Are you worried someone in your household is at risk of suicide? Piloting ways to acceptably and feasibly increase safe firearm storage in rural Alaska

Background Reducing access to firearms decreases suicide risk, and Alaska Native (AN) communities are disproportionately impacted. Most suicide prevention interventions target individuals, while AN communities prioritise family and community. The Family Safety Net (FSN) is a firearm injury prevention intervention tailored to AN/Inupiaq communities. FSN uses screening questions to identify adults concerned about a household member and provides suicide prevention education, firearm safe storage supplies (eg, cable locks) and supportive reminder texts. Methods From March to May 2023, a community-driven, parallel-arm trial in Northwest Alaska assessed FSN feasibility, acceptability and preliminary efficacy. Screened and randomised to either FSN (counselling or scripted, both with supplies) or a general firearm safety intervention (scripted with supplies or supplies only), participants did baseline and follow-up surveys to assess their satisfaction, household firearm storage patterns and use of safety supplies. FSN recipients were invited to follow-up interviews. Results Of 62 enrolled participants, 58 (93%) completed follow-up surveys. All participants indicated high satisfaction, used the firearm safety materials and increased safe firearm storage. Nearly one-third (n=19) indicated concern about a household member and received a version of FSN. Nearly all FSN participants (n=17) did an additional follow-up interview, which reflected high acceptability. Discussion Offering firearm storage materials to participants increased safe home firearm storage for all. Prioritising adults with concern about a family member’s suicide risk offers a feasible way to engage higher risk households in firearm lethal means reduction, an effective suicide prevention strategy. Conclusion FSN is an innovative ‘upstream’ intervention for decreasing firearm-related suicide risk in Alaska.