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Means Restriction Saves Lives

October 8, 2016

One important protective factor in the prevention of suicide at school is the restriction of access to potentially lethal means of self-harm and suicide. A comprehensive college mental health and suicide prevention plan underscores the importance of means restriction as a primary intervention for suicide prevention. Means restriction starts with a survey of the physical environment where students live and work. Collaboration between campus administration and mental health professionals with campus safety, custodial services, and campus facilities professionals is instrumental in identifying potential solutions for lethal means restriction.

For college students who die by suicide, firearms, hanging, jumping and overdose are the most commonly used methods. Other highly lethal means for suicide on campus include access to rooftops, windows and bridges, access to laboratory chemicals, and alcohol and drugs. Removal of highly lethal means on campus will diminish the likelihood that a suicide attempt will occur or that a fatal outcome will result from an attempt. An all-inclusive strategy for means restriction also promotes practices that serve to lengthen the time between an impulse to harm oneself and the opportunity to access the means to do so because it is well established that suicidal urges and attempts often occur in the midst of brief suicidal crises. Gun lockers on a campuses where guns are permitted,safe storage of dangerous chemicals, breakaway closet rods in residence halls and securing roofs and windows of campus buildings are examples of barriers to suicide.

Specific campus settings can influence the type of means restriction actions required. Where appropriate, it is desirable for the college to work with community partners such as a police department or nearby gun club, in order to broaden means restriction in the community and monitor off campus access to lethal means.

It is well documented that lethal means restriction reduces one major risk factor for a fatal outcome from attempted suicide. It is important for college mental health and suicide prevention programs to be supplemented by changes in the campus environment that reinforce the safety net for students at risk for impulsive, potentially lethal behavior.
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The World Health Organization defines “mental health” “as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” In using this definition, S2i recognizes that some mental health challenges reflect brain diseases that, like physical diseases, require appropriate stigma-free and patient-centered care and include both mental health and substance use disorders. Other mental health challenges stem from social conditions and marginalization and require different forms of interventions.