Betz, M. E., Knoepke, C. E., Simpson, S., Siry, B. J., Clement, A., Saunders, T., Johnson, R., Azrael, D., Boudreaux, E. D., Omeragic, F., Adams, L. M., Almond, S., Juarez-Colunga, E., and Matlock, D. D. (2020). An interactive web-based lethal means safety decision aid for suicidal adults (Lock to Live): Pilot randomized controlled trial. Journal of Medical Internet Research, 22(1), Article e16253.
Throughout the pandemic, there has been an increase in firearm sales, which poses a greater risk to individuals experiencing suicidal ideation. At the same time, not all staff working in emergency rooms are comfortable assessing risk of suicide with patients. The researchers examined the usefulness of an online decision aid to reduce firearm access to individuals who present to the emergency room with suicidal ideation. The online interactive decision aid “Lock to Live” was developed by researchers from the University of Colorado with input from suicide prevention experts and individuals with lived experiences. The tool includes graphics and brief videos depicting steps to safely storing firearms and medications.
Forty-nine adult patients in an emergency room setting were randomized to receive a link to the “Lock to Live” site or information on preventing suicide without steps to locking away firearms and medications. All 39 patients who were randomized to receive the “Lock to Live” link completed the online decision aid intervention and even reported that the decision aid was user-friendly and relatable to their current situation. The patients also reported that they would recommend the online decision aid to friends and family who owned a firearm or medication and were struggling with suicidal ideations. Among the 14 patients who responded to follow-up and reported having firearms at both the beginning and end of the study, roughly half of the group reported moving their firearms to a safe location, which shows that the online decision aid is useful for individuals who are struggling with suicidality and have access to firearms.
While the authors only examined the usefulness of the application and noted that future research is warranted on whether it influences suicidal outcomes, they overall confirmed that the “Lock to Live” online decision aid is feasible and applicable in various settings. The online decision aid could serve as a gateway to more intensive, evidence-based interventions for suicidality.