What is “safety”?: Lethal means counseling as a cross-cultural communication

ABSTRACT

U.S. suicide rates have risen every year over the past two decades with self-directed firearm use as the method accounting for the highest proportion of deaths. This pattern is particularly pronounced among veterans and members of the U.S. Armed Forces. The numerical burden of firearm-related suicide accompanied by characteristics of self-directed firearm injury have motivated the development of lethal means safety initiatives focused on firearms. Simultaneously, research has sought to characterize patterns of firearm ownership and use among veterans as well as optimal strategies for clinicians to deliver suicide prevention messages to firearm owners. Increasingly, findings from research have been understood as cultural factors that warrant greater attention to improve the quality of lethal means counseling. Here, we review and interpret selected research on cultural aspects of firearm ownership and suggest that cultural differences between health care practitioners and firearm owners may result in health care practitioners delivering clinical interventions that are broadly divergent from perspectives within the cultural frameworks of firearm owners. We follow by organizing these cultural factors into existing frameworks of cultural competency training as a basis for developing curriculum for health care practitioners to improve clinical care.

KEYWORDS:

• Suicide
• firearm
• veterans
• culture
• safety

Disclosure statement

No potential conflict of interest was reported by the author(s).

Disclaimer

The views, opinions, and/or findings contained in this article are those of the authors and should not be construed as an official Department of Defense nor Department of Veterans Affairs position, policy or decision unless so designated by other official documentation.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.