Cited by 252Suicide and Self-Harm StudiesGun Ownership and Violence ResearchHomicide, Infanticide, and Child Abuse

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Suicide and Violence Prevention: Parent Education in the Emergency Department

Kruesi, Markus J.P., Grossman, Janet, Pennington, James M., Woodward, Paul J., Duda, David, Hirsch, Jay G.·1999·Journal of the American Academy of Child & Adolescent Psychiatry

DOI 10.1097/00004583-199903000-00010

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Abstract

Objective To determine prospectively whether parental receipt of injury prevention education is associated with new action limiting access to lethal means and if so, what action was taken for which means.Method Prospective follow-up of 103 adults whose children made an emergency department visit for mental health assessment or treatment. Record review assessed whether hospital staff provided injury prevention education. Logistic regression was used to determine the likelihood of new caretaker action limiting access to the following potentially lethal means: firearms, alcohol, prescription medications, and over-the-counter medications.Results Significant associations were found between exposure to injury prevention education and action to limit access (adjusted odds ratio = 3.6, 95% confidence interval = 1.1-12.1, p = .04). Five of 8 adults whose households contained firearms took new action to limit access after injury prevention education, whereas none of the 7 firearm-owning families who did not receive injury prevention education took new action to limit firearm access. Similar patterns were seen for other means. Adults more often chose to lock up rather than dispose of lethal means.Conclusions Injury prevention education should be provided to parents during child/adolescent emergency department mental health-related visits. Potential for violence prevention is real because parents do take new action to limit access to lethal means when means restriction education is provided.

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Mirowsky, J., & Ross, C. E. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.023 · Cited by 60
Suicide Risk Screening in Healthcare Settings: Identifying Males and Females at Risk
King, C. A., Horwitz, A. G., Czyz, E. K., & Lindsay, R. G. (2017) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-017-9486-y · Cited by 61
Enhanced Mental Health Interventions in the Emergency Department: Suicide and Suicide Attempt Prevention
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“(11) In 40% of the sample, the education was provided.”
BackgroundMethodInfluential
Suicide in pediatrics: epidemiology, risk factors, warning signs and the role of the pediatrician in detecting them
Dilillo, D., Mauri, S., Mantegazza, C., Fabiano, V., Mameli, C., & Zuccotti, G. (2015) · The Italian Journal of Pediatrics/Italian journal of pediatrics · doi:10.1186/s13052-015-0153-3 · Cited by 58
“In particular literature supports the importance of education in injury prevention: Kruesi [35] showed that educating parents in this field in the emergency room, leads to actions such as limiting the access to lethal means, for example locking up their firearms.”
Background
A Quasi-Experimental Analysis of Lethal Means Assessment and Risk for Subsequent Suicide Attempts and Deaths
Boggs, J. M., Beck, A. L., Ritzwoller, D. P., Battaglia, C. T., Anderson, H. D., & Lindrooth, R. C. (2020) · Journal of General Internal Medicine · doi:10.1007/s11606-020-05641-4 · Cited by 51
“Providers may be uncomfortable with firearm safety counseling or unfamiliar with options for secure firearm storage(33,34), but there is evidence that these barriers can be improved through training.(35,36) There are a handful of small studies with promising findings for patient adherence to lethal means safety recomm…”
Background
Gun Safety Management with Patients at Risk for Suicide
SIMON, R. I. (2007) · Suicide and Life-Threatening Behavior · doi:10.1521/suli.2007.37.5.518 · Cited by 48
Work and Unemployment as Stressors
Lennon, M. C., & Limonic, L. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.015 · Cited by 46
Clinical Approaches to the Prevention of Firearm-Related Injury.
Carter, P. M., & Cunningham, R. M. (2024) · New England Journal of Medicine · doi:10.1056/nejmra2306867 · Cited by 32
Hospital Emergency Department Lethal Means Counseling for Suicidal Patients
Runyan, C. W., Brooks‐Russell, A., Tung, G. J., Brandspigel, S., Betz, M. E., Novins, D. K., & Agans, R. (2017) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2017.10.023 · Cited by 46
Children's Mental Health Emergencies-Part 1: Challenges in Care: Definition of the Problem, Barriers to Care, Screening, Advocacy, and Resources
Baren, J., Mace, S., Hendry, P., Dietrich, A., Grupp-Phelan, J., & Mullin, J. (2008) · Pediatric emergency care · doi:10.1097/pec.0b013e318177a6c6 · Cited by 54
“In a follow-up study on families of child suicide attempters who received injury prevention education, only 62% took action to limit access to firearms.(69) Families receiving education did not limit access to medications.”
Background
Perceived Roles of Emergency Department Physicians Regarding Anticipatory Guidance on Firearm Safety
Price, J. H., Thompson, A. J., Khubchandani, J., Wiblishauser, M. J., Dowling, J., & Teeple, K. (2013) · Journal of Emergency Medicine · doi:10.1016/j.jemermed.2012.11.010 · Cited by 42
Who owned the gun in firearm suicides of men, women, and youth in five US states?
Barber, C. W., Azrael, D. R., Miller, M., & Hemenway, D. (2022) · Preventive Medicine · doi:10.1016/j.ypmed.2022.107066 · Cited by 40
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Hoops, K., Fahimi, J., Khoeur, L., Studenmund, C., Barber, C., Barnhorst, A., Betz, M. E., Crifasi, C. K., Davis, J. A., Dewispelaere, W. B., et al. (2021) · Academic Medicine · doi:10.1097/acm.0000000000004226 · Cited by 41
Mental Health and Firearms in Community-Based Surveys
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“Moreover, unlike the cross-sectional data used in this study, longitudinal research may find that the acquisition of a firearm changes mental health.”
Review of evaluations of educational approaches to promote safe storage of firearms: Table 1
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Cultural Diversity and Mental Health Treatment
Walton, E. C., Berasi, K., Takeuchi, D. T., & Uehara, E. S. (2009) · Cambridge University Press eBooks · doi:10.1017/cbo9780511984945.027 · Cited by 40
Firearm restriction as suicide prevention: variation in belief and practice among providers in an urban emergency department
Betz, M. E., Barber, C. W., & Miller, M. (2010) · Injury Prevention · doi:10.1136/ip.2009.025296 · Cited by 39
“Previous work found that parents of at-risk youth who were counselled by ED providers to remove lethal medications and firearms from the home were more likely to do so than those parents who were not counselled”
Background
An Emergency Department Intervention to Increase Booster Seat Use for Lower Socioeconomic Families
Gittelman, M. A., Pomerantz, W. J., & Laurence, S. (2006) · Academic Emergency Medicine · doi:10.1111/j.1553-2712.2006.tb00316.x · Cited by 39
A Handbook for the Study of Mental Health
(2017) · Cambridge University Press eBooks · doi:10.1017/9781316471289 · Cited by 43
Loaded Questions: Internet Commenters’ Opinions on Physician-Patient Firearm Safety Conversations
Knoepke, C. E., Allen, A. N., Ranney, M. L., Wintemute, G. J., Matlock, D. D., & Betz, M. E. (2017) · Western Journal of Emergency Medicine · doi:10.5811/westjem.2017.6.34849 · Cited by 38
An Overview of Sociological Perspectives on the Definitions, Causes, and Responses to Mental Health and Illness
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Boggs, J. M., Beck, A. L., Hubley, S. H., Peterson, E. L., Hu, Y., Williams, L. K., Prabhakar, D., Rossom, R. C., Lynch, F. L., Lu, C. Y., et al. (2018) · Psychiatric Services · doi:10.1176/appi.ps.201700237 · Cited by 37
Child Injury Risks are Close to Home: Parent Psychosocial Factors Associated with Child Safety
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“population in greater need of preventive interventions [11], but also amenable to such interventions [12–15].”
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Bardach, N. S., Burkhart, Q., Richardson, L. P., Roth, C. P., Murphy, J. M., Parast, L. M., Gidengil, C. A., Marmet, J., Britto, M. T., & Mangione-Smith, R. M. (2018) · PEDIATRICS · doi:10.1542/peds.2017-3554 · Cited by 36
Do parents value drowning prevention information at discharge from the emergency department?
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Pediatrician Guidance in Supporting Families of Children Who Are Adopted, Fostered, or in Kinship Care
Jones, V. F., Schulte, E. E., Waite, D., Springer, S. H., Szilagyi, M. A., Forkey, H. C., Fortin, K., Greiner, M. V., Harmon, D., Partap, A. N., et al. (2020) · PEDIATRICS · doi:10.1542/peds.2020-034629 · Cited by 34
Impact of a Firearm Safety Device Distribution Intervention on Storage Practices After an Emergent Mental Health Visit
Uspal, N. G., Strelitz, B., Cappetto, K. D., Tsogoo, A., Jensen, J., Rutman, L., Schloredt, K. A., Bradford, M. C., Bennett, E., & Paris, C. A. (2021) · Academic Pediatrics · doi:10.1016/j.acap.2021.04.024 · Cited by 32
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Predictors of Parent Behavioral Engagement in Youth Suicide Discharge Recommendations: Implications for Family-Centered Crisis Interventions
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The practice of lethal means restriction counseling in US emergency departments to reduce suicide risk: a systematic review of the literature
Hunter, A. A., DiVietro, S., Boyer, M., Burnham, K., Chenard, D., & Rogers, S. C. (2021) · Injury Epidemiology · doi:10.1186/s40621-021-00347-5 · Cited by 31
“Studies that described the demographics of patients and/or caregivers receiving LMR counseling were majority female (Kruesi et al. 1999; Asarnow et al. 2017; Parast et al. 2018) and majority white (Kruesi et al.”
Background

Authors: Kruesi, M. J. P., Grossman, J., Pennington, J. M., Woodward, P. J., Duda, D., & Hirsch, J. G.
Affiliations: University of Illinois Chicago (US)
Corresponding author: Kruesi, Markus J.P.
Venue: Journal of the American Academy of Child & Adolescent Psychiatry
Publisher: Elsevier BV
Published: 1999-03
Volume: 38
Issue: 3
Pages: 250-255
ISSN: 0890-8567 (ISSN-L)
DOI: 10.1097/00004583-199903000-00010
OpenAlex: W1974471858
Cited by: 251
References: 45
Citations by year: 2026: 2 · 2025: 3 · 2024: 7 · 2023: 6 · 2022: 6 · 2021: 14 · 2020: 12 · 2019: 8 · 2018: 4 · 2017: 44 · 2016: 13 · 2015: 5 · 2014: 13 · 2013: 6 · 2012: 9
FWCI: 7.70
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of the American Academy of Child & Adolescent Psychiatry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
Social Sciences › Health › Gun Ownership and Violence Research
Social Sciences › Sociology and Political Science › Homicide, Infanticide, and Child Abuse
Keywords: suicide prevention, violence prevention, injury prevention education, parental education, emergency department, means restriction, firearm access, alcohol access, prescription medication access, child and adolescent mental health
MeSH terms: Suicide Prevention, Adolescent, Adult, Child, Emergency Service, Hospital, Female, Follow-Up Studies, Humans, Male, Outcome and Process Assessment, Health Care, Parents, Prospective Studies, Suicide, Violence, Wounds and Injuries

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Suicide and Violence Prevention: Parent Education in the Emergency Department

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