Policy Priority: Lethal Means Safety

Lethal means safety is among the most effective ways to reduce suicide attempts and deaths. It is characterized by putting time and distance between a person at risk for suicide and lethal means or methods of suicide. This allows time for the suicidal risk to diminish, for the intense suicidal impulse to pass, or for someone to intervene. Most individuals who are prevented from making a suicide attempt via one method typically do not go on to attempt with another method, making lethal means safety a critical and effective component of any suicide prevention strategy. Safer environments support people at risk for suicide.

Firearms are highly lethal and are used in over half of all U.S. suicide deaths. Suicide risk increases when a firearm or other lethal means are present in the home or readily accessible. Individuals with firearm access are no more likely to have suicidal thoughts or a suicide plan than those without firearm access, but individuals at risk with access to firearms in the home are much more likely to use a firearm than those without. While substitution is rare overall, if another means for suicide is substituted when a firearm is inaccessible, that attempt will likely be less lethal.

• Support and fund research on firearms and suicide prevention.
• * Promote the creation and distribution of educational materials regarding firearms and suicide prevention, including secure storage.
• * Promote financial incentives for secure storage devices and practices, such as sales tax holidays or exemptions.
• Educate healthcare professionals about the importance of lethal means counseling in the treatment of individuals who may be at risk for suicide.
• * Implement voluntary removal initiatives including temporary transfer exceptions, firearm hold agreements, community storage options, and Voluntary Do-Not-Sell Lists.
• * Implement Extreme Risk Protection Orders (ERPOs) as a tool to help prevent suicide when voluntary efforts to separate an at-risk individual from a firearm are unsuccessful or impossible and suicide risk is imminent.

Barriers that physically restrict access are the most reliable and effective means of preventing attempted and completed suicides at bridges, buildings, railroads, and other publicly accessible areas that pose risk for suicide. AFSP supports funding for and the installation of barriers and other physical structures to limit the potential for suicide attempts and deaths at these accessible areas.

• * Encourage, incentivize, or require the building of physical barriers and structures to prevent suicides at bridges, buildings, railroads, and other publicly accessible areas that pose suicide risk.

Access to prescription and over-the-counter medications, household cleaners and pesticides, and other potentially lethal substances should be closely monitored and potentially restricted during a suicidal or behavioral health crisis. While many of these substances can be helpful when used properly, they can also cause harm if misused by a person in crisis. Access to these substances, just like access to any lethal means, can also increase suicide risk if accessible to people with risk factors for suicide.

• Promote secure storage (e.g., lock boxes, safes, limited quantities) for medications, toxic chemicals, and other substances and the use of safe disposal programs.
• Extend restrictions on the sale of toxic levels and amounts of substances with the goal of protecting at risk individuals and fostering consumer product safety.
• Educate healthcare professionals, including pharmacists, about the importance of lethal means counseling in the treatment of individuals who may be at risk for suicide.

* policy recommendations noted with an asterisk showcase where AFSP is taking or will be taking a leading role in furthering advocacy efforts. This document is intended to be used by advocates, partners, and public officials at all levels of government as a resource for identifying policy opportunities to better promote suicide prevention and improve mental health.