Health Services Research & Development

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2017 HSR&D/QUERI National Conference Abstract

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4078 — Acceptance for Interventions to Slow Firearm Access During High Risk Periods Among Veterans in VA Mental Health Care

Lead/Presenter: Heather Walters, COIN - Ann Arbor
All Authors: Walters H (COIN-Ann Arbor) Pfeiffer P (COIN-Ann Arbor) Ganoczy D (COIN-Ann Arbor) Ilgen M (COIN-Ann Arbor) Bossarte R (Department of Veterans Affairs Center of Excellence for Suicide Prevention, Canandaigua) Valenstein M (COIN-Ann Arbor)

Objectives:
Veterans are at high risk for suicide, and most who die from suicide use firearms. Voluntarily reducing firearm access during high-risk periods could potentially reduce risk. We surveyed veterans using VA mental health services in five VA facilities to assess the acceptability of a variety of interventions to reduce access during high-risk periods, taking into account whether they had current access to a firearm, current mental health symptoms, suicidal ideation, and exposure to suicide deaths in others.

Methods:
The survey was developed following qualitative work and piloting and included the domains above as well as items on potential interventions. The survey was mailed to 1354 veterans in five geographical areas between 5/11/15-10/19/15, using a modified Dillman method. 677 veterans returned surveys (50% response rate).

Results:
In this high risk group of veterans, many (62.0%) had known others who died by suicide (71.0% by firearms) and many (58.0%) were concerned about suicide among veterans. The majority of veteran respondents were accepting about facility-based interventions to slow firearm access during high-risk periods (66.8% to 84.4%, depending on intervention). Veterans with current firearm access were less likely to be open, but most still found several interventions acceptable (60.1%-82.0%). When veterans with firearm access were asked about personal participation, substantial percentages were open to personally participating in several potential interventions (34.9% to 77.5%, depending on intervention). Veterans reporting suicidal ideation in the past 12 months (OR = 2.06 CI = 0.72, 5.93), who expressed concerns about veteran suicide (OR = 2.29 CI = 1.17, 4.48), and those exposed to suicide deaths (OR = 1.11 CI = 0.57, 2.17) were more likely to be open to interventions to delay access. Educational interventions for families, screening for gun access, and providing gunlocks were the most widely accepted interventions but other more intensive interventions such as institutional storage of guns or gunlock keys were also accepted by substantial percentages of veterans.

Implications:
Most veterans in VA mental health treatment, including those with current firearm access, are willing to consider health system interventions to reduce access during high risk periods.

Impacts:
Current VA programs to reduce access during high-risk periods should be maintained and additional programs to reduce access should be strongly considered.