Discussing Firearm Ownership and Access as Part of Suicide Risk Assessment and Prevention: “Means Safety” versus “Means Restriction”

Abstract

The goal of this study was to describe the relative utility of the terms “means safety” versus “means restriction” in counseling individuals to limit their access to firearms in the context of a mock suicide risk assessment. Overall, 370 participants were randomized to read a vignette depicting a clinical scenario in which managing firearm ownership and access was discussed either using the term “means safety” or “means restriction.” Participants rated the term “means safety” as significantly more acceptable and preferable than “means restriction.” Participants randomized to the “means safety” condition reported greater intentions to adhere to clinicians’ recommendations to limit access to a firearm for safety purposes (F[1,367] = 7.393, p = .007, ). The term “means safety” may be more advantageous than “means restriction” when discussing firearm ownership and access in clinical settings and public health-oriented suicide prevention efforts.

Keywords:

• firearms
• means restriction
• means safety
• public health
• suicide risk assessment
• suicide

Notes

¹In the case of other methods of suicide (e.g., pills, ligatures, knives), so too might the word “restriction” carry negative and unintended consequences, especially if it is interpreted as meaning indefinite (perhaps permanent) withholding of access to the given object. There is less unresolved debate in this context; thus, the current study will focus on nomenclature issues surrounding assessing for firearm ownership and access, specifically.

²Notably, the National Rifle Association (NRA) also advocates for firearm safety to mitigate risk of harm. The NRA's Eddie Eagle GunSafe® program for “gun accident prevention” among youth involves teaching youth to not touch—indeed, to “run away” from—firearms to promote safety (https://eddieeagle.nra.org/).

³Over the past several years, the Veterans Health Administration—the largest integrated healthcare system in the United States—has shifted towards adoption of the term “means safety” for use in training mental health providers who interface with suicidal patients who may value firearm ownership (e.g., San Francisco VA Health Care System [SFVAHCS], 2016). To our knowledge, this shift in nomenclature was not based on published empirical inquiry, which is an important step to ensure validity and enhance scalability to other healthcare and public health contexts.

⁴The order of these questions was also randomized to control for potential order effects.

⁵We emphasize that, even among patients at relatively low risk for suicide, assessment of firearm ownership and access is recommended (see Chu et al., 2015).

Additional information

Notes on contributors

Ian H. Stanley

Ian H. Stanley, Department of Psychology, Florida State University, Tallahassee, Florida, USA.

Melanie A. Hom

Melanie A. Hom, Department of Psychology, Florida State University, Tallahassee, Florida, USA.

Megan L. Rogers

Megan L. Rogers, Department of Psychology, Florida State University, Tallahassee, Florida, USA.

Michael D. Anestis

Michael D. Anestis, Department of Psychology, University of Southern Mississippi, Hattiesburg, Mississippi, USA.

Thomas E. Joiner

Thomas E. Joiner, Department of Psychology, Florida State University, Tallahassee, Florida, USA.