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Health Services Research & Development

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2012 HSR&D/QUERI National Conference Abstract

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2012 National Meeting

1095 — Firearm Access and Potential Interventions to Increase Safety for VA Patients in Mental Health Treatment

Valenstein MWalters HGanoczy DForman J, and Ilgen M, Ann Arbor COE/SMITREC; Bossarte R, Canandaigua COE;

Objectives:
VA patients with mental health (MH) conditions are at increased risk for suicide, and access to firearms may increase their risks further. We surveyed VA MH patients to better understand their access to guns, gun storage practices, and perceptions of interventions to delay access during high-risk periods.

Methods:
Following qualitative work, a survey was developed that included items regarding a variety of health behaviors, including gun access and storage, and items eliciting perceptions of interventions to delay gun access. The survey was mailed to 292 VA patients treated for mental health or substance use disorders in a Midwestern VA and 66% responded. Data analyses were completed using descriptive statistics and bivariate analyses.

Results:
66% of survey respondents had experienced suicidal ideation (SI), 38% reported a suicide attempt, and 31% reported SI in the last 12 months. 39% of respondents had access to guns and there were no significant differences in access between patients with and without SI. Among patients with firearm access, 74% had more than one gun, 71% had a handgun, and 44% had a loaded and unlocked gun. Only 31% of respondents had talked to their clinicians about guns, although 78% thought it was important to do so. Veterans were positive about several interventions to delay gun access: 61% endorsed screening for firearm access, 68% endorsed using free gunlocks, and 71% endorsed family education on mental health and guns. Smaller percentages endorsed VA storage of gun lock keys (54%) or storage of guns off site (58%) for suicidal patients.

Implications:
Although there are high rates of SI and of gun access among VA patients in mental health treatment, less than a third have talked with a clinician about guns. Patients were positive about a number of interventions to reduce access during high-risk treatment periods.

Impacts:
This study indicates opportunities to improve suicide risk assessments for VA patients in mental health treatment by routinely inquiring about gun access. Several interventions to delay access during high-risk periods are acceptable to VA patients. Free gun locks are now being distributed in VA settings and other interventions may also be feasible.


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