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      • Lethal Means Counseling
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  • Home
  • About
    • Brief CBT
    • Crisis Response Planning
    • Lethal Means Counseling
  • Training
  • Research
  • Contact Us

Suicide Prevention Therapy

Suicide Prevention TherapySuicide Prevention TherapySuicide Prevention Therapy

Preventing someone from dying by suicide at a particular time using a particular method could prevent them from ever dying by suicide at any time using any method.


Michael Anestis, PhD

What is Lethal Means Counseling (LMC)?

LMC is a collaborative process involving education about the risks associated with easy access to potentially lethal suicide attempt methods and discussing practical strategies for reducing or limiting access to the methods. LMC proceeds through several steps based on motivational interviewing:


  1. Engaging: The first step is to establish rapport and build trust. Expressing curiosity in a non-judgmental way is critical in this first step.
  2. Focusing: The second step directs the conversation towards the specific topic of environmental safety. 
  3. Evoking: The third step is where the most time is spent. In this step, open-ended questions are asked to better understand the person's opinions, values, and perspectives about environmental safety.
  4. Planning: The final step involves development of concrete steps that someone will take to reduce or limit access to potentially lethal suicide attempt methods.

How effective is LMC?

The four-step LMC process described above has been tested in a randomized controlled trial with firearm-owning adults. Results of that study showed that firearm owners who received LMC were 30% more likely to lock up their personally owned firearms than firearm owners who did not receive the intervention (Anestis et al., 2021). 


Another study found that parents of children treated in emergency departments for a suicide attempt were more likely to lock up medications, alcohol, and firearms, and take other steps to limit their child's access to suicide attempt methods after receiving LMC as compared to parents who did not receive the intervention (Kruesi et al., 1999).


EFFECTIVENESS OF LMC

  • Firearm owners were 30% more likely to lock up personal firearms at home 
  • Parents of suicidal youths were twice as likely to lock up medications and alcohol, and 63% more likely to lock up or remove firearms from the home

Read the Studies

Who can learn LMC?

Everyone.  Although LMC is often talked about as a strategy for healthcare professionals to reduce the risk of suicide among their patients, anyone can learn how to have these important and potentially life-saving conversations. Researchers believe LMC's effectiveness will be maximized when families and friends have these conversations before a loved one experiences a suicidal crisis. Because suicidal crises can occur rapidly, conversations about secure firearm storage in particular are critical for helping people survive sudden and unexpected moments of despair and stress. 

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What about firearms?

LMC has been shown to increase firearm owners' willingness to use secure firearm storage methods like gun safes and locking devices (Anestis et al., 2021). Studies have shown that secure firearm storage practices like these are associated with approximately 50% reduced rates of suicide (Lubin et al., 2010; Shenassa et al., 2004). Our team includes military veterans and firearm owners who have extensive experience working with firearm owners and navigating these sensitive conversations.

References

Anestis, M. D., Bryan, C. J., Capron, D. W., & Bryan, A. O. (2021). Lethal means counseling, distribution of cable locks, and safe firearm storage practices among the Mississippi national guard: a factorial randomized controlled trial, 2018–2020. American journal of public health, 111(2), 309-317. 

Kruesi, M. J., Grossman, J., Pennington, J. M., Woodward, P. J., Duda, D., & Hirsch, J. G. (1999). Suicide and violence prevention: parent education in the emergency department. Journal of the American Academy of Child & Adolescent Psychiatry, 38(3), 250-255. 

Lubin, G., Werbeloff, N., Halperin, D., Shmushkevitch, M., Weiser, M., & Knobler, H. Y. (2010). Decrease in suicide rates after a change of policy reducing access to firearms in adolescents: a naturalistic epidemiological study. Suicide and Life-threatening behavior, 40(5), 421-424. 

Shenassa, E. D., Rogers, M. L., Spalding, K. L., & Roberts, M. B. (2004). Safer storage of firearms at home and risk of suicide: a study of protective factors in a nationally representative sample. Journal of Epidemiology & Community Health, 58(10), 841-848. 


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