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

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.