WIP 108 - Suicide prevention through Lethal Means Counseling in the Pediatric ED: Implementation of Gunlock and Medication Lockbox Distribution Using Quality Improvement
Medical student Duke University School of Medicine Durham, North Carolina, United States
Background:
Background: Suicide is the second leading cause of death in youth aged 14-17. These numbers are only increasing as the post-pandemic mental health crisis has led to record numbers of presentations to pediatric emergency departments (PEDs) for suicidality and increased suicide deaths among youth.
Local Problem: In our PED, we have also seen increased visits for suicidality. Our psychiatric team inquiries about access to lethal means (LMs) and recommends securing firearms and medications, but many families may not have the equipment required to do this when their child is experiencing an acute suicidal crisis. Objective:
Objective: The objective of this study is to reduce access to LMs of suicide for patients presenting to the PED with suicidality. Our SMART aim is to provide LM counseling and distribute gunlocks and medication lockboxes to 80% of PED patients with suicidality by February 2024. Design/Methods: Methods: We convened a group of interdisciplinary key stakeholders including nursing, emergency medicine and child psychiatry physicians, and psychiatry social workers. Together we conducted a problem analysis and constructed a key driver diagram. We also created and distributed a process map for screening and distribution, targeting patients presenting to the PED < 18 with suicidality.
Interventions: We trained Pediatric and Emergency Medicine residents and faculty using the American Academy of Pediatrics Counseling on Access to Lethal Means (CALM) training. We screened patients presenting with suicidality for LMs, and distributed gunlocks and medication lockboxes to interested families. We implemented a dot phrase to facilitate documentation of screening and distribution and provided educational flyers to families.
Results: in progress •Obtained firearms and gunlocks via grant funding (May 2023) •Completed CALM Training of providers (September 2023) •Measure patients presenting with suicidality starting November 2023 •Measure monthly screening for LM and product distribution starting November 2023
