Family Safety Net – Piloting Family-Focused Firearm Lethal Means Reduction in Alaska Native Village Clinics

Suicide is a major and rising public health problem in rural America. In Alaska, suicide rates are consistently triple the national rate. In rural Alaska Native (AN) communities, virtually all homes have multiple guns for subsistence hunting, which increases suicide risk significantly; in rural Alaska, 60% of the suicide fatalities are due to firearms. The Family Safety Net (FSN) initiative, a collaboration between the University of Michigan and Maniilaq Association, aims to address the critical issue of youth firearm access. Located in remote, rural Alaska, Maniilaq Association represents twelve federally recognized tribes. FSN was developed in partnership with a local community steering committee and remote AN participants to create a culturally-affirming brief intervention to reduce quick access to firearms for youth. The purpose of the FSN is to create a widely used strategy to support home safety by reducing quick access to guns in homes, giving community members gun storage materials and offering other resources to keep loved ones safe. The FSN brief intervention represents a fundamental shift from solely identifying individuals at heightened suicide risk, which is currently not working (only 2% of Maniilaq patients screen positive using the PHQ2), toward engaging adult family members in firearm lethal means reduction to keep their loved ones safe. Tailored to be culturally responsive and respectful, the FSN universally screens to identify adults who are worried that someone in their household is at risk of suicide. These family members then participate in a brief lethal means reduction intervention, go home with gun safety materials, and finally, receive supportive and affirming text messages for a month following the intervention. By supporting people to keep their loved ones safe through reducing easy access to guns, FSN provides culturally-relevant and equitable clinical intervention to reduce firearm-related deaths among young people in Northwest Alaska.