Originally published on February 25, 2019 at the Education Development Center.
Limiting access to lethal means—such as medications and firearms—is an effective way to save the life of someone who is experiencing an acute suicidal crisis. However, according to research from EDC’s Zero Suicide Institute, an estimated 90 percent of clinicians have not been trained in lethal means counseling and may need additional training on how to talk to patients about these issues.
In response to this need, the Suicide Prevention Resource Center (SPRC) at EDC recently released an updated version of its popular Counseling on Access to Lethal Means (CALM) online course. Designed for mental health clinicians, the two-hour course offers strategies for talking to patients about their access to firearms and lethal medications and working with them to develop strategies for staying safe during an acute suicidal crisis.
“These topics can be very sensitive, and this course gives clinicians the words and the context to have those conversations,” says Elly Stout, director of SPRC.
The updated course includes current data on suicide methods and updated recommendations for clinical practice. It also contains a number of case studies to help mental health professionals navigate common, yet sometimes challenging, situations, such as counseling a patient at risk for suicide who owns a firearm or talking to gun owners about how to help a friend or loved one stay safe when they have suicidal thoughts.
Erin Cope, a crisis response therapist in Oregon who took the online CALM course, recounts receiving a call from a young man who expressed that he was feeling suicidal. Guided by the CALM training, Cope asked the man about his access to guns, and when she learned that he owned one, kept talking to him until she was able to convince him to come into her office. Then she worked with his family to create a safety plan that limited his access to firearms until he was feeling better.
“[The course] reminded me just how important it is to ask about access to firearms,” Cope says.
Half of all suicide deaths are caused by gunshot wounds, and suicide attempts with firearms are usually fatal. But research has also found that 90 percent of people who survive a suicide attempt do not eventually die by suicide. Temporarily removing lethal means, then, may be the difference between a patient dying by suicide and making it through an acute suicidal crisis alive.
To date, 44,000 clinicians across the United States have received training through the online CALM course. Stout says that the way clinicians introduce the idea of temporarily reducing access to firearms or medications may be the difference between confrontation and collaboration.
“A discussion about firearms can be tricky, and it is important to not be judgmental and to frame these conversations around patient safety,” she says. “Safety is something everyone can agree on.”
Learn more or enroll in the online Counseling on Access to Lethal Means course. While this course is primarily designed for mental health professionals, others who work with people at risk for suicide, such as health care providers and social service professionals, may also benefit.
If you or someone you know is experiencing signs of distress, please reach out to a mental health professional or get confidential, free support and text LOOKUP to 494949 or chat online here.
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