Veterans’ Health

Grantee Name

Bronx Veterans Medical Research Foundation

Funding Area

Veterans’ Health

Publication Date

April 2023

Grant Amount


Grant Date:

January 2021 – December 2021

Veterans in New York experience suicide rates nearly twice as high as their civilian counterparts and have witnessed a dramatic increase in firearm usage in each of the last seven years.

During the onset of the COVID-19 pandemic, researchers warned that veterans may experience a “perfect storm” of circumstances that could elevate their risk of suicide, including increases in social isolation, widespread economic anxiety, and decreased access to mental health care. Equally concerning is the growing number of veterans in New York who use firearms in suicide attempts—the deadliest lethal mean, fatal in 85% of attempts compared with 5% for all others.

The Counseling on Access to Lethal Means (CALM) training model was developed to help health care providers implement counseling strategies to assist clients who are at risk for suicide by reducing access to lethal means—particularly, though not exclusively, to firearms. Though it is the gold standard for lethal means access counseling, there is a need to expand the reach of CALM and further adapt it for nonclinical communities. In 2020, NYHealth awarded the Bronx Veterans Medical Research Foundation (BVMRF) a grant to tailor and deliver CALM trainings to families and caregivers as well as increase its uptake among clinicians throughout New York State.

Outcomes and Lessons Learned

Under this grant, BVMRF:

  • Conducted outreach and engagement among clinical networks to educate clinicians about the importance of reducing lethal means access and helped them integrate CALM into onboarding and training programs at their organizations.
  • Consulted with suicide and legal experts to develop the content for the training, including information about New York State-specific gun laws.
  • Developed interview guides and conducted 20 interviews with family members affected by veteran suicide to identify needs of the targeted audience, anticipate potential concerns, obtain feedback, and recognize gaps in knowledge.
    • Found that family members of veterans felt alone and isolated, in addition to being unclear about where to turn to for support and advice on how to deal with issues involving suicide risk and firearm access.
    • Learned that a traditional didactic learning/training format was less desirable for family members, who preferred an engaging, interactive experience that validates their concerns and provides helpful information.

Informed by the results of the interviews, BVMRF pivoted toward creating an interactive website—rather than delivering traditional training workshops. The website adapts CALM training elements and highlights stories of families who successfully identified suicide risk, were able to voice their concerns, navigated lethal means safety, and effectively instituted some form of safe storage of firearms for the veteran in need. In April 2022, BVMRF launched the website, which hosts seven family member and veteran video vignettes, including an interview with a veteran gun owner who is also a clinician at the U.S. Department of Veterans Affairs and provides counseling on firearm safety. Since its launch, the website been viewed more than 10,000 times and accessed by more than 5,000 new users. Website content focuses on five content areas based on feedback from focus group and firearm safety experts, including:

  1. How to identify suicide risk,
  2. How to reach out for help,
  3. How to start the conversation about safe storage,
  4. Options for safe storage, and
  5. When to return firearms

Building on the success of this project, NYHealth awarded a second grant to create in-person, train-the-trainer workshops to expand these efforts and deepen their reach throughout New York State. Coalitions in seven other states are exploring options to duplicate this resource and expand the reach nationally.

Co-Funding and Additional Funds Leveraged: James J. Peters Department of Veterans Affairs Medical Center ($78,000).