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Assessing the Current State of Lethal Means Safety in Vermont Emergency Departments
Bourdeau, Jenna Burke, Molly Cussen, Audrey Haimovich, Alexander Lyttleton, Jackson Nguyen, Brian Roeder, Nathan Root, Andrew
Bourdeau, Jenna
Burke, Molly
Cussen, Audrey
Haimovich, Alexander
Lyttleton, Jackson
Nguyen, Brian
Roeder, Nathan
Root, Andrew
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Abstract
Background: In 2022, 14 emergency departments (EDs) in Vermont joined a quality improvement project focused on suicide prevention and lethal means safety (LMS). This mixed-methods study sought to assess attitudes and practices in these areas through interviews with participating EDs.
Methods: Semi-structured interviews were conducted with personnel in three EDs during the Fall of 2025. Interviews were recorded, transcribed, de-identified, and thematically analyzed following Braun and Clarke’s framework. Zero Suicide Organizational Self-Study assessments from 12 participating hospitals were reviewed to supplement interviews.
Results: Thematic analysis identified four major themes: providers exhibit varied perceptions of the endeavor’s goals and effectiveness; all programs reported resource limitations and operational pressures related to care pathway implementation; Interviewees expressed ambiguity regarding organizational roles and responsibilities; and increasing suicide care pathway fragmentation leads to uncertainty about outcomes beyond an individual’s purview.
Almost all EDs use the Columbia-Suicide Severity Rating Scale (C-SSRS). Seven EDs provide training using Counseling on Access to Lethal Means (CALM), and seven EDs have written protocols for LMS and counseling in their suicide pathway. While 83% of EDs include LMS planning in collaborative safety planning documents, only 58% attempt to confirm lethal means removal after plan creation.
Conclusion: This study assessed perspectives on suicide prevention and LMS care pathways in Vermont EDs. While there was variation in views on the effectiveness of these endeavors, they were largely considered worthwhile. Perception of challenges was common, especially concerning resource allocation. Furthermore, thematic analysis suggested confusion among personnel concerning roles and responsibilities of those involved.
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2026-01-28
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VDH Injury Prev.pdf
Adobe PDF, 317.58 KB
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VT Department of Health – Injury Prevention