Saving Lives with Firearm and Lethal Means Safety

by Brian Ahmedani, Ph.D., LMSW, MI Mind Program Co-director

A recreational hunter and rifle owner, Brian Ahmedani is an advocate for firearm safety and keeping people at risk for suicide alive.

People can live for years with active suicidal thoughts. But the moment their thoughts turn to action, things escalate quickly. During crisis, people typically experience a “brain paralysis.” Their pain is so severe and their mind is cognitively set on such a narrow, intense path that from their standpoint, there is little choice other than suicide. However, any disruption in that path can lead to disruption of the suicide attempt. If a firearm or other planned means is not available, suicidal people seldom switch to another means in that moment.

In more than half of all suicides, people die using a firearm. Suicide attempts with firearms are lethal more than 90 percent of the time. Women attempt suicide more often, but men are three times more likely to die by suicide because they frequently use firearms in their attempts.

From a health perspective, we recommend removing access to firearms from the environment of people at risk. The goal is to disrupt that cognitive path and extend the time for the crisis to dissipate, keeping them alive long enough to receive help. Firearms can be returned when people have demonstrated that they can sustain a healthier mental space.

How can providers approach firearm removal with their patients?

Any patient identified as at risk for suicide should have a Safety Plan, which reduces suicide risk by 20-25 percent. I sometimes use the following analogy with patients: It’s ok to drive to the bar, but that changes when a person has had several drinks then wants to drive home. To protect them and others, it’s necessary to take the car keys away while they’re intoxicated. In the same way, when a person is having thoughts of killing themselves, having easy access to a firearm may be lethal for them and potentially, others. For their safety, access needs to be limited until they are healthier.

These tools, available on the Tools & Materials page of the MI Mind website, are helpful:

Behavioral health providers: When a patient sees a behavioral health provider, they often have some risk factors for suicide. The message is: “I care about you and your health and safety, and the risk for suicide is increased for you. To keep you safe, while you are in treatment, we want to work with you and your family to keep weapons, including firearms and large stashes of pills, and any specific lethal means you have been contemplating, out of your path. Many people kill themselves using firearms, and we want you to be in an environment where you are safe. This is temporary, and when you’re in a sustained healthy space, the firearm can be brought back.”

Primary care providers: Ideally, collaborative care and immediate psychosocial assessment are swiftly available via behavioral health partners. However, because primary care providers are often trusted and familiar to family members and other loved ones, their continued involvement can be beneficial. A therapist may be a new person in everyone’s lives. Primary care providers can be called upon to talk to loved ones (with patient consent, part of the MI Mind protocol), engaging them in firearm or lethal means safety and counseling. Providers should feel empowered to involve family members/loved ones when patients consent. Strengthening relationships and processes between primary care and behavioral health providers is one of the core tenets of MI Mind.

Alternative strategies: Police officers, army veterans, victims of crime and others may not be willing or able to remove firearms from the home. Alternative strategies, which require patient and/or loved one involvement, include:

  • Tape one of more of the following to the firearm:
  • Lock firearms in a safe
  • Use a firearm lock (75-80 percent of firearm owners are supportive of firearm lock use to keep themselves or someone in their home safe)

We can’t predict when a suicide attempt will happen, but it’s incredibly important to act on weapon and lethal means safety. Helping patients get through times of crisis is possible, and while we can’t always be there in the moment, we can intervene by ensuring firearms and other lethal means are out of the patient’s path.


Cookie Consent

We use cookies to improve your web experience. By using this site, you agree to our Terms of Use. Read our Internet Privacy Statement to learn what information we collect and how we use it.

Accept All Cookies