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The Impact of Lethal Means Counseling on Openness to Out-of-Home Firearm Storage: Results From Project Safe Guard

In brief

Brief counseling raises willingness for out-of-home firearm storage in Guard members

In a randomized trial of 232 Mississippi National Guard personnel, a single lethal-means counseling session increased participants' openness to temporarily store firearms outside the home during personal distress, with the biggest effect seen right after the session. The finding suggests counseling could be a useful tool for suicide prevention, though the actual change in storage behavior remains to be measured.

Journal
Suicide & life-threatening behavior (Q1)
Published
1 August 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Michael D Anestis, Jennifer Paruk, Allison E Bond, Nicholas Allan, Craig J Bryan, Daniel W Capron, et al.
PMID
42592737
DOI
10.1111/sltb.70135

Why clinicians should know about it

Abstract

INTRODUCTION: Firearm access increases suicide risk and lethal means safety (LMS) counseling is widely promoted to reduce this risk by encouraging voluntary limitations on firearm access during crises. Although LMS has been shown to increase secure in-home firearm storage, less is known regarding its ability to promote temporary out-of-home storage-an approach that may more clearly prevent suicide. This study evaluated whether Project Safe Guard (PSG), a brief LMS intervention, increases willingness to store firearms outside the home during periods of heightened distress. METHOD: Participants were 232 Mississippi National Guard members with home firearm access enrolled in the original PSG randomized trial. Individuals received either a single session of PSG or a time-matched control condition. Willingness to store firearms outside the home during personal or household distress was assessed pre-intervention, post-intervention, and at 3 and 6-month follow-ups. Repeated-measures ANOVAs tested change over time and the impact of condition. RESULTS: Participants receiving PSG showed significantly greater increases in willingness to store firearms outside the home when distressed, with effects more robust immediately post-treatment and in analyses focused on participants' own distress. CONCLUSION: PSG increases openness to temporary out-of-home storage and may represent a promising firearm suicide prevention strategy. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT03375099.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.