithika</creatorcontrib><creatorcontrib>Simpson, Scott A.</creatorcontrib><creatorcontrib>Azrael, Deborah</creatorcontrib><creatorcontrib>Ranney, Megan L.</creatorcontrib><creatorcontrib>Wintemute, Garen J</creatorcontrib><creatorcontrib>Betz, Marian E.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Suicide & life-threatening behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Diurba, Sofiya</au><au>Johnson, Rachel L.</au><au>Siry, Bonnie J.</au><au>Knoepke, Christopher E.</au><au>Suresh, Krithika</au><au>Simpson, Scott A.</au><au>Azrael, Deborah</au><au>Ranney, Megan L.</au><au>Wintemute, Garen J</au><au>Betz, Marian E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms</atitle><jtitle>Suicide & life-threatening behavior</jtitle><addtitle>Suicide Life Threat Behav</addtitle><date>2020-10</date><risdate>2020</risdate><volume>50</volume><issue>5</issue><spage>1054</spage><epage>1064</epage><pages>1054-1064</pages><issn>0363-0234</issn><eissn>1943-278X</eissn><abstract>Objective
This study examined emergency department (ED) and behavioral health (BH) provider attitudes and behaviors related to lethal means screening and counseling of patients with suicide risk, specifically examining differences by provider type and whether providers had firearms in their own home.
Methods
Emergency department providers (physicians and mid‐level practitioners) and behavioral health (BH) providers at four Colorado EDs completed an anonymous, web‐based survey.
Results
Fewer ED providers (35%) than BH providers (81%) felt confident in their ability to counsel patients about lethal means (p < .001). In multivariable analysis, the only clinical or provider factor associated with often or almost always asking patients about firearm access was provider type, with BH providers more likely than ED providers to ask in all scenarios (OR: 5.58, 95% CI 1.68–18.6). Behaviors and attitudes about lethal means counseling did not vary by whether the provider had firearms at home. Almost all providers said that additional training and protocols about how to help patients make firearm storage decisions would be helpful.
Conclusions
Gaps in ED‐delivered lethal means counseling persist, highlighting directions for future provider education and protocol development.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>32598076</pmid><doi>10.1111/sltb.12649</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-1643-6565</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0363-0234 |
| ispartof | Suicide & life-threatening behavior, 2020-10, Vol.50 (5), p.1054-1064 |
| issn | 0363-0234 1943-278X |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7722150 |
| source | Wiley |
| subjects | Behavior Colorado Counseling Departments Emergency Service, Hospital Firearms Humans Patients Suicidal Ideation Suicide - prevention & control Weapons |
| title | Lethal Means Assessment and Counseling in the Emergency Department: Differences by Provider Type and Personal Home Firearms |
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