University of Rochester Medical Center

In New York State, veterans die by suicide at almost twice the rate of their civilian counterparts.

Particularly concerning is the use of firearms, which accounts for nearly half of deaths by suicide in the New York veteran community. In response, lethal means access counseling, which includes the safe storage of firearms, has emerged as a core strategy to address this issue. The Counseling on Access to Lethal Means (CALM) training is the gold standard for lethal means access counseling. CALM is the only training evaluated by peer-reviewed research that shows its efficacy and has been delivered to more than 25,000 clinicians across the country. New York State counties are using a handful of complementary suicide prevention and lethal means access programs, including CALM. Given the crucial role that family members play in supporting people at risk for suicide, NYHealth has invested in adapting and tailoring the CALM training to be used by non-clinicians, as well. In 2023, NYHealth awarded the University of Rochester Medical Center (URMC) a grant to expand the use of CALM for family members and community providers.

Under this grant, URMC will monitor and assess training needs, create a community toolkit, and provide technical assistance to high-need communities. It will work with a subset of 26 counties that are implementing CALM to assess which complementary programs fit their needs and preferences. In each county, URMC will build connections with stakeholders; conduct interviews and surveys to assess reach, gaps, and opportunities; and determine how different suicide prevention programs can fit simultaneously. It will consolidate feedback and data to provide an individualized assessment to each county. In addition, URMC will develop a community toolkit that provides evidence-based suicide prevention and lethal means access training; recommendations for workshop selection, implementation, and coordination; and considerations based on veteran community. Using this toolkit, URMC will partner with networks in three high-need communities to deliver and assess tailored workshops. Through these workshops, it will identify the trainings, including CALM, that best meet veteran communities’ needs. With its partners, URMC will disseminate the toolkit and training materials to all county suicide prevention coalitions, the New York State Department of Veterans’ Services, and others focused on veteran suicide prevention.