Only half of suicidal patients who are sent to the emergency department are asked about their access to guns or other lethal weapons, according to a new study.
U.S. guidelines note that emergency department doctors are supposed to ask suicidal patients if they have access to firearms or other lethal implements. However, new research from the University of Colorado Anschutz Medical Campus reveals that only 50 percent of doctors actually ask their patients.
The latest study involved 1,358 patients from eight emergency departments in seven states. All participants had attempted suicide or were thinking about committing suicide.
"We asked the patients about their access to firearms and then reviewed their charts," said lead researcher Emmy Betz of the University of Colorado School of Medicine. "We found in about 50 percent 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."
The results revealed that 25 percent of suicidal patients who reported having guns at home had at least one gun that was loaded and unlocked. The researchers noted that half of these patients also reported having easy access to guns.
"On chart review, 50 percent of patients had documentation of lethal means access assessment. Frequency of documented assessment increased over study phases but was not associated with state firearm ownership rates. Among the 337 patients discharged to home, 55 percent had no documentation of lethal means assessment; of these, 13 percent actually had [one or more] firearm at home. Among all those reporting [one or more] home firearm to study staff, only half had provider documentation of assessment of lethal means access," the researchers wrote in the study.
"Multiple emergency department visits appear to be a risk factor for suicide and many suicide victims are seen in the emergency department shortly before death," they added. "Based on models using national suicide statistics, ED-based interventions might help decrease suicide deaths by 20 percent annually."
The research team said that the latest findings suggest that emergency department doctors need to step it up when it comes to lowering suicide rates.
"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. "Lethal means assessment is important for both overall risk assessment and for safety planning for patients being discharged."
"It is legal and appropriate to ask about this when it is relevant as it is in the case of suicide attempts or suicidal ideation," Betz explained. "Do it in a respectful, non-judgmental way and it will usually be well-received. Still, there isn't a lot of training on this. As a result, we are missing the chance to save a lot of lives."
The study was recently published in the journal Depression and Anxiety.
