(PS2-D80) Locking Families into Lethal Means Interventions: A PRISMA Scoping Review (ScR)

Introduction: Counselling to reduce lethal means, such as firearms and medications, is not often routinely practiced despite being recommended and part of many brief suicide-focused interventions such as the Suicide Safety Plan. Given the disparity in families often owning firearms and having mixed storage practices, the field is left with the question of why there are so few interventions integrating family members into lethal means counseling. Understanding family members’ potential roles in lethal means counseling is particularly critical given the prevalence of injuries and deaths surrounding family-owned firearms and youth lethal means access. The prevalence of firearm injuries and deaths among children and adolescents substantiates calls to involve family members in lethal means counseling and interventions. Although there are previous PRISMA reviews focusing on prevention of firearm injuries among children and adolescents, this is the first review to focus on incorporating family members into such interventions jointly.

Method: We sought to identify all articles addressing interventions that include families in lethal means safety counseling for suicidal individuals. This review followed the PRISMAS-Scoping Review reporting guidelines and the methodology was informed by Arksey and O’Malley’s (2005) five-stage framework. In accordance with this, we formed the research question, identified appropriate articles, selected the studies, extracted the data, and then summarized and reported the data. A comprehensive search was constructed in various databases. All search results were imported into the Covidence software and independently screened by two reviewers, followed by full text review of the remaining articles by the same two reviewers. Conflicts in abstracts and full-texts were resolved by a third reviewer. Inclusion/exclusion criteria will be discussed at time of conference. Two members of the research team reviewed the included articles, extracted the pertinent information from the articles and filled in the tables with it.

Results: From a total of 3166 original search results, 10 studies were selected for inclusion. Eight additional studies were identified from other sources and included, for a total of 18 included studies. These were separated into family lethal means interventions done separate from and as a part of safety planning by table. Each of the articles studied an intervention that included a lethal means safety training component and involved at least one family member, caregiver, or friend in the treatment. Descriptions of interventions and their study participants as well as overarching themes among existing interventions will be provided at time of conference.

Conclusions: Most of the existing interventions incorporating families into lethal means counseling target youth populations and include one parent or guardian. Future interventions should target the entire family unit as past research indicates fathers are more likely to be gun owners, yet mothers are more likely to accompany children to pediatric doctor appointments. There also need to be interventions for individuals across the lifespan, specifically geriatric populations who are at a great risk of suicide by firearm.