Background: Together with Veterans (TWV), a community-based suicide prevention intervention, is being implemented in rural locations across the United States, with individuals designing and implementing action plans based on community-specific strengths and needs. To increase understanding regarding lethal means safety (LMS) among those living in 3 diverse rural communities where TWV is being implemented (Mississippi [MS], New Mexico [NM], Oregon [OR]), demographic and mortality data were obtained, and a survey was conducted. Responses are presented in the context of demographics and mortality rates.
Methods: Demographic and mortality data were drawn from the American Community Survey and the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research database. In addition, a random survey sample was selected from the United States Postal Service delivery sequence file. Survey recruitment was conducted primarily by mail.
Results: Notable differences exist between communities in terms of demographics and mortality rates (eg, average annual suicide mortality rates: MS 11.8/100,000; NM 33.0/100,000, OR 28.0/100,000). Across these communities, 3,846 individuals responded to the survey. Whereas most respondents were at least somewhat willing to discuss access to firearms with health care providers, only 3.8%-10.8% reported that any provider had asked about such access. A low proportion reported discussions with providers regarding safe storage of medications (14.1%-21.66%). Many respondents did not agree that gun locks and safes reduce suicide risk (16.9%-23.5%).
Conclusions: Findings highlight room for growth in terms of education regarding the positive impact of LMS. It is recommended that strategies be guided by community-specific contextual factors.
Keywords: death; firearms; lethal means safety; medications; rural.
Published 2026. This article is a U.S. Government work and is in the public domain in the USA.