Turning a psychiatric crisis into a chance to prevent gunshot wounds


Newswise – A new effort to reduce the risk of firearm injury by providing free gun locks and educational resources to people receiving care for a mental health crisis is now underway at Michigan Medicine.

Initially, the effort is focused on patients at the University of Michigan Health Psychiatric Emergency Department and their accompanying loved ones, who can now take home free padlocks to protect guns in their homes, as well as educational material on safe storage.

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

Free screening and padlocks for people in mental health crisis

The UM care team has recently stepped up efforts to ask all psychiatric emergency patients, or their parents or guardians of patients under 18, about the presence of firearms in their homes and the how these firearms and ammunition are stored.

Even if a patient or family does not need a lock or declines the offer, psychiatric emergency staff provide information on the benefits of safe storage practices.

SEE ALSO: Most school shooters get their guns at 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 based at 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.

“We’ve asked questions about firearms at home as part of our routine intake questions for years, but this expanded gun screening, education and lockout program pushes our effort forward. prevention at the next level,” said John Kettley, LMSW, the chief social worker for psychiatric emergency services in the psychiatry department. “We hope other mental health, emergency and primary care providers will consider adding detailed screening and education to their patients, regardless of their diagnosis.”

He notes that gun locks are also available free to the community at many law enforcement agencies and at low cost at many retailers.

Taking prevention to the next level

Victor Hong, MD, medical director of psychiatric emergency services, notes that psychiatric emergency providers are increasingly seeing the importance of using the crisis that brings a child, adolescent, or adult into their care as a “teachable time”.

“If someone has chosen to have firearms in their home and does not protect them, they need to understand what this means for the risk of suicide and injury, whether intentional or not, for everyone who lives there or visits them. “, did he declare. “A locked gun, with the key and ammunition stored separately, can make the difference in the heat of battle.”

All psychiatric emergency service personnel have also received specialized training called Counseling on Access to Lethal Means. It is available free of charge to anyone involved in patient care or outreach, to help them identify and counsel those at risk.

Disseminating best practices in suicide prevention strategies in Michigan emergency departments is one component of the Michigan Youth Suicide Prevention SAMHSA Grant.

“We hope other mental health, emergency and primary care providers will consider adding detailed screening and education to 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 UM’s Department of Psychiatry.

“It’s wonderful to see the generosity of our Michigan Medicine team sharing their expertise with other emergency departments across the state while taking advantage of 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 information technology experts to create a new electronic health record screening tool to integrate into the admissions process when a patient arrives for medical care. psychiatric emergency.

The wording of the screening tool was informed by firearms and suicide researchers who belong to the Consortium for Child and Teen Gun Safety, FACTS for short, a nationally funded research effort by the federal government based at UM.

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

The team also created a publicly available pamphlet on specific steps to reduce the risk of suicide at home by removing or locking up potentially deadly means. It is adapted from one created by the Oakland Community Health Network.

Another resource developed as part of this effort is a pamphlet that includes information on other safe storage options for firearms, which is available on the UM Injury Prevention Center website.

Plans for safer storage

The Psychiatric Emergency Team is working to launch an additional program to allow patients or families of patients to voluntarily have their firearms stored away from home in law enforcement safes.

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

“Creating partnerships between law enforcement, mental health agencies and providers who work together toward a common goal of reducing the harm caused by intentional and unintentional firearm discharges is a huge benefit to the overall health of our community,” said Brian Uridge, deputy director of UM. security and director of security for Michigan Medicine.

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

Household advice without risk of suicide

  • Fire arms : Remove firearms from the household if anyone in the household has expressed suicidal thoughts or attempted suicide or has a mental health issue. Ask a trusted friend or family member to hold them temporarily. If firearms cannot be removed from the house, lock them securely and their ammunition separately.

  • Medications : Follow the MEDS method: Keep track: Keep track of the number of pills in each prescription bottle or box and don’t keep lethal doses at home. Educate yourself: Educate yourself and your family members about the dangers of prescription drug abuse. Dispose: Dispose of drugs safely to avoid drug abuse and environmental pollution. Secure: Store medications, both prescription and over-the-counter, in a safe and secure place, such as a locked cabinet or private bathroom.

  • Other materials: Talk to children and teens about alcohol and drug use as a major risk factor for suicide. Lock up common household products and potentially harmful poisons.

  • Provide support: Know the suicide warning sign. Create a safe, non-judgmental environment when talking about difficult issues. If you notice significant changes, ask them directly if they are thinking about suicide. Asking does not increase the risk of a suicide attempt. Don’t be afraid to ask for help when needed.

When and how to get help

Dial 911 if:

  • A suicide attempt has been committed.

  • A weapon is present during a suicidal crisis.

  • The person is out of control or your safety is at risk.

Take immediate action and call a local crisis line or psychiatric hotline if someone:

  • Seriously threatens to commit suicide.

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

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

  • Donate his possessions.

  • Exhibits unusual behavior such as: Depression/hopelessness; Withdrawal from family or friends; rage, anger or desire for revenge; Anxiety, restlessness or irregular sleep; Reckless or risky behavior; Dramatic mood swings; Excessive consumption of alcohol or drugs; Expressions of having no reason to live or having no purpose.

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

Grant information: Transforming Youth Suicide Prevention in Michigan, 5H79SM082148-02.

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