1 firearms and suicide prevention. 2 objectives to understand suicide including the problem the risk...
TRANSCRIPT
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Firearms and Suicide Prevention
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Objectives
To understand suicide including The problem The risk factors Interventions Implementation issues Evaluation
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THE PROBLEM
CANADA Suicide in Canada: 3700 per year Second leading cause of death in 15-
24 year olds Firearms are the most common
instrument particular for males
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Quebec
1/3 of suicides with firearms - most common is .22 rifle
Quebec rates above national average males, youth and elderly at risk some professions, eg. policing, have
particular firearm risk regional variations particular problem in rural areas
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links to violence - 50% domestic murders with firearms end in suicide
presence of firearm is correlated with completed suicides - lethality
inquiry - David
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Causal Factors
Environmental Host Agent
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Risk Factors Are Known
Previous suicidal behaviour Male Substance and alcohol abuse Mental illness Recent loss Family history etc. BUT MANY DO NOT FIT THE PROFILE -
opportunistic esp. youth
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Lethality Model
Factors Affecting theFrequency of ViolentEvents
Incidenceof Violence
Injury Outcomes
Factors Affectingthe Severity ofViolent Incidents
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Links to firearm access
Risk of suicide in urban homes with guns: 5x increase
Risk of homicide in urban homes with guns: 3x increase
Regional variations in Canada BUT: in Quebec decline in firearm
suicides not reflected in overall decline
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INTERVENTION MODELS
Engineering
Enforcement
Education
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Engineering
Limit access to the agent: e.g. trigger locks
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Legislative/Enforcement
Licensing - screening process Safe Storage Removal of firearms where risk
identified
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Educational
Counseling and professional and public education raise awareness of general risks early identification Counsel re neighbors and family
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Reinforce Other
Inquire re risk Encourage patients or family
members to remove guns from the home when suicide risk exists
Direct family members to legal authorities for assistance with involuntary hospitalization
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Implementation
With suicide prevention major concerns relate to unintended consequences of education programs
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STAKEHOLDER ROLES Understand Risks - parents, teachers,
social workers, health professionals, police Take Preventative Action - voluntary
removal of firearms; counselling; legal interventions
Community awareness of problem and solutions
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Target Audiences Parents and families: understand the
risks and take appropriate action Health care professionals: know the
signs, provide counselling, intervene Guidance Counsellors and teachers:
know the signs, provide counselling, intervene
Police: identify risks, intervene Communities: report potential problems
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OPPORTUNITY AREAS increase awareness of suicide risks
and firearms: data and trend analysis (fact-based decisions and interventions)
integration of “firearms” into other suicide prevention and community strategies
taking preventative action - clear procedures: “when in doubt say no”
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use of tools eg. questions on risk assessment
thinking “guns” in counselling storage better support from community
partnerships (eg. licensing) resources and support
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Success Stories
Licensing process improves risk assessment and includes hotline
Decline in reported suicides with firearms 1990-1999 in Quebec (but increase in suicide overall)
Increased awareness of problem and improved procedures
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Best Practice Examples
Romeo Dallaire who suffers from depression and PST asked police to take his firearms
Police called to suicide attempts routinely query presence of firearms
Quebec provincial strategy recognizes firearms issues
Educational efforts already underway (eg. pamphlet)
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Batshaw Family Services: screening for firearms in domestic violence calls and for suicidal youth in their care
Centres de Jeunesse, Services Psycho-sociaux are also looking at adding specific question re:guns in Batshaw Children and Family services implementing conjugal violence
Montreal Children’s Crisis Team- screening for firearms
Best Practice Examples
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Best Practices reporting and record keeping to support licensing and
revocation procedures: determine presence of guns when risk is
identified enforcement: prohibition orders, short term
confiscation of gun and license communications: physicians, teachers, community
organizations awareness and access: community engagement and
support
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Best Practices
appropriate enforcement of safe storage safe storage of police firearms
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TOOLS
Model Policies and GuidelinesTraining - knowledge, skills, attitudes Procedures - counseling, interventionSupport - awareness of CPFO, HotlinesPartnerships - focal point, proceduresOutreach - integrating firearms into existing
suicide prevention strategies- les Centres de prevention du suicide
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NEXT STEPS
suggestions! more current data re Quebec link to current initiatives - provincial
strategy etc. additional examples of specific
projects and practices resource materials contacts