Firearm Suicide Prevention in the U.S. Military: Recommendations From a National Summit

Abstract

The U.S. DoD has identified firearm suicide prevention as a key operational priority. One vital approach to addressing firearm suicides is through promoting lethal means safety, which involves the voluntary use of secure storage for personally owned firearms and/or temporarily moving firearms out of the home during risk periods. Despite promising approaches to lethal means safety, critical gaps remain in research, programming, and communication among and across scientists, DoD programmatic leaders, front-line commanders, and service members. To address these gaps, the first-ever national “Firearm Suicide Prevention in the Military: Messaging and Interventions Summit” was convened in June 2022, bringing together DoD personnel and researchers with expertise in firearm suicide prevention and lethal means safety. The Summit identified 10 recommendations to enhance firearm suicide prevention messaging and interventions in the U.S. military, including (1) repeal or amend prohibitions on questioning service members about personal firearms; (2) develop, examine, and use common language for firearm injury prevention; (3) implement a universal approach to training on comprehensive firearm injury prevention; (4) encourage leadership across disciplines and levels; (5) aim for broad culture change; (6) support innovative research; (7) consider various outcome measures; (8) promote “cultural competence” for better communication; (9) reduce territorialism; and (10) develop creative partnerships. Ultimately, these recommendations can facilitate productive partnerships with a shared goal: to develop, test, and implement strategies that standardize lethal means safety and reduce firearm suicides and other firearm injuries or harm among service members.

Emergency medical services (EMS) clinicians' views on EMS‐delivered interventions to promote secure firearm storage practices

“…Thus, targeted interventions based on an acute need may, out of necessity, predominate decision‐making for EMS clinicians. This targeted approach for secure firearm storage contrasts with recommendations for more universal, upstream delivery of LMSC (i.e., delivery of LMSC to all individuals regardless of their current suicide risk status; Betz, Stanley, et al, 2022; Betz, Thomas, et al, 2022). However, the prehospital setting may be more suitable to targeted, rather than universal, LMSC, aligning with EMS clinicians' perspectives in this study.…”

“…Often, community paramedics have a strong focus on preventative health care and injury prevention (e.g., surveying a home for rugs that may be trip hazards). Thus, community paramedics may be particularly well‐suited to deliver LMSC, including as a universal preventative intervention (Betz, Stanley, et al, 2022; Betz, Thomas, et al, 2022). This is a critical area of future scientific and programmatic inquiry, to identify potential novel and impactful community‐based messengers of secure firearm storage.…”

“…By contrast, secure firearm storage, such as using a locking device or storing a firearm unloaded and separate from its ammunition, is associated with a decreased risk for firearm suicide (Monuteaux et al, 2019; Shenassa, 2004). Accordingly, lethal means safety counseling (LMSC) to promote secure firearm storage is a key component of strategies to prevent suicide and firearm‐related morbidity and mortality more broadly, including homicide and unintentional injuries (Betz, Stanley, et al, 2022; Butkus et al, 2018; McLean et al, 2019; Pallin et al, 2019; The White House, 2021; US Department of Veterans Affairs, 2018, 2020).…”

Project Safe Guard: Challenges and opportunities of a universal rollout of peer‐delivered lethal means safety counseling at a US military installation

“…The prevention of firearm‐related harms is a key operational priority of the US Department of Defense (DoD; Iwamasa et al., 2023; US Department of Defense, 2022). One of the most common and robust approaches to firearm injury prevention involves decreasing access to lethal means, such as firearms (Betz, Stanley, Anestis, et al., 2023). Indeed, the DoD and other stakeholders recommend developing, testing, and implementing programs that promote the secure storage of personal firearms, including the use of lethal means safety counseling (LMSC; Defense Suicide Prevention Office, 2015; Iwamasa et al., 2023; The White House, 2021; US Department of Defense, 2020).…”

“…In a randomized controlled trial of 232 firearm‐owning National Guard personnel, PSG outperformed the control condition in prompting new use of firearm locking devices at 6‐month follow‐up (55.0% vs. 39.0%; odds ratio [OR] = 1.91 [95% CI = 1.10, 3.32]; Anestis, Bryan, et al., 2021). This has led to the implementation of PSG in multiple settings, including broadly in the National Guard (Betz, Stanley, Anestis, et al., 2023). Importantly, PSG was designed for universal delivery to recipients regardless of their level of current risk of harm to self or others.…”