Lethal Means Counseling and Distribution of Cable Locks Increase Safe Firearm Storage among Military Personnel

Posted January 26, 2021

Michael Anestis, PhD, Rutgers University, New Jersey Gun Violence Research Center

Michael Anestis, PhD, Rutgers University, New Jersey Gun Violence Research Center Dr. Michael Anestis

Suicides are more likely to occur in a household where firearms are not stored safely, and access to firearms contributes to more than 60% of military suicides. Given the rate with which firearms are used as a method for military suicides, promoting safe firearm storage may be an instrumental means for military suicide prevention. Safe firearm storage is encouraged through lethal means counseling, which involves discussing behaviors to restrict an individual’s access to methods of suicide. However, research on lethal means counseling’s acceptability and effectiveness is limited.

With support from the Defense Health Program-funded Military Suicide Research Consortium (MSRC) provided to the University of Southern Mississippi, Dr. Anestis and colleagues tested whether lethal means counseling or providing gun cable locks would create sustained adoption of safe firearm storage practices1. The lethal means counseling session followed a motivational interviewing-based protocol where participants developed a plan for safe firearm storage with a clinician by reflecting on their reasons for and against safe firearm storage and why they wanted to adopt or use certain firearm storage methods. In control (health and stress counseling) sessions, participants developed a plan with a clinician to manage stress, sleep quality, diet, or exercise. After these guided sessions, the plan was written down and given to the participant to take back to their household. Two hundred and thirty-two United States National Guard Service Members were divided into four interventions, those who received: lethal means counseling alone, lethal means counseling with cable gun locks, control counseling alone, or control counseling with cable locks. Firearm storage practices were assessed 3 and 6 months later.

Dr. Anestis’ team found Service Members were more likely to implement a higher number of safe storage practices if they received lethal means counseling instead of the control counseling, specifically by increased use of gun safes and locking devices. Service Members were also more likely to use locking devices if they were provided a cable lock compared to those who did not receive cable locks. However, safe storage practices did not improve further with the combination of lethal means counseling and cable locks. Taken together, these findings support the notion that lethal means counseling may be equally as effective as directly providing Service Members with cable locks in implementing safe storage practices into their homes.

These results highlight that lethal means counseling and the distribution of cable locks can promote substantial and continued changes in firearm storage practices; implementing these interventions within the United States military may aide the progression toward lowering the military suicide rate.

For more information about the MSRC and its funded studies, please visit If you or someone you know is in crisis, contact the Military Crisis Line by texting 838255, calling 1-800-273-8255, or starting a confidential chat at


Bryan CJ, Bryan AO, Anestis MD, et al. Firearm Availability and Storage Practices Among Military Personnel Who Have Thought About Suicide. JAMA Netw Open. 2019; 2(8):e199160. doi:10.1001/jamanetworkopen.2019.9160

Anestis MD, Bryan CJ, Capron DW, and Bryan AO. 2020. Lethal means counseling, distribution of cable locks, and safe firearm storage practices among the Mississippi National Guard: A factorial randomized controlled trial, 2018-2020. American Journal of Public Health, e1-e9. PMID: 33351652


Public and Technical Abstracts: Military Suicide Research Consortium: Extension to New Opportunities and Challenges

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Last updated Thursday, May 26, 2022