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Firearm access assessed in only half of suicidal patients in ED

Many individuals who presented to the ED with suicidal ideation or attempts did not have a documented assessment for home access to lethal means, according to recent findings.

“We asked the patients about their access to firearms and then reviewed their charts,” Marian E. Betz, MD, MPH, of the University of Colorado School of Medicine, Aurora, said in a press release. “We found in about 50% of cases there is no documentation by the doctor that anyone asked the patients about firearms access. That means there is a large group of patients we are missing a chance to intervene for.”

To assess home firearm access and ED provider assessment of access to lethal means, researchers analyzed data from the Emergency Department Safety Assessment and Follow-up Evaluation, a three-phase study of 1,358 adults in the ED due to suicidal ideation or attempts. The study was conducted in eight centers from 2010 to 2013.

Overall, 11% of study participants reported at least one firearm at home. These rates varied from 6% to 26% across sites but not over time.

Chart review indicated 50% of participants had documentation of a lethal means access assessment.

Documented assessment increased over the study period, from 40% to 60% (P < .001), but was not associated with state firearm ownership rates.

Fifty-five percent of participants discharged to home had no documentation of lethal means assessment. Of these, 13% had at least one firearm at home.

Among participants who reported having at least one firearm at home to study staff, 50% (95% CI, 42-59) had provider documentation of lethal means assessment.

“This rate of assessment falls short of national guidelines recommending that all suicidal patients receive counseling about reducing access to firearms and other lethal means,” Betz said in the release. “Lethal means assessment is important for both overall risk assessment and for safety planning for patients being discharged.” – by Amanda Oldt

Disclosure: The study was funded by the NIMH. Please see the full study for a list of all authors’ relevant financial disclosures.