Online Program

Lethal Means Counseling in Pediatric Emergency Care

Tuesday, November 3, 2015 : 2:45 p.m. - 3:00 p.m.

Carol Runyan, MPH, PhD, Pediatric Injury Prevention, Education and Research Program, Colorado School of Public Health, Aurora, CO
Sara Brandspigel, MPH, Pediatric Injury Prevention, Education and Research Program, Colorado School of Public Health, Aurora, CO
Amy Becker, MD, Psychiatry, U. of Colorao School of Medicine, Aurora
Catherine Barber, MS, School of Public Health, Harvard University, Boston, MA
Jarrod Hindman, MS, Colorado Department of Public Health and Environment, Denver, CO

Douglas Novins, Professor, University of Colorado School of Medicine, Aurora, CO
Background:  Youth suicide is a major public health issue in the Rocky Mountain region and the emergency department (ED) is a potentially important point of intervention.

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

Learning Objectives:
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

Presenting author's disclosure statement:

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.

Back to: 4327.0: Suicide Prevention