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Study: Questions during health visits about firearm access may prevent suicides

Asking at-risk adults about firearm access may help prevent suicides, according to a new study. Photo by MikeGunner/Pixabay
Asking at-risk adults about firearm access may help prevent suicides, according to a new study. Photo by MikeGunner/Pixabay

Aug. 6 (UPI) -- Questions to patients about firearm access during routine primary care and mental health visits can help prevent suicide, according to a study published Friday by JAMA Health Forum.

For the study, those who receive care for mental health issues, either from their primary care physicians or mental health professionals, were asked to complete a standardized questionnaire that included the question, "Do you have access to guns?" according to the researchers.

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Most provided a response, creating a potential platform for providers to initiate conversations about the safe storage of firearms, particularly when patients are at risk of suicide.

The finding "helps dispel concerns by clinicians and health-system leaders that patients won't respond to firearm questions," study co-author Julie Richards told UPI in an email.

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"If people report access to firearms in combination with suicidal thoughts, then clinicians should start a dialogue with [them] about what strategies they can use to limit access to their firearms," said Richards, a research associate at Kaiser Permanente Washington Health Research Institute.

"[This means] how they can create time and distance between them and their firearm so they are less likely to use it when they might be experiencing emotional pain, [such as] temporarily storing their firearms with a family member or friend or paying for storage at a shooting facility," she said.

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One of the study co-authors, Dr. Marian E. Betz, of the University of Colorado in Denver, has developed a web-based resource called Lock2Live that is designed to help people make decisions about temporarily limiting access to potentially dangerous items, including firearms.

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Although suicide rates have declined in the United States since the start of the COVID-19 pandemic, nearly 50,000 people nationally died by suicide in 2020, the Centers for Disease Control and Prevention estimates.

Firearms are the most common -- and lethal -- method of suicide across the country, according to the agency.

A study by Richards and her colleagues published in May found that patients may choose to not disclose firearm access due to privacy concerns, among others.

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However, these issues can be mitigated by making clear the purpose of the firearm question, the study showed.

Since 2015, Kaiser Permanente-Washington has included a question about firearm access on a standard questionnaire given to all patients during visits at its outpatient mental health clinics, Richards and her colleagues said.

Currently, the health system, which has integrated some mental health services into primary care, has administered the questionnaire during all visits to clinics by adults age 18 year and older with a depression or substance use disorder diagnosis.

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Patient responses are included in their electronic health record to help guide appropriate follow-up care, the researchers said.

In the analysis of more than 128,000 patient responses collected during nearly 500,000 in-person primary care or mental health clinic visits between 2016 and 2019, most answered the question on firearm access.

Among primary care patients, 83% answered the firearm access question, with 21% reporting access, the data showed.

Among patients visiting Kaiser Permanente mental health clinics, 92% answered the question, with 15% reporting access.

Men were more likely to report access than women, as were people living in rural and suburban areas than people in urban areas, the researchers said.

Those who reported a prior-year suicide attempt had the lowest rates of firearms access, they said.

"My personal opinion is that standard questions about firearm access should be part of routine healthcare, like other questions used for injury prevention, like questions about seat-belts or bicycle helmets," Richards told UPI.

"Normalizing this practice could really help us make an impact and save lives," she said.

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