It is almost two decades since Professor John Mann wrote his paper identifying the removal of lethal means as a proven strategy for suicide prevention. Often observed as a component of suicide safety planning interventions, lethal means safety is now an effective brief intervention in its own right.
Despite this long-standing evidence, in my work advocating for the Zero Suicide Healthcare framework, there is little evidence that this strategy is consciously and deliberately applied in our health services.
So, as the dawn breaks on World Suicide Prevention Day 2023 with the theme “creating hope through action” my response has been to take action to help address this shortfall in service delivery.
Building on the work of colleagues at the US Zero Suicide Institute who produced the Counselling on Access to Lethal Means (CALM) program, this new Australian program addresses a wide range of methods by which people may choose to take their own life and the techniques that healthcare workers can use to respond.
There have been some critical advances in our understanding and use of language and terminology in suicide prevention. Ensuring workers have an ongoing openness to learn from those they work with, regarding how they prefer to explore their experiences of suicidality is central to effective rapport building and suicide prevention. It is important to highlight changes in ways of discussing lethal means that facilitate empowerment and intentions towards safety. This means drawing on a person’s narrative of their suicidal experience to describe the fluctuations in intensity, frequency and duration. To emphasise the potential opportunities to increase safety by introducing distance or time between a person at their most suicidal, and the mechanism. This process can assist the person to make decisions about and manage their own safety.
For some people exploring details of suicide method is confronting, particularly if bereaved by suicide. While research often draws broad conclusions regarding how, when and what should be communicated, these studies are not commonly undertaken with groups of people actively engaged in clinical treatment. For healthcare workers who may not have been exposed to lethal means safety conversations, or find discussing suicide methods challenging, it is important to consider how to manage these challenges when working with a person experiencing suicidality.
Take action. Create hope. On this World Suicide Prevention Day learn about lethal means safety conversations and strengthen your health service’s suicide prevention toolkit.