1. 1 Firearms and Suicide Prevention

2. 2 Objectives To understand suicide including The problem The risk factors Interventions Implementation issues Evaluation

3. 3 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

4. 4 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

5. 5  links to violence - 50% domestic murders with firearms end in suicide  presence of firearm is correlated with completed suicides - lethality  inquiry - David

6. 6 Causal Factors Environmental Host Agent

7. 7 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

8. 8 Lethality Model Factors Affecting the Frequency of Violent Events Incidence of Violence Injury Outcomes Factors Affecting the Severity of Violent Incidents

9. 9 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

10. 10 INTERVENTION MODELS  Engineering  Enforcement  Education

11. 11 Engineering Limit access to the agent: e.g. trigger locks

12. 12 Legislative/Enforcement  Licensing - screening process  Safe Storage  Removal of firearms where risk identified

13. 13 Educational Counseling and professional and public education raise awareness of general risks early identification Counsel re neighbors and family

14. 14 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

15. 15 Implementation  With suicide prevention major concerns relate to unintended consequences of education programs

16. 16 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

17. 17 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

18. 18 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”

19. 19  use of tools eg. questions on risk assessment  thinking “guns” in counselling  storage  better support from community partnerships (eg. licensing)  resources and support

20. 20 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

21. 21 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)

22. 22  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

23. 23 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

25. 25 Best Practices  appropriate enforcement of safe storage  safe storage of police firearms

26. 26 TOOLS Model Policies and Guidelines Training - knowledge, skills, attitudes Procedures - counseling, intervention Support - awareness of CPFO, Hotlines Partnerships - focal point, procedures Outreach - integrating firearms into existing suicide prevention strategies- les Centres de prevention du suicide

27. 27 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