Suicide

Family Safety Net: Universal firearm safety to keep youth safe at home

Dr. Lisa Wexler

Suicide is a major and rising public health problem in the United States. In one of the most rural states, Alaska, suicide rates are consistently triple the national rate. There, 60% of the suicide fatalities are due to firearms. In rural Indigenous Alaska Native (AN) communities, virtually all homes have multiple guns for subsistence hunting, which increases suicide risk significantly. Our innovation focuses upstream: on adults living with youth (caregivers and others) who are likely able to reduce access to firearms and other environmental risks to safeguard younger family members.  Reducing access to ‘lethal means’ to prevent suicide is one of the most effective strategies to date.  Key challenges are widespread uptake, particularly within high-risk and hard-to-reach populations. The Family Safety Net (FSN) uses a universal ‘family-focused’ screening to identify households that may particularly benefit from increasing their home safety (i.e. households where someone is experiencing mental health struggles).  Our underlying premise is that all adults living with younger family members who are experiencing mental health challenges will be receptive to taking preventative actions to make their homes safer. This shift from targeting individuals to engaging adult family members, is a potentially important innovation, particularly in collectivist AN populations, who prioritize family and community (rather than ‘the self’ individually). With a focus on safety and family, our family-focused approach closely aligns with the cultural, family orientation of AN people. Our central hypothesis is that by supporting adult family members in lethal means reduction, we can reduce key environmental risk factors that contribute to youth suicidal behavior.