Mental health professionals who work with adolescents should ask about access to lethal means, including firearms, when assessing their patients who are at risk of suicide, according to the authors of a clinical perspectives piece in the Journal of the American Academy of Child & Adolescent Psychiatry.
“Many adolescent suicide attempts are impulsive; completed suicides may be prevented if access to firearms is limited during periods of crisis,” wrote Apurva Bhatt, M.D., of the University of California, Davis, and colleagues. “However, many clinicians do not talk about firearms with patients even when clinically relevant. This may be due to assumptions that adolescents do not have access to firearms, or to lack of comfort with this topic.”
The authors offered several tips to help child and adolescent mental health professionals approach the topic of firearms with their patients:
Be informed and respectful. Conversations about reducing the risk of firearm suicide are more effective if they are approached with knowledge and respect for the various reasons for ownership.
Establish context, assess risk, and ask about firearms. This should be a nonjudgmental conversation wherein the mental health professional asks about whether the adolescent has access to firearms not only at home, but at the homes of friends or family members where the adolescent spends time.
Provide tailored recommendations. Once an adolescent has been identified as at risk for suicide, mental health professionals should discuss their concerns with the adolescent’s caregiver and work collaboratively to reduce the youth’s access to firearms. They can use a harm reduction approach with shared decision-making and emphasize that the goal is to keep the person at risk as safe as possible.
Follow up with continued discussions. Follow-up discussions can foster a trusting relationship about the health and safety of all family members.
“By being informed and respectful, establishing context, and providing tailored recommendations for each clinical situation, clinicians can provide this important suicide prevention intervention in their clinical practice,” the authors concluded.
For related information, see the Psychiatric Services article “Promoting Firearm Safety as a Suicide Prevention Strategy Within Health Care Systems: Challenges and Recommendations.”
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