An ED-based RCT of Lethal Means Counseling for Parents of At-Risk Youth
Completed · Not applicable
Conditions studied: Suicidal and Self-injurious Behavior
In brief
The National Action Alliance to Prevent Suicide recently released a research agenda aimed at significantly reducing suicide over the next decade. Aspirational Goal 12, "Reduce access to lethal means that people use to attempt suicide," calls for identifying effective strategies to reduce a suicidal person's access to firearms and other lethal means. A promising strategy is to counsel patients seen in the emergency department (ED) for a psychiatric emergency to reduce access to firearms (the most lethal suicide method) and medications (the most common method of suicide attempt). To date, however, few studies have evaluated changes in firearm storage practices among those who received lethal means counseling (LMC), and those that have, including a pilot conducted in Colorado by the study team, have lacked control groups. Results from the pilot, which provided emergency department based LMC counseling to parents of suicidal adolescents, found that among gun-owning parents, 33% had unlocked guns at home on the day of the ED visit and none did on follow up. Using the piloted LMC protocol, we will conduct the first randomized, controlled trial (RCT) of the effectiveness of ED-based LMC on firearm and medication storage. The proposed RCT, to be conducted in five Colorado hospitals, will test whether parents of at-risk adolescents who are treated in hospitals that have (vs. have not yet) implemented our LMC protocol are more likely to store household firearms and medications safely. In addition, we will conduct in-depth, qualitative interviews with parents who have received LMC counseling to better understand those factors that affect parents' willingness and ability to make changes to firearm and medication storage. We will also conduct qualitative interviews with clinicians to understand factors affecting clinician engagement in LMC. AIM 1: To assess the effectiveness of an ED-based LMC intervention to improve how parents of pediatric patients (age 10-17) who visit the ED for a mental health emergency store household firearms and medication. AIM 2: To examine how attitudinal and contextual factors shape a) parents' decisions about firearm and medication storage following LMC, and b) clinicians' delivery of LMC messages.
Key facts
- Study ID
- NCT03143283
- Run by
- Northeastern University
- People needed
- 575
- Starts
- 2017-08-01
- Expected to finish
- 2019-07-31
- Last updated by the study team
- 2020-09-10
Who can join
Age: 10 and older, up to 17. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Age limits pertain to the patient seen at the ED for a psychiatric or substance abuse crisis. It is their parents/guardians who receive the intervention. Parents must speak either English or Spanish and have a working telephone number or email address.
You may not qualify if…
- A patient in institutional care would be excluded. Parents/guardians who were not at the ED with their child are excluded.
Where it is running
- Penrose Hospital — Colorado Springs, Colorado, United States
- Memorial Central — Colorado Springs, Colorado, United States
- Memorial North — Colorado Springs, Colorado, United States
- St. Francis Hospital — Colorado Springs, Colorado, United States
- Poudre Valley Hospital — Fort Collins, Colorado, United States
- Medical Center of Rockies — Loveland, Colorado, United States
- St. Mary Corwin Medical Center — Pueblo, Colorado, United States
- Lutheran Medical Center — Wheat Ridge, Colorado, United States
Full record on ClinicalTrials.gov
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