Participants will recognize patients who may benefit from lethal means counseling and develop skills to ask direct, supportive questions about access to lethal methods. They will learn practical strategies to collaborate with patients, families, and care teams to temporarily reduce access to lethal means during periods of crisis, strengthening suicide
prevention efforts within the healthcare setting.

Agenda:

1. Introduction
2. Understanding Suicide Crisis and Risk
   1. Characteristics of an acute suicidal crisis
   2. Challenges in predicting suicide attempts
   3. Importance of creating time and distance between individuals at risk and lethal methods
3. Suicide Attempts and Survival Data
   1. Long-term outcomes following suicide attempts
   2. Evidence that most individuals who survive an attempt do not later die by suicide
   3. Importance of reducing lethality of attempts
4. Common Lethal Means
   1. Overview of the most common methods used in suicide attempts
   2. Role of method lethality in suicide mortality
5. Firearm Access and Suicide Risk
   1. Relationship between firearm access and suicide fatality rates
   2. Understanding the “deadly triad” of access, crisis, and lethality
   3. Implications for suicide prevention efforts
6. Strategies for Reducing Access to Lethal Means
   1. Off-site firearm storage options
   2. Safe firearm storage practices in the home
   3. Medication safety and storage strategies
   4. Community and environmental interventions (e.g., bridge barriers, policy approaches)
7. Public Health Examples of Means Reduction
   1. Bridge barriers and suicide prevention
   2. Pesticide restrictions and reduced suicide rates in Sri Lanka
   3. Reduction of toxic domestic gas in the United Kingdom
8. Identifying Individuals Who May Benefit from Lethal Means Counseling
   1. Individuals experiencing suicidal thoughts
   2. Individuals with prior suicide attempts
   3. Individuals with mental health or substance use disorders experiencing distress
9. Asking About Suicide and Lethal Means
   1. Tips for asking direct questions about suicide
   2. Strategies for discussing suicide in a supportive and non-judgmental manner
   3. Key questions for assessing suicide risk and plans
10. Working with Families and Supports
    1. Engaging family members and natural supports
    2. Framing lethal means safety as a temporary and protective measure
    3. Using culturally responsive language
11. Follow-Up and Ongoing Support
    1. Importance of continued follow-up with individuals at risk
    2. Strategies for maintaining safety and connection to care
12. Resources for Lethal Means Safety
    1. Lock to Live decision aid
    2. Harvard Means Matter
    3. Zero Suicide training resources
    4. Hold My Guns firearm storage partnership
    5. Columbia Suicide Severity Rating Scale training
    6. Suicide Prevention Resource Center
13. Practice and Application
14. Discussion/ Questions