Lethal Means Counseling in Pediatric Emergency Care
Methods: Using an online adaptation of the Counseling on Access to Lethal Means (CALM) model, we trained behavioral health providers in a large pediatric emergency department to counsel parents of suicidal youth at discharge and to provided lockboxes. We queried providers about implementation issues and interviewed parents after the visit.
Results: Sixteen clinicians completed training and, during the study period, saw 236 patients with suicidal ideation or behaviors; 114 parents participated in follow-up interviews. Chart reviews indicated 89% of 236 eligible families received the counseling and most accepted the free lockbox. Among the 114 parents we interviewed, 93% remembered the clinician talking about medication storage and 79% of the 33 families who reported having guns remembered counseling about gun storage. Both parents and clinicians found the intervention helpful. At follow-up, parents reported unlocked medication storage had dropped from 86% to 23%; all 33 parents who reported having guns indicated that, after means restriction counseling, their guns were either no longer stored at home or were locked.
Discussion: This intervention proved viable for implementation in this ED and appeared to favorably influence parent behavior. Wider testing in more facilities is important.
Learning Areas:Planning of health education strategies, interventions, and programs
Describe a quality improvement project for suicide prevention in a pediatric emergency department. Explain the results of a formative evaluation of the intervention.
Keyword(s): Suicide, Adolescents
Qualified on the content I am responsible for because: I am a public health professional with experience on multiple studies related to suicide, youth violence, and injury prevention. I led the data analysis for the submitted abstract on means restriction counseling for parents of suicidal adolescents.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.