Turning a psychiatric crisis into an opportunity to prevent gunshot injuries

Newswise – Michigan Medicine is now making a new effort to reduce the risk of firearm injuries by offering free gun locks and educational resources to people being treated for a mental health crisis.

Initially, the effort will focus on University of Michigan Health Psychiatric Emergency Department patients and their accompanying family members, who can now take home free gun locks to protect firearms in their homes, as well as training materials on safe keeping.

Research has shown that the risk of suicide or other harm is higher when firearms are not stored securely, whether someone has a mental illness or not. About half of all suicide deaths in the United States involve firearms, and 90% of firearm suicide attempts are fatal.

Screening and free gun locks for people in mental health crises

The UM nursing team recently increased efforts to ask all psychiatric emergency patients, or their parents or guardians of patients under the age of 18, about the presence of firearms in their homes and the storage of those firearms and ammunition.

Even if a patient or their family does not require a gun lock or declines the offer, the psychiatric emergency service provides information on the benefits of safekeeping practices.

SEE ALSO: Most school shooters get their guns from home – and during the pandemic, the number of guns in households with teenagers has increased

The initiative is supported in part by the Federal Substance Abuse and Mental Health Services Administration through a grant from the Michigan Department of Health and Human Services called Transforming Youth Suicide Prevention in Michigan-3. The goal is to create a model that other emergency providers can use.

“For years we have asked about firearms at home as part of our routine admissions questions, but this expanded screening, education and gun prohibition program takes our prevention efforts to the next level,” said John Kettley, LMSW, senior social worker for Psychiatric Emergency Services at the Department of Psychiatry . “We hope that other mental health, emergency care and primary care providers will consider extensively screening and educating their patients, regardless of their diagnosis.”

He points out that community gun locks are available free from many law enforcement agencies and at low cost from many retailers.

Taking prevention to the next level

Victor Hong, MD, medical director of the Emergency Mental Health Service, notes that emergency mental health providers are increasingly finding it important to use the crisis that brings a child, teen, or adult into their care as a “teachable moment.”

“If someone has chosen to have firearms in their home and is not securing them, they need to understand what that means for the risk of suicide and intentional or unintentional harm to anyone living or visiting there,” he said he. “A locked gun that keeps keys and ammo separate can make a difference in the heat of a crisis.”

All psychiatric emergency services personnel have also received special training called ‘advising on access to lethal agents’. It is available free of charge to anyone involved in patient care or education to help them identify and counsel those at risk.

Disseminating proven suicide prevention strategies in emergency departments throughout Michigan is a component of Michigan’s SAMHSA Adolescent Suicide Prevention Grant.

“We hope that other mental health, emergency care and primary care providers will consider extensively screening and educating their patients, regardless of their diagnosis.”

John Kettley, LMSW

Cynthia Ewell Foster, Ph.D., directs the Emergency Department’s Technical Assistance Center for Suicide Prevention, which includes Kettley, Hong, and other members of the UM Psychiatric Division.

“It’s wonderful to see how generously our team at Michigan Medicine is sharing their expertise with other emergency departments across the state while also taking this opportunity to improve our own care at UM,” said Ewell Foster, clinical associate professor of psychiatry.

SEE ALSO: The Power of Caring: Forming a circle of support around suicidal teens

The team worked with Michigan Medicine’s IT experts to create a new screening tool within the electronic health record to make it part of the admissions process when a patient comes to emergency mental health care.

The wording of the screening tool was determined by firearms and suicide researchers affiliated with the Firearm Safety Among Children & Teens Consortium, or FACTS for short, a government-funded national research effort based at UM.

This means the firearms screening tool could be used in other areas of care or duplicated in other healthcare systems that use the same electronic health record system as UM.

The team has also created a public-facing booklet on specific steps to reduce the risk of suicide at home by removing or confining potentially lethal agents. It is adapted from one created by the Oakland Community Health Network.

Another resource developed as part of this effort is a flyer with information on other safe firearm storage options available on the UM Injury Prevention Center website.

Plans for safer storage

The psychiatric emergency team is working to roll out an additional program that would allow patients or patient families to voluntarily store their firearms outside their homes in law enforcement vaults.

Once this program is launched, they hope to share the procedures with other mental health providers and law enforcement agencies so they can model their own safe storage programs afterward.

“Building partnerships between law enforcement agencies, mental health agencies and providers working towards a common goal of reducing the harm from intentional and accidental firearm firing is a major benefit to the overall health of our community,” said Brian Uridge, Associate Director of Public Safety for UM and Director of Safety for Michigan Medicine.

UM recently launched a Firearm Injury Prevention Institute to generate new knowledge and drive innovative solutions to reduce firearm injuries across the country. Ewell Foster and several FACTS members are members of the Institute.

Suicide-proof household tips

  • firearms: Remove firearms from the household if anyone in the household has expressed or attempted suicide or has mental health concerns. Ask a trusted friend or family member to keep them temporarily. If firearms cannot be removed from the home, securely lock them and their ammunition separately.

  • Medicines: Follow the MEDS method: Monitor: Keep track of how many pills are in each prescription bottle or pack and don’t keep lethal doses at home. Education: Educate yourself and family members about the dangers of misusing prescription drugs. Dispose of: Dispose of medicines safely to prevent drug abuse and environmental pollution. Safe: Keep prescription and over-the-counter medications in a safe place, such as a B. in a locked closet or private bathroom.

  • Other substances: Talk to children and young people about alcohol and drug use as the main risk factors for suicide. Include potentially harmful household products and toxins.

  • Offer help: Do you know the suicide warning sign? Create a safe, non-judgmental environment when discussing difficult topics. If you notice significant changes, ask them directly if they are considering suicide. Questions do not increase the likelihood of a suicide attempt. Don’t be afraid to seek help if you need it.

When and how to get help

Call 911 if:

  • A suicide attempt was made.

  • A weapon is present during a suicide crisis.

  • The person is out of control or your safety is threatened.

Act immediately and call a local crisis or psychiatric emergency number if someone:

  • Seriously threatens to kill himself.

  • Looks for a way to carry out a suicide plan.

  • Conversations about death or suicide in text messages, social media posts, etc.

  • Giving away their possessions.

  • Displays uncharacteristic behaviors such as: Depression/hopelessness; withdrawal from family or friends; anger, rage, or desire for revenge; anxiety, restlessness or trouble sleeping; Reckless or risky behavior; Dramatic mood swings; Excessive use of alcohol or drugs; Expressions without meaning to life or meaninglessness.

If you or someone you know is having a mental health crisis:

Funding information: Transformation of Adolescent Suicide Prevention in Michigan, 5H79SM082148-02.

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