In this scenario, you'll see Daniel Martin, a 34-year-old veteran with post traumatic stress disorder and depression. He was admitted a week ago after presenting voluntarily to the emergency department with his partner Lauren with thoughts of suicide. Today, Lauren and Daniel are meeting with Daniel's psychiatrist, Dr. Thompson for a discharge [inaudible]. Hi, Daniel? I'm Dr. Thompson. How are you feeling today? I'm doing pretty well. Thanks. This new medication seems to be helping. I was really in a dark place before Lauren told me I needed to get some help. Thinking about killing myself, sitting and just staring at my gun. Lauren saved my life. I know I've got a long way to go, but I've got a lot to live for. You've made a lot of progress in the last week. Do you feel like you're ready to go home? Yeah, I think so. I think so too. What do we need to do to make sure he keeps getting better? Great question, Lauren. Daniel, you'll keep taking your medications and follow up with your new psychiatrist in one week. We'll want to follow you very closely. These treatments take time and even though today is a good day, you are at the start of a process that will likely include some dark days still to come. As you make it back to full strength, there may still be more of the days that brought you here, when life didn't feel worth living. That's why we made our safety plan. Okay. I understand. I want to talk about your guns. I really worry about your handgun and those hunting rifles you have at home. I know you're feeling better, but again, these treatments take time. Here's why I worry. Suicide is impulsive. Seventy one percent of suicides happen within an hour of someone making the decision to hurt themselves, and the vast majority of suicides happen within 30 days of hospital discharge. How can we work together to make your home safer for you right now? What do you mean? I feel strongly that in order to be safe at home, we need to get the guns out of the house for a while. Daniel, you're getting better, but you're still not yourself. I don't want to be back where we were last week, but if that happens, I want you to survive it. What are the options Dr. Thompson? Do you know someone who could hold onto the guns for you? That's called a voluntary transfer. If your brother can have guns legally, I can help you give them to him, to keep safe for you until you're better. Will that be an option? I can give my brother my hand gun, but it's hunting season. I love being outside hunting with my family. I hear you with the numbers. I do, but I really think I'm better. I think it might make me more depressed if I can't do the things I love to do. I don't want you to miss out on those things either. But, you know, if you were a football player and you've got a bad concussion, I'd say you can play next season. We need to focus on your health. You can hunt next season. This is life or death. We've got to get them out of the house, Daniel. I'm still so worried about you. This has not been a great feeling for me either. But, shouldn't it be focused on doing the things that make me happy? Daniel, I care about you and your safety, and yes, we want you to do the things that make you happy. But, like I said, this is a very high risk time in your recovery. I think it's best if I make the decision for you. I'm going to ask for something called an extreme risk protective order. In our state, doctors and clinicians can ask the courts to remove guns from the homes of people who might be in danger, to themselves or others. When you're better, when it's safe, usually in a year, the guns will be returned. Let me walk you through the next steps. A patient at imminent risk of suicide may need inpatient psychiatric care. An order could be considered upon discharge from the hospital or for patients who may not meet criteria for inpatient stabilization. Limiting access to firearms is an important way to prevent suicide, because suicide is impulsive. Seventy one percent of suicides happen within one hour of someone making the decision to attempt suicide. While firearms represent only a small portion of total suicide attempts, because they're extraordinarily lethal with up to 85-90 percent case fatality, they account for more than a half of fatal suicides. The vast majority of suicides happen within 30 days of hospital discharge, making this time especially critical.
