Client Firearm Assessment and Safety Counseling: The Role of Social Workers

By Slovak, Karen; Brewer, Thomas W. et al. | Social Work, October 2008 | Go to article overview

Client Firearm Assessment and Safety Counseling: The Role of Social Workers


Slovak, Karen, Brewer, Thomas W., Carlson, Karen, Social Work


Professional social work cuts across all age groups, mental health issues, and behavioral problems in a variety of roles and settings. In addition, social workers are often considered the frontline practitioners in dealing with mental health issues because the number of social workers providing mental health services in the United States is greater than that of the professions of psychiatry and psychology (Colby & Dziegielewski, 2001).Yet, these social work professionals are likely to have little knowledge about an issue that can profoundly affect clients, namely clients' safety related to ownership and access to firearms. Sherman and colleagues (2001) stated that the mental health community should emphasize managing firearm risks among clients because firearms are fairly easy to acquire and those with mental health issues are at risk of hurting themselves or others by this means. Gathering information on social workers' awareness, knowledge, and practices of assessment and intervention with clients on the issue of firearm safety holds the potential to enhance the efficacy of mental health practice in this area.

CURRENT UNDERSTANDING OF SOCIAL WORKERS ASSESSMENT AND COUNSELING PRACTICE

When mental health practitioners work with clients and their families dealing with emotional and behavioral issues, it is important that they routinely assess and provide educational intervention on the risks of keeping a gun in the home or otherwise having access to a firearm. Although many clients may not initially present in crisis, the possibility of crisis remains significant with many clients; therefore, initial assessment and counseling on firearms is a proactive practice. Suicide is rare in the absence of psychiatric illness (Beautrais, 2006), and although mental health practitioners are key gatekeepers, the U.S. Department of Health and Human Services (2001) stated that gaps still exist in specialized assessment techniques and in risk factor recognition. This report points out that whereas at-risk individuals often seek professional help, only 18 percent of suicide decedents reported suicide ideation to a health professional (Robins, cited in U.S. Department of Health and Human Services, 2001). Furthermore, as many as 90 percent of suicide decedents carry a psychiatric diagnosis at the time of death (Conwell & Brent, 1995; Moscicki, 2001),indicating the need for proper assessment and recognition of risk factors by mental health practitioners. Although the present study is focused on mental health practitioners, this issue is still relevant to community organizers and policy practitioners in the mental health community.

An effort to study the attitudes, knowledge, and behaviors surrounding client gun ownership and access has been approached within the mental health practice fields of psychology, psychiatry, and medicine. Sullivan (2004) documented the practices and comfort level of psychologists in firearm assessment and discussion with clients. Gallagher (2002) collected data on psychiatrist's knowledge, attitude, and risk assessment practices of firearm-related suicide. In the field of medicine, the American Academy of Pediatrics recommended that physicians advise patients and families on firearm injury prevention (American Academy of Pediatrics Committee on Adolescents, 1992).

Research has demonstrated that clients are receptive to clinicians' counsel in this area. Sherman et al. (2001) illustrated the effectiveness of a multidisciplinary firearm risk management program in Ohio among high-risk mental health clients who expressed intent to commit suicide by means of a firearm upon inpatient admission to a mental health facility. The program was successful in eliminating access to firearms before discharge and thus neutralized this environmental risk factor for clients. In addition, studies in the medical field have demonstrated that parents and guardians are receptive to recommendations against having guns in the home (Haught, Grossman, & Connell, 1995) and to guidance about safe storage practices (Webster, Wilson, Duggan, & Pakula, 1992). …

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