Date of Publication


Project Team

Faculty Advisor: Jean Pelski, Agency Mentor: Thomas Delaney


Introduction: Adolescents nationwide are exhibiting intentional self-harm behaviors at a rate significantly higher than past years. The Vermont Department of Health has called for expansion of intentional self-harm and suicide prevention. Pediatric primary care clinicians in Vermont would benefit from education and materials necessary for safety planning and safe storage of medication for the at-risk adolescent patients in their practice. The purpose of this DNP project is to collect data regarding acceptability and feasibility of an approach for distributing medication lockboxes in primary care as a method promoting of lethal means safety.

Methods: Primary care practices received medication lockboxes and educational materials to distribute to patients deemed at-risk for intentional self-poisoning. Feasibility was measured by number of lockboxes distributed over a 90-day period, patient information gathered on the Self-Harm Office Checklist, and post-implementation surveys and provider debrief interviews.

Results: Results demonstrate 17 lockboxes were received by patients (mean age 14.8 years, 47.0% female). 82.4% of risk identification used a formal screening tool and 76.4% had documentation of a safety plan; 41.2% had indication of a referral made for additional services. Survey data from 9 providers were included in analysis, of whom 6 agreed it was convenient to incorporate lockboxes into practice, with all respondents wanting to continue using lockboxes to promote lethal means safety.

Conclusions: While this intervention was widely accepted among the practices, providers faced challenges. Barriers to distribution include time for retrieving lockboxes, absence of scripting for patient encounters, and need for integration with the electronic health record.

Document Type


Available for download on Thursday, May 01, 2025