Means Restriction Counseling: Reducing Suicide Risk Through Safer Environments
Reducing the means of suicide involves removing access to items that someone could use to take their own life. As a suicide prevention strategy, means restriction is a practical approach that can make a big difference in a crisis. If those means aren’t available, it causes a delay, which increases the likelihood that the intensity of the crisis will pass without suicidal action.
As with all suicide prevention strategies, adults at risk should be included in discussions about means reduction so that counseling and support are done collaboratively. To explore this topic in detail, this article will cover:
- Suicide prevention approaches.
- Why means restriction can be effective.
- Examples of means reduction in practice.
- Medication safety and overdose prevention.
- How means reduction counseling for suicide works.
- How to find support for suicidal ideation.
Suicide and Suicide Prevention
Suicide can happen at any stage of life, as a result of mental health issues, and impulsively during moments of crisis.[1] There are many forms of support for people who feel suicidal, ranging from crisis lines to inpatient stays.
While these services can be very helpful for de-escalating crises and treating people at risk, reducing the means of suicide is an important strategy for prevention. Below, we will look at the different types of support and why means reduction can be so effective.
Approaches to Preventing Suicide
There are many approaches to preventing suicide, from identifying warning signs to implementing strategies that reduce social isolation. These approaches can be implemented by governments, large-scale organizations, local healthcare providers, and even family members with loved ones at risk. They include:[2]
- Identifying people who are at risk of suicide by understanding the signs.
- Encouraging people to seek help for suicidal thoughts and intentions.
- Providing evidence-based therapies and treatments for people who feel suicidal.
- Involving and educating the person’s support network about suicide prevention.
- Making crisis phone lines, mobile support teams, walk-in crisis clinics, and peer support programs widely available.
- Fostering the development of skills for coping with stressful circumstances so that they don’t escalate to suicide crises.
- Promoting social connectedness to reduce loneliness and isolation.
- Reducing access to means of suicide.
This article focuses on reducing the means of suicide. The other approaches are also important, and it is crucial that people who feel suicidal receive therapeutic support for their thoughts and feelings.[3]
However, many suicides are carried out impulsively in moments of crisis.[1] Reducing the means of suicide for someone who is at risk can help to limit their options in these emergency moments.
Importance of Means Restriction
Means restriction involves reducing or restricting someone’s access to specific methods that are likely to be used to attempt suicide. It can be effective because:[3][4]
- Suicidal states do not remain constant and are short-lived in many people. In a crisis, the urge to take suicidal action can be incredibly intense, but this intensity is more likely to diminish if the person is delayed. The longer this delay can be, the more likely a crisis will pass. Research finds that the active suicidal state lasts about an hour for 30% of people.[4]
- People with suicidal ideation often have a means that they have decided on. If their preferred means are not readily available to them, people tend to either not seek out alternative means or seek out less lethal alternatives.
- Some means are more lethal than others. For example, 85-90% of suicide attempts with firearms result in death, while the figure is 1-2% for medication overdoses and sharp instrument wounds.[4] Therefore, reducing access to highly lethal means can bring down the likelihood of death and increase survival.
- Reducing access to highly lethal means can help people survive periods of intense suicidality. 90% of people who survive their first suicide attempt will not go on to die by suicide afterward.[4]
For these reasons, reducing the means of suicide is a crucial part of protecting people who are at risk. But how can this be done effectively?
How to Make Environments Safer for People With Suicidal Ideation
Family members, friends, and healthcare providers can take several actions to reduce access to means of suicide for people at risk. These are often practical actions for reducing suicide risk at home that make it a safer environment.[5]
Ways of reducing access to means include:[2][3][4]
- Safely storing and locking away any guns on your premises.
- Removing means from the person’s home, such as storing guns away from the home temporarily.
- Disposing of potentially poisonous products, such as unnecessary medications or cleaning products.
- Limiting access to means, such as keeping hold of the key to a medicine cabinet and dispensing medications in safe quantities.
- Giving things that could aid with suicide to a trusted person until the mental health crisis has passed.
The specific ways to mitigate risk in a mental health crisis will depend on the loved one you’re protecting from harm. However, removing their preferred means is often one of the most important suicide prevention strategies for adults and teens.
Means Reduction Counseling
Means reduction counseling is a collaborative effort between clinicians and people receiving treatment to reduce access to means of suicide.[3] This article is aimed at loved ones wanting to reduce access to things that can be used by a person at risk, but it can feel like there is a divide between you if you don’t involve them in your efforts.
Means reduction counseling aims to educate people at risk of suicide about how your steps can support them. Counselors, individuals, and their loved ones can then work collaboratively to limit physical means of suicide.[3]
Means reduction counseling can be found in both inpatient and outpatient services, as well as primary care and emergency settings. It will typically involve:[3]
- Being asked directly about suicidal thoughts, behaviors, reasons, plans, preferred means, and alternative means.
- Making plans to limit access to means, such as medications, rope, and guns.
- Counseling around triggers that may increase the risk, such as alcohol and substance use.
- Talking through avoiding potentially dangerous situations if the preferred means of suicide include stepping in front of a train or off a building.
- Planning to involve family members, friends, or neighbors who can support means reduction efforts.
- Addressing any beliefs, thoughts, or feelings about means reduction.
- Inviting the person at risk to think about ways they can make their environment safer.
- Follow-up meetings to assess suicide risk and the effectiveness of the means reduction plan.
Depending on the person’s preferred means, their counseling could focus on medication safety and overdose prevention, or firearm safety and removing other lethal means. This process may feel arduous or administrative, but it’s all about keeping people safe.
Sometimes it feels as though we shouldn’t ask directly about suicide because it’s taboo. However, having direct conversations is often the best way to alleviate crises. Suicide prevention counseling for adults and teens is most effective when it addresses these practical safety concerns alongside emotional support.
Mission Connection is here to help you or your loved one take the next steps towards an improved mental well-being.
Get Means Restriction Counseling for Suicide Prevention
At Mission Connection, we offer a range of support for people who feel suicidal. Here are the three main aspects of treatment you can expect when reaching out to us for help with your mental health:
Assessing Suicidality
When someone comes to Mission Connection for support for suicidal thoughts, they’ll first be invited for a meeting to discuss their symptoms, history, and mental health overall.
This kind of evaluation will ask directly about suicidal thoughts, their frequency, and any plans you might have made. We’ll also ask about your history of suicidality, which means asking about times in the past you’ve felt suicidal and if you’ve made any attempts.
We will also work with you to develop suicide risk reduction strategies. By identifying the most likely potential means and how they can be removed from your home environment, we’ll work collaboratively to create a mental health safety home checklist.
This checklist can become a practical tool for reducing suicide risk at home and can be shared with trusted family members or friends.
Outpatient Therapy
Our various outpatient mental health treatment programs give you the space to work through, manage, and reduce suicidal thoughts with a licensed mental health professional. We offer a range of therapeutic approaches, including cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and psychodynamic therapy.
Suicide prevention strategies for adults and teens often combine therapeutic support with practical safety planning. Whichever therapies you take part in, your therapists will be aware of your suicide prevention plan and regularly check in with you about preventing self-harm and environmental risks.
Lifestyle Changes
At Mission Connection, we don’t view mental health as purely biological. We understand that there are many historical, social, and lifestyle factors that influence mental health positively and negatively.
That’s why therapeutic support at our services includes guidance for making lifestyle changes that will support your well-being long-term.
Working collaboratively with one of our licensed professionals, you’ll identify the things you can adjust and implement in order to feel better supported and less stressed on a daily basis.
This could mean developing an exercise or mindfulness practice, reengaging with your spirituality, or leaning on your family and friends. It can also be a way to identify activities that can be a distraction from suicidal thoughts when they arise.
Our flexible outpatient treatment models include in-person programs at our facilities, telehealth services, or a hybrid approach that combines in-person and virtual care.
Reach out to us today to start your therapy journey or learn more about our services. Our compassionate team is available 24/7 to speak with you at no cost or obligation. Call 866-833-1822 now.
