Preventing Suicides With Gun Locks, Screenings and Conversation at Community Health

Suicide is tragic, and when it’s a child, it’s even more heartbreaking. Parents often are astounded that their child would know where a gun was kept and how to load it. “That’s a preventable death,” said Community Health Behavioral Health Director Christopher Chadwick.

September is National Suicide Prevention Month, an opportunity to highlight the steps to take to identify those at risk. At Community Health, providers use screening, safety plans and conversation as proactive preventive methods.

“We are screening clients at a minimum of every three months,” said Jason Keicher, LICSW, Community Health. “We use screening tools to identify risk factors and challenges that might make an individual more at risk for suicide. We work with each individual. It’s a very positive effort making sure our clients are safe and protected.”

In Vermont, firearms are the number one method for suicide. According to the Vermont Department of Health, Rutland County ranks second in the state in emergency room visits for suicidal ideation and self-directed violence with 464 reported from January through July 2022. There were three suicides in Rutland County and four in Addison County this year to date.

“Our primary care practices have been screening for access to firearms in the home,” said Chadwick, whose behavioral health team has seen the impact of suicide by firearm. “There are steps being taken to heighten awareness of lethal means and using a gun lock for the firearm is an easy fix.”
Community Health Behavioral Health is collaborating with Moms Demand Action for Gun Sense in America, a grassroots movement focused on public safety measures and encouraging responsible gun ownership. “The organization is partnering with Community Health to help us obtain gun locks as well as the educational support so everyone who answers affirmative to having unsecured guns in the home will leave with a gun lock,” Chadwick said. The organization is awaiting funding approval to support the purchase of the gun locks and to develop an educational program on how to appropriately distribute them.

Keicher said he was surprised at the number of young individuals who have access to guns in Vermont. “That goes back to the screening and counseling on access to lethal means,” Keicher said. Understanding access and how to mitigate that risk is part of the “safety plan” process that Keicher puts in place for each person identified as “at risk” through the screening process.

Some of the questions in the screening are a little provocative, Keicher said, like, “Have you ever thought about killing yourself?” Someone might say, “I am here because I am struggling with anxiety. Why are you asking me these questions?” The reason, he said, is to identify if there is any risk, identify the potential for risk and have that dialogue about what protective measures can be taken to reduce access to lethal means by creating a personal safety plan.

“There are individuals who are afraid if they bring up the subject of suicide or if they thought about it, they are fearful they are automatically going to be sent to an inpatient facility,” Keicher said. “It’s important that when someone brings this up, we talk about it. What is the imminent risk? Can we put a safety plan in place that keeps you safe and focused on recovery and moving forward? Finding that positive meaning in life.”

The safety plan takes 20-30 minutes to complete and includes honest conversation.

• What are the unique warning signs of a suicidal crisis? (the death of a loved one, no longer taking medications)
• What coping strategies worked for you in the past? (contact a loved one, using a weighted blanket to ground yourself, exercise)
• Who are individuals in your support network? (professionals, personal individuals, friends, family who you can contact)
• How do you reduce availability of means to commit suicide? (gun locks, etc.)

Keicher said that the completed safety plan is typically a welcome result. “They say it’s a relief. I have a guideline for how to navigate the stress versus the additional worrying and stress of having to tell my counselor.”

The plan lists:

• warning signs
• coping strategies
• professional agencies to contact when in crisis
• creating a safe environment
• suicide prevention lifeline

This July, the 988 Suicide & Crisis Lifeline (formerly known as the National Suicide Prevention Lifeline)  became available in every state in the US. The Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, seven days a week.  The Lifeline is comprised of a national network of over 200 local crisis centers, combining custom local care and resources with national standards and best practices. If someone is in crisis, they simply call 988 or text TALK to 741741 to connect with the Crisis Text Line.

Community Health participates in the Zero Suicide project, a collaboration between the Brattleboro Retreat, Rutland Regional Medical Center, Rutland Mental Health Services and Community Health. Zero Suicide and the Suicide Safer Care programs teach Community Health staff how to screen people who might be suicidal and find the right pathway to care and recovery for each individual person.

Each year in September, the Vermont chapter of the American Foundation For Suicide Prevention holds the “Walk Out of the Darkness” community collaboration and fundraiser to support services that work to educate individuals, families and communities about the impact, causes and preventive measures for saving lives and bringing hope to those affected by suicide.

This year, Community Health sponsors a team of walkers at the 2022 Walk Out of the Darkness in Rutland

Join the 2022 Walk Out of the Darkness in Rutland Saturday, September 10^th and support the American Foundation for Suicide Prevention.

If you are in crisis, please call 988 or contact the Crisis Text Line by texting TALK to 741741.

Follow this series of real-life stories every Friday, as we discuss primary care, value-based care and Community Health’s role in providing high quality health care services that include support groups and educational programs. Find out more about Community Health’s preventive programs and watch for our follow up stories about care management, diabetes education, Alzheimer’s support and behavioral health programs exclusive to Community Health.

Christopher Chadwick, MS, LADC, AFC, is Community Health Director of Behavioral Health and MAT Services.

Jason Keicher, LICSW, a licensed independent clinical social worker, joined Community Health Behavioral Health in 2019.

Community Health is Vermont’s largest Federally Qualified Health Center (FQHC), a network of primary care, pediatric, behavioral health, dental and pharmacy services with offices in Rutland, Brandon, Castleton, West Pawlet and Shoreham. Community Dental offices are located in Rutland and Shoreham; Community Kids Dental is in Rutland; Community Health Pediatrics is in Rutland and Behavioral Health services are available at all of our locations. Community Health Express Care Centers, open 7 days a week, are located at the Rutland and Castleton Community Health Centers. For more information about Community Health, check our website https://www.chcrr.org/.