Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality
Introduction: A youth’s emergency department (ED) visit for suicidal behaviors or ideation provides an opportunity to counsel families about securing medications and firearms (i.e., lethal means counseling). Methods: In this quality improvement project drawing on the Counseling on Access to Letha...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2016-01-01
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| Series: | Western Journal of Emergency Medicine |
| Subjects: | |
| Online Access: | http://escholarship.org/uc/item/0td33354 |
| _version_ | 1818540968436039680 |
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| author | Carol W. Runyan, MPH, PhD Amy Becker, MD Sara Brandspigel, MPH Catherine Barber, MPA Aimee Trudeau, MPH Douglas Novins, MD |
| author_facet | Carol W. Runyan, MPH, PhD Amy Becker, MD Sara Brandspigel, MPH Catherine Barber, MPA Aimee Trudeau, MPH Douglas Novins, MD |
| author_sort | Carol W. Runyan, MPH, PhD |
| collection | DOAJ |
| description | Introduction: A youth’s emergency department (ED) visit for suicidal behaviors or ideation provides an opportunity to counsel families about securing medications and firearms (i.e., lethal means counseling).
Methods: In this quality improvement project drawing on the Counseling on Access to Lethal Means (CALM) model, we trained 16 psychiatric emergency clinicians to provide lethal means counseling with parents of patients under age 18 receiving care for suicidality and discharged home from a large children’s hospital. Through chart reviews and follow-up interviews of parents who received the counseling, we examined what parents recalled, their reactions to the counseling session, and actions taken after discharge.
Results: Between March and July 2014, staff counseled 209 of the 236 (89%) parents of eligible patients. We conducted follow-up interviews with 114 parents, or 55% of those receiving the intervention; 48% of those eligible. Parents had favorable impressions of the counseling and good recall of the main messages. Among the parents contacted at follow up, 76% reported all medications in the home were locked as compared to fewer than 10% at the time of the visit. All who had indicated there were guns in the home at the time of the visit reported at follow up that all were currently locked, compared to 67% reporting this at the time of the visit.
Conclusion: Though a small project in just one hospital, our findings demonstrate the feasibility of adding a counseling protocol to the discharge process within a pediatric psychiatric emergency service. Our positive findings suggest that further study, including a randomized control trial in more facilities, is warranted. |
| first_indexed | 2024-12-11T22:02:22Z |
| format | Article |
| id | doaj.art-5753282d4a1f4f2b96ff2ed54fa5f4c8 |
| institution | Directory Open Access Journal |
| issn | 1936-900X 1936-9018 |
| language | English |
| last_indexed | 2024-12-11T22:02:22Z |
| publishDate | 2016-01-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Western Journal of Emergency Medicine |
| spelling | doaj.art-5753282d4a1f4f2b96ff2ed54fa5f4c82022-12-22T00:49:04ZengeScholarship Publishing, University of CaliforniaWestern Journal of Emergency Medicine1936-900X1936-90182016-01-0117181110.5811/westjem.2015.11.28590Lethal Means Counseling for Parents of Youth Seeking Emergency Care for SuicidalityCarol W. Runyan, MPH, PhD0Amy Becker, MD1Sara Brandspigel, MPH2Catherine Barber, MPA3Aimee Trudeau, MPH4Douglas Novins, MD5Colorado School of Public Health, Departments of Epidemiology and of Community and Behavioral Health, Program for Injury Prevention, Education and Research, Aurora, ColoradoUniversity of Colorado School of Medicine, Department of Psychiatry, Aurora, ColoradoColorado School of Public Health, Program for Injury Prevention, Education and Research, Aurora, ColoradoHarvard University, Harvard T. H. Chan School of Public Health, Boston, MassachusettsColorado Department of Public Health, Denver, ColoradoUniversity of Colorado School of Medicine, Department of Psychiatry, Aurora, ColoradoIntroduction: A youth’s emergency department (ED) visit for suicidal behaviors or ideation provides an opportunity to counsel families about securing medications and firearms (i.e., lethal means counseling). Methods: In this quality improvement project drawing on the Counseling on Access to Lethal Means (CALM) model, we trained 16 psychiatric emergency clinicians to provide lethal means counseling with parents of patients under age 18 receiving care for suicidality and discharged home from a large children’s hospital. Through chart reviews and follow-up interviews of parents who received the counseling, we examined what parents recalled, their reactions to the counseling session, and actions taken after discharge. Results: Between March and July 2014, staff counseled 209 of the 236 (89%) parents of eligible patients. We conducted follow-up interviews with 114 parents, or 55% of those receiving the intervention; 48% of those eligible. Parents had favorable impressions of the counseling and good recall of the main messages. Among the parents contacted at follow up, 76% reported all medications in the home were locked as compared to fewer than 10% at the time of the visit. All who had indicated there were guns in the home at the time of the visit reported at follow up that all were currently locked, compared to 67% reporting this at the time of the visit. Conclusion: Though a small project in just one hospital, our findings demonstrate the feasibility of adding a counseling protocol to the discharge process within a pediatric psychiatric emergency service. Our positive findings suggest that further study, including a randomized control trial in more facilities, is warranted.http://escholarship.org/uc/item/0td33354SuicidePreventionEmergency CareLethal Means |
| spellingShingle | Carol W. Runyan, MPH, PhD Amy Becker, MD Sara Brandspigel, MPH Catherine Barber, MPA Aimee Trudeau, MPH Douglas Novins, MD Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality Western Journal of Emergency Medicine Suicide Prevention Emergency Care Lethal Means |
| title | Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality |
| title_full | Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality |
| title_fullStr | Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality |
| title_full_unstemmed | Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality |
| title_short | Lethal Means Counseling for Parents of Youth Seeking Emergency Care for Suicidality |
| title_sort | lethal means counseling for parents of youth seeking emergency care for suicidality |
| topic | Suicide Prevention Emergency Care Lethal Means |
| url | http://escholarship.org/uc/item/0td33354 |
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