Comparison of Lethal Means Counseling and an Active Control Condition, With and Without Provision of Gun Locks
Condition: Intentional Self-Harm by Other Specified Means
MeSH terms: Self-Injurious Behavior
Study type: Interventional

Summary: 
      In 2013, the National Guard reported a suicide rate that was substantially higher than both
      the general population and the active duty component of the United States military. The
      prototypical National Guard suicide decedent appears to be a young male firearm owner not
      currently deployed who dies using his own gun. Prior research within the military has
      revealed that soldiers are unlikely to seek out or engage in mental health services. In sum,
      current best practices in suicide risk assessment are poorly equipped to identify the
      individuals most likely to die by suicide. This study aims to examine the acceptability,
      feasibility, and utility of a single lethal means counseling session as part of a suicide
      prevention approach targeting demographic groups overrepresented in National Guard firearm
      suicides. 232 firearm-owning National Guard personnel will be randomized to one of four
      conditions, each of which requires a single 15-25 minute session: (1) lethal means counseling
      (2) lethal means counseling plus the provision of free gun locks (3) health and stress
      control condition (4) health and stress control condition plus the provision of free gun
      locks. The investigators anticipate that those who receive lethal means counseling will
      subsequently store their personal firearms more safely and report being more willing to store
      their firearms away from the home during any hypothetical future suicidal crisis. The
      overarching goal of each hypothesis is to examine the extent to which gun owning young male
      National Guard personnel at varying levels of suicide risk are willing to engage in means
      safety.
    

Detailed description: 
      In 2013, the National Guard reported a suicide rate that was substantially higher than both
      the general population and the active duty component of the United States military. The
      prototypical National Guard suicide decedent appears to be a young male firearm owner not
      currently deployed who dies using his own gun. Prior research within the military has
      revealed that soldiers are unlikely to seek out or engage in mental health services. In sum,
      current best practices in suicide risk assessment are poorly equipped to identify the
      individuals most likely to die by suicide. This study aims to examine the acceptability,
      feasibility, and utility of a single lethal means counseling session as part of a suicide
      prevention approach targeting demographic groups overrepresented in National Guard firearm
      suicides. The study will utilize a 2x2 Factorial Design: Intervention (Lethal Means
      Counseling, Health and Stress Control) X Gun-Lock (Provided, Not Provided). Participants will
      be 232 firearm owning National Guard personnel. Lethal Means Counseling comprises education
      on risk factors for suicide, information on preventative resources, and encouragement to
      store guns safely and to temporarily remove guns during high risk periods. The Health and
      Stress Program is designed to control for effects of general mental and physical health
      education in the active condition. Each condition utilizes a motivational interviewing
      framework. The overarching goal of each hypothesis is to examine the extent to which gun
      owning young male National Guard personnel at varying levels of suicide risk are willing to
      engage in safety planning and find means safety approaches acceptable
    

Intervention name(s): Lethal Means Counseling; Health and Stress Reduction
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Single session motivational interviewing based interaction aimed to increase the safe storage of firearms in an effort to reduce suicide risk.; Single session motivational interviewing based interaction aimed to reduce vulnerability to negative outcomes across four domains: sleep, diet, exercise, and stress.
Allocation: Randomized
Intervention model: Factorial Assignment
Intervention model description: 2 (Lethal Means Counseling vs Health and Stress Reduction) x 2 (Provision of free gun locks vs No gun locks)
Masking: Single (Participant)
Primary purpose: Prevention
Keywords: Firearms; Guns; Suicide; Means Safety; Means Restriction; Lethal Means Counseling