AAS Lethal Means Restriction 5 — Questions and Answers
Question 1: Which US state was among the first to pass an Extreme Risk Protection Order (ERPO) law, sometimes called a red flag law?
- Texas
- California
- Connecticut (Correct answer)
- Florida
Correct answer: Connecticut
Connecticut enacted one of the first ERPO laws in 1999, which has since been associated with reductions in firearm suicide rates in that state.
Question 2: When training healthcare providers in lethal means counseling, what does the CALM (Counseling on Access to Lethal Means) curriculum emphasize?
- Always requiring patients to sign firearm surrender forms
- Practicing specific language for asking about and addressing firearm access during risk assessment (Correct answer)
- Referring all firearm-owning patients to specialized programs
- Avoiding the topic unless the patient raises it first
Correct answer: Practicing specific language for asking about and addressing firearm access during risk assessment
The CALM curriculum trains providers to use specific, non-judgmental language when asking about firearm access and counseling on safe storage.
Question 3: In means restriction counseling, what does 'means safety' emphasize compared to 'means removal'?
- Means safety focuses on police involvement, means removal focuses on family
- Means safety addresses secure storage as an option, not just complete removal (Correct answer)
- Means safety applies only to medications, means removal applies only to firearms
- There is no meaningful distinction between the two terms
Correct answer: Means safety addresses secure storage as an option, not just complete removal
Means safety is a broader concept that includes secure storage (e.g., gun safes, trigger locks) as an alternative to complete removal, which may be more acceptable to some patients.
Question 4: What does research indicate about the effectiveness of means restriction for individuals with a history of a previous suicide attempt?
- Means restriction is less effective because they will find another method
- Means restriction remains effective because most re-attempts also occur impulsively (Correct answer)
- Means restriction is only effective for first attempts
- Means restriction is contraindicated for this population
Correct answer: Means restriction remains effective because most re-attempts also occur impulsively
Even among those with prior attempts, crises and re-attempts often occur impulsively, so reducing access to lethal means still provides a protective buffer.
Question 5: A healthcare provider asks a patient in crisis if there are firearms at home, and the patient denies it but later an attempt occurs with a firearm. What does this scenario highlight about lethal means assessment?
- Clinicians should always contact law enforcement to verify firearm ownership
- Self-report of firearm access may be unreliable, underscoring the importance of collateral sources (Correct answer)
- The clinician was negligent for not performing a physical search
- Lethal means assessment is not a standard of care requirement
Correct answer: Self-report of firearm access may be unreliable, underscoring the importance of collateral sources
Patients in crisis may underreport or deny firearm access, highlighting the value of collateral information from family members or other sources when possible.
Question 6: Which of the following best describes the 'window of opportunity' concept in lethal means restriction?
- The brief period after a psychiatric hospitalization when patients are most at risk
- The narrow time frame during a suicidal crisis when restricting means can prevent a death (Correct answer)
- The timeframe in which legal means restriction orders are valid
- The interval between prescription refills for at-risk patients
Correct answer: The narrow time frame during a suicidal crisis when restricting means can prevent a death
The window of opportunity refers to the brief, acute nature of many suicidal crises, during which restricting access to lethal means can prevent death.
Question 7: Which professional organization has specifically called on clinicians to routinely ask patients about firearm access as part of suicide risk assessment?
- The American Medical Association only
- Multiple organizations including the AAS, AFSP, and Joint Commission (Correct answer)
- The NRA's safety division
- The Department of Defense exclusively
Correct answer: Multiple organizations including the AAS, AFSP, and Joint Commission
The AAS, AFSP, Joint Commission, and several medical associations have issued guidelines calling for routine assessment of firearm access in clinical suicide risk evaluations.
AAS Lethal Means Restriction 5
Which US state was among the first to pass an Extreme Risk Protection Order (ERPO) law, sometimes called a red flag law?