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Firearms and Suicide Prevention

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Objectives

To understand suicide including The problem The risk factors Interventions Implementation issues Evaluation

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THE PROBLEM

CANADA Suicide in Canada: 3700 per year Second leading cause of death in 15-

24 year olds Firearms are the most common

instrument particular for males

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Quebec

1/3 of suicides with firearms - most common is .22 rifle

Quebec rates above national average males, youth and elderly at risk some professions, eg. policing, have

particular firearm risk regional variations particular problem in rural areas

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links to violence - 50% domestic murders with firearms end in suicide

presence of firearm is correlated with completed suicides - lethality

inquiry - David

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Causal Factors

Environmental Host Agent

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Risk Factors Are Known

Previous suicidal behaviour Male Substance and alcohol abuse Mental illness Recent loss Family history etc. BUT MANY DO NOT FIT THE PROFILE -

opportunistic esp. youth

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Lethality Model

Factors Affecting theFrequency of ViolentEvents

Incidenceof Violence

Injury Outcomes

Factors Affectingthe Severity ofViolent Incidents

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Links to firearm access

Risk of suicide in urban homes with guns: 5x increase

Risk of homicide in urban homes with guns: 3x increase

Regional variations in Canada BUT: in Quebec decline in firearm

suicides not reflected in overall decline

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INTERVENTION MODELS

Engineering

Enforcement

Education

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Engineering

Limit access to the agent: e.g. trigger locks

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Legislative/Enforcement

Licensing - screening process Safe Storage Removal of firearms where risk

identified

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Educational

Counseling and professional and public education raise awareness of general risks early identification Counsel re neighbors and family

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Reinforce Other

Inquire re risk Encourage patients or family

members to remove guns from the home when suicide risk exists

Direct family members to legal authorities for assistance with involuntary hospitalization

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Implementation

With suicide prevention major concerns relate to unintended consequences of education programs

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STAKEHOLDER ROLES Understand Risks - parents, teachers,

social workers, health professionals, police Take Preventative Action - voluntary

removal of firearms; counselling; legal interventions

Community awareness of problem and solutions

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Target Audiences Parents and families: understand the

risks and take appropriate action Health care professionals: know the

signs, provide counselling, intervene Guidance Counsellors and teachers:

know the signs, provide counselling, intervene

Police: identify risks, intervene Communities: report potential problems

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OPPORTUNITY AREAS increase awareness of suicide risks

and firearms: data and trend analysis (fact-based decisions and interventions)

integration of “firearms” into other suicide prevention and community strategies

taking preventative action - clear procedures: “when in doubt say no”

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use of tools eg. questions on risk assessment

thinking “guns” in counselling storage better support from community

partnerships (eg. licensing) resources and support

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Success Stories

Licensing process improves risk assessment and includes hotline

Decline in reported suicides with firearms 1990-1999 in Quebec (but increase in suicide overall)

Increased awareness of problem and improved procedures

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Best Practice Examples

Romeo Dallaire who suffers from depression and PST asked police to take his firearms

Police called to suicide attempts routinely query presence of firearms

Quebec provincial strategy recognizes firearms issues

Educational efforts already underway (eg. pamphlet)

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Batshaw Family Services: screening for firearms in domestic violence calls and for suicidal youth in their care

Centres de Jeunesse, Services Psycho-sociaux are also looking at adding specific question re:guns in Batshaw Children and Family services implementing conjugal violence

Montreal Children’s Crisis Team- screening for firearms

Best Practice Examples

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Best Practices reporting and record keeping to support licensing and

revocation procedures: determine presence of guns when risk is

identified enforcement: prohibition orders, short term

confiscation of gun and license communications: physicians, teachers, community

organizations awareness and access: community engagement and

support

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Best Practices

appropriate enforcement of safe storage safe storage of police firearms

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TOOLS

Model Policies and GuidelinesTraining - knowledge, skills, attitudes Procedures - counseling, interventionSupport - awareness of CPFO, HotlinesPartnerships - focal point, proceduresOutreach - integrating firearms into existing

suicide prevention strategies- les Centres de prevention du suicide

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NEXT STEPS

suggestions! more current data re Quebec link to current initiatives - provincial

strategy etc. additional examples of specific

projects and practices resource materials contacts