An important piece of any suicide prevention program is reducing access to lethal means or “means restriction.” This refers to making an effort to limit or eliminate the ability for a person at risk of suicide to access the means for their suicide plan.
Firearms are the most lethal and most common method of suicide in the U.S. More people who die by suicide use a gun than all other methods combined. Suicide attempts with a firearm are almost always fatal, while those by other methods are less likely to be fatal. Another important fact is that nine out of ten people who survive a suicide attempt do not go on to die by suicide later.
Many suicide attempts are made impulsively during a short-term crisis period. If highly lethal means are made less available to impulsive attempters and they substitute less lethal means, or temporarily postpone their attempt, the odds are increased that they will survive. Studies in a variety of countries have indicated that when access to lethal means is reduced, both the means-specific suicide rate and, very often, the overall suicide rate decline.
(Information obtained from Harvard Injury Research Center’s Means Matter program. Visit www.meansmatter.org for more information)
Other forms of means restriction include:
- Improvements in the use of catalytic converters in motor vehicles
- Restrictions on pesticides
- Reduce lethality or toxicity of prescription
- Use of lower toxicity antidepressants
- Change packaging of medications to blister packs
- Restrict sales of lethal hypnotics (i.e. Barbiturates)
From Mann, J. J., Apter, A., Bertolote, J., Beautrais, A., Currier, D., et. al., (2005). Suicide prevention strategies: A systematic review. Journal of the American Medical Association 294 (16), 2064-2074.
Reducing access to alcohol is also an important component of means restriction, given that alcohol is a factor in about one-fourth of suicide deaths (IOM 2002). Educating individuals and families about the dangers of alcohol in relation to suicide risk can be an effective intervention. Persons should also be educated about the potential for alcohol to amplify the negative effects of other substances, including prescription medications.
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