Skip to main content

Advertisement

Log in

Firearm Anticipatory Guidance Training in Psychiatric Residency Programs

  • Original Article
  • Published:
Academic Psychiatry Aims and scope Submit manuscript

Abstract

Objective

Most suicides (60%) are committed with firearms, and most (80%) of individuals attempting suicide meet diagnostic criteria for mental illness. This study assessed the prevalence of firearm injury prevention training in psychiatric residency programs. Methods: A three-wave mail survey was sent to the directors of 179 psychiatric residency programs. Outcome measures were the portion of programs offering training in anticipatory guidance for firearms safety, the content of training if offered, and the perceived benefits and barriers to providing such training.

Results

A total of 115 directors responded, a response rate of 64%. The vast majority (79%) reported they had not seriously thought about providing firearm injury prevention training. However, more than half(55%) reported that they routinely screened patients for firearm ownership. The directors perceived more benefits than barriers to offering such training. Additionally, the majority (62%) thought APA should provide curriculum guidelines regarding firearm injury prevention training.

Conclusion

Psychiatrists are uniquely positioned for helping to prevent firearm suicides and homicides among the mentally ill. However, psychiatric residency programs are inadequately training residents and thereby keeping them from maximizing their roles as mental health professionals. Leadership is needed by APA to help reduce firearm violence in the United States.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Centers for Disease Control and Prevention: Web-Based Injury Statistics Query and Reporting System (WISQARS). Available at http://www.cdc.gov/injury/wisqars/index.html

  2. Kaplan MS, Geling O: Firearm suicides and homicides in the United States: regional variations and patterns of gun ownership. Soc Sci Med 1998; 46:1227–1233

    Article  CAS  PubMed  Google Scholar 

  3. Wiebe DJ: Homicide and suicide risks associated with firearms in the home: a national case-control study. Ann Emerge Med 2003; 41:771–782

    Article  Google Scholar 

  4. Karch DL, Dahlberg LL, Patel N, et al: Surveillance for violent deaths: national violent death reporting system, 16 states, 2006. MMWR Surveill Summ 2009; 58:1–44

    PubMed  Google Scholar 

  5. Cook PJ, Ludwig J: Gun Violence: The Real Costs. New York, Oxford University Press, 2000

    Google Scholar 

  6. American Academy of Family Physicians: Firearms, handguns, and assault weapons. Available at http://www.aafp.org/online/en/home/policy/policies/f/firearmlaws.html

  7. Committee on Trauma of the American College of Surgery: Statement on firearm injuries. Bull Am College Surg 2000; 85:24

    Google Scholar 

  8. American Academy of Pediatrics, Committee on Injury and Poison Prevention: Firearm-related injuries affecting the pediatric population. Pediatrics 2000; 10:888–895

    Article  Google Scholar 

  9. American Medical Association: Firearms: safety and regulation. Available at http://www.ama-assn.org/ad-com/polfind/Hlth-Ethics.pdf

  10. American Association of Orthopedic Surgeons: Firearms violence. Available at http://www.aaos.org/about/papers/position/1134.asp

  11. Kellermann AL, Rivara FP, Somes G: Suicide in the home in relation to gun ownership. N Engl J Med 1992; 327:467–472

    Article  CAS  PubMed  Google Scholar 

  12. Miller M, Lippmann S, Azrael D: Household firearm ownership and rates of suicide across the 50 United States. J Trauma 2007; 62:1029–1035

    Article  PubMed  Google Scholar 

  13. Bertolote JM, Fleischmann A, De Leo D, et al: Psychiatric diagnoses and suicide: revisiting the evidence. Crisis 2004; 25:147–155

    PubMed  Google Scholar 

  14. Ilgen MA, Zivin K, McCammon RJ, et al: Mental illness, previous suicidality, and access to guns in the United States. Psychiatr Serv 2008; 59:198–200

    Article  PubMed  Google Scholar 

  15. Shoenber EZ: Safety training for medical students during their psychiatry clerkship. Presented at 160th Annual Meeting of the American Psychiatric Association, May 19 -24, 2007, San Diego

  16. Dubin WR, Wilson SJ, Mercer C: Assaults against psychia-trists in outpatient settings. J Clin Psychiatry 1988; 49:338–345

    CAS  PubMed  Google Scholar 

  17. Sudak H: Encountering patient suicide: the role of survivors. Acad Psychiatry 2007; 31:333–335

    Article  PubMed  Google Scholar 

  18. Price JH, Kinnison A, Dake JA, et al: Psychiatrists’ practices and perceptions regarding anticipatory guidance on firearms. Am J Prev Med 2007; 33:370–373

    Article  PubMed  Google Scholar 

  19. The Liaison Committee on Medical Education: Current LCME Accreditation Standards. Available at http://www.lcme.org/standard.htm

  20. American Medical Association: Fellowship and Residency Interactive Database (FREIDA). Available at http://www.ama-assn.org/ama/pub/category/2997.html

  21. Prochaska JO, DiClemente CC, Norcross J: In search of how people change: applications to addictive behaviors. Am Psychol 1992; 47:1102–1114

    Article  CAS  PubMed  Google Scholar 

  22. Harrison JA, Mullen PD, Green LW: A meta-analysis of studies of the health belief model with adults. Health Educ Res 1992; 7:107–116

    Article  CAS  PubMed  Google Scholar 

  23. King KA, Pealer LN, Bernard AL: Increasing response rates to postal questionnaires: a review of inducement strategies. Am J Health Educ 2001; 32:4–15

    Article  Google Scholar 

  24. Edwards P, Roberts I, Clarke M: Increasing response rates to postal questionnaires: systematic review. BMJ 2002; 324: 1183–1187

    Article  PubMed  Google Scholar 

  25. Balon R: Encountering patient suicide: the need for guidelines. Acad Psychiatry 2007; 31:336–337

    Article  PubMed  Google Scholar 

  26. McNiel DE, Chamberlain JR, Weaver CM, et al: Impact of clinical training on violence risk assessment. Am J Psychiatry 2008; 165:195–200

    Article  PubMed  Google Scholar 

  27. Haught K, Grossman D, Connell F: Parent’s attitudes toward firearm injury prevention counseling in urban pediatric clinics. Pediatrics 1995; 96:649–653

    CAS  PubMed  Google Scholar 

  28. Barkin SL, Finch SA, Ip EH, et al: Is office-based counseling about media use timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics 2008; 122:e15–e25

    Article  PubMed  Google Scholar 

  29. Goldstein MG, Whitlock EP, Depue J: Multiple behavioral risk factor interventions in primary care: summary of research evidence. Am J Preventive Med 2004; 27: 61–79

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to James H. Price Ph.D. M.P.H..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Price, J.H., Thompson, A.J., Khubchandani, J. et al. Firearm Anticipatory Guidance Training in Psychiatric Residency Programs. Acad Psychiatry 34, 417–423 (2010). https://doi.org/10.1176/appi.ap.34.6.417

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1176/appi.ap.34.6.417

Keywords

Navigation