Temporary Transfer of Firearms From the Home to Prevent Suicide

McCourt, Alexander D.; Vernick, Jon S.; Betz, Marian E.; Brandspigel, Sara; Runyan, Carol S. Wolf

doi:10.1001/jamainternmed.2016.5704

Cited by 77 publications

(46 citation statements)

References 40 publications

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“…43 Future research should examine the effectiveness of safety messages, with and without providing safety devices and also consider the effectiveness of new “extreme risk protection orders” for temporary removal of guns. 44–46 The American Medical Association recently resolved that physicians should “educate and counsel patients about firearm safety” and supported physicians having “free and open communication with their patients regarding firearm safety and the use of gun locks in their homes.” 47 A recent report provides recommendations about who should be trained and what safety counseling should include. 48 …”

Section: Discussionmentioning

confidence: 99%

Hospital Emergency Department Lethal Means Counseling for Suicidal Patients

Runyan

Brooks‐Russell

Tung

et al. 2018

American Journal of Preventive Medicine

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Introduction Lethal means counseling of suicidal individuals in emergency departments has the potential to reduce suicide. This study examines the provision of lethal means counseling and the presence of written protocols in a region with high rates of both firearm ownership and suicide. Methods In 2015–2016, emergency department nurse managers in hospital-based emergency departments throughout eight states were surveyed using an 80-item survey developed through qualitative interviews and pilot testing. Questions focused on discharge counseling with suicidal patients and the presence of written protocols. Using survey weights to adjust for nonresponse, relationships of protocols with counseling practices were examined. Results Data were obtained from 52.3% of all 363 eligible hospital emergency departments in the region. Among facilities that discharge suicidal patients, 79.7% (95% CI=75.0%, 84.4%) reported asking about access to firearms and 68.9% (95% CI=62.9%, 74.8%) counsel about safe storage when patients reported access. Forty-four percent of emergency departments reported having written protocols for lethal means counseling. Presence of written protocols was associated with a higher rate of counseling for all suicidal patients even if they were not planning to use a gun (45.0% [95% CI=33.4%, 56.7%] in hospitals with protocols vs 21.5% [95% CI=14.9%, 29.0%] in facilities without protocols). Conclusions There are significant gaps in attention to lethal means counseling in emergency departments. This signals an opportunity to increase consistency and thoroughness of care for suicidal patients in the emergency department and for leadership from key professional organizations to advocate for protocols.

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Section: Discussionmentioning

confidence: 99%

Hospital Emergency Department Lethal Means Counseling for Suicidal Patients

Runyan

Brooks‐Russell

Tung

et al. 2018

American Journal of Preventive Medicine

Self Cite

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“…The longer this process takes, the longer the patient is at risk. There are, however, exceptions to UBC laws in some states that can facilitate transfers intended to save a life [13]. Medical professionals should be aware of state laws pertaining to firearm counseling, temporary transfer, and safe storage, but they should offer anticipatory guidance when clinically appropriate.…”

Section: Resultsmentioning

confidence: 99%

“…Most states allow private transfers to occur without a background check, but 19 states and Washington, DC, have so-called universal background check (UBC) laws mandating a background check whenever a firearm is transferred, although some of these laws apply to handguns only [11]. The definition of a transfer in state laws is typically quite broad, including even gifts or other nonsale transfers [13]. While these laws make it harder for high-risk persons to acquire firearms and are therefore associated with reductions in rates of firearm suicide and other harms [14][15][16][17], they could make it more difficult for patients to temporarily transfer a firearm to reduce access to lethal means.…”

Section: Laws Restricting Temporary Firearm Transfermentioning

confidence: 99%

Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home

2018

AMA Journal of Ethics

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Firearms in the home pose a risk to household members, including homicide, suicide, and unintentional deaths. Medical societies urge clinicians to counsel patients about those risks as part of sound medical practice. Depending on the circumstances, clinicians might recommend safe firearm storage, temporary removal of the firearm from the home, or other measures. Certain state firearm laws, however, might present legal and ethical challenges for physicians who counsel patients about guns in the home. Specifically, we discuss state background check laws for gun transfers, safe gun storage laws, and laws forbidding physicians from engaging in certain firearm-related conversations with their patients. Medical professionals should be aware of these and other state gun laws but should offer anticipatory guidance when clinically appropriate.

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“…Options for storage include out-of-home storage with a family member or friend or at a range, gun shop, or other business, although state laws may dictate which of these options is legal or requires a background check [16]. In-home strategies to reduce firearm access include the use of various locking devices and disassembling the firearm.…”

Section: Counseling Patients About Firearm Safetymentioning

confidence: 99%

How Should Physicians Make Decisions about Mandatory Reporting When a Patient Might Become Violent?

Barnhorst

Wintemute²,

Betz

2018

AMA Journal of Ethics

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Mandatory reporting of persons believed to be at imminent risk for committing violence or attempting suicide can pose an ethical dilemma for physicians, who might find themselves struggling to balance various conflicting interests. Legal statutes dictate general scenarios that require mandatory reporting to supersede confidentiality requirements, but physicians must use clinical judgment to determine whether and when a particular case meets the requirement. In situations in which it is not clear whether reporting is legally required, the situation should be analyzed for its benefit to the patient and to public safety. Access to firearms can complicate these situations, as firearms are a wellestablished risk factor for violence and suicide yet also a sensitive topic about which physicians and patients might have strong personal beliefs. CaseAfter a painful breakup with his long-time girlfriend, Thomas struggled to get over feeling angry about his girlfriend's decision to end their relationship. Specifically, Thomas was unable to sleep well, despite trying numerous over-the-counter sleep aids. He decided to make an appointment with Dr.

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Temporary Transfer of Firearms From the Home to Prevent Suicide

Cited by 77 publications

References 40 publications

Hospital Emergency Department Lethal Means Counseling for Suicidal Patients

Hospital Emergency Department Lethal Means Counseling for Suicidal Patients

Law, Ethics, and Conversations between Physicians and Patients about Firearms in the Home

How Should Physicians Make Decisions about Mandatory Reporting When a Patient Might Become Violent?

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