Lethal Means Restriction and Advocacy: How Counselors and Counselor Educators  Can Save Lives

By Rebecca Mathews, MA, LPC-S

This holiday season, friends and families gather to experience warmth, tradition, and renewal.  It is not a joyous experience for all, as many consider or attempt suicide. As counselors, we are trained to assess and treat individuals who have suicidal ideation or behavior.  This season, let us consider how we can use our role as counselors and counselor educators to advocate in our communities for lethal means restriction.

Lethal means restriction (LMR) is the intentional securing of potentially lethal items to prevent or delay a suicide attempt (Harvard, 2018).  LMR creates a barrier to items that can be used for suicide, thereby creating delay between a suicidal thought and action. In a study wherein 153 survivors of near-fatal suicide attempts were asked about their experience, 48% of the participants indicated that the time between the thought of suicide and the attempt was 10 minutes or less (Simon, 2005).  71% reported less than an hour between thought and action. By securing potentially lethal items, community and family members can support those who struggle with suicidal thoughts.

Lethal means restriction is one of only a handful of suicide prevention interventions supported by research (Betz et al, 2013).  LMR is backed by the Centers for Disease Control and Prevention (CDC), American Foundation for Suicide Prevention (AFSP), American Academy of Child & Adolescent Psychiatry (AACAP), and Suicide Prevention Resource Center (SPRC) to name a few.  Parents of children and teens who have suicidal ideation can feel empowered to know that there is something they can do to help their child be safe. The same is true for relatives, neighbors, and community members whose homes are visited by this vulnerable population.

Potentially lethal items that could be secured behind a lock include: firearms and other weapons, “sharps” (including knives, scissors, razor blades, box cutters), medication (including over the counter and prescribed), household cleaners, and other items (e.g., scarves, ropes, extension cords, belts, plastic bags).

As counselors and educators, we have knowledge that can help to save lives.  We already use this knowledge with clients and in training future counselors.  But how can we better advocate for lethal means restriction within our communities and towns?  Below are several links that you can use with schools, community members, and local and state governments to provide education to the public and members of the profession about the importance of lethal means restriction as a suicide prevention strategy.  Harvard has a comprehensive site dedicated to education about suicide and lethal means restriction filled with resources, presentation and brochure material, and trainings for free! (see https://www.hsph.harvard.edu/means-matter/) 

“While some suicidal crises last a long time, others are short-lived. Reducing access to lethal means during periods of crisis can make it more likely that the person will delay or survive a suicide attempt.  In either case, the person’s odds of long-term survival are improved” (U.S. Department of Health and Human Services, 2012).  This holiday season, let us give the gift of life through advocacy and education about this important issue.  

Resources:

www.sprc.org/resources-programs/calm-counseling-access-lethal-means

https://www.hsph.harvard.edu/means-matter/means-matter/duration/

http://www.cdc.gov/violenceprevention/suicide/index.html

References

Betz, M. E., Miller, M., Barber, C., Miller, I., Sullivan, A. F., Camargo, C. A., Boudreaux, E. D., ED-SAFE Investigators (2013). Lethal means restriction for suicide prevention: beliefs and behaviors of emergency department providers. Depression and anxiety, 30(10), 1013-20. 

Harvard Injury Control Research Center. (2018). Means matter. Retrieved fromwww.meansmatter.org.

Simon, T.R., Swann, A.C., Powell, K.E., Potter, L.B., Kresnow, M., and O’Carroll, P.W.  (2001). Characteristics of impulsive suicide attempts and attempters. Suicide and Life-Threatening Behavior, 32, 49-59.

U.S. Department of Health and Human Services, Office of the Surgeon General, & National Action Alliance for Suicide Prevention. (2012). 2012 National strategy for suicide prevention: Goals and objectives for action. Washington, DC: Author.