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← Prevention & Intervention Library

Lock to Live: A Firearm Safety Decision Support Tool

Violence Domain:

  • General Firearm Injury
  • Suicide

Clinical Setting:

  • Primary Care
  • Emergency Departments
  • Specialty Care

Key Staff:

  • Primary Care Provider
  • Emergency Department Provider
  • Mental Health Provider

Delivery Mode:

  • Self-administered
  • Paper
  • Electronic health record
  • Virtually

Primary Audience:

  • May be universally distributed or tailored for specific groups of patients such as those experiencing high stress or crisis, those with depression or suicidal ideation, or patients identified as having firearms in the home

Primary Outcomes:

  • Increased adoption of safety behaviors (e.g., secure storage for firearms)​
  • Decreased unauthorized access to firearms
  • Decreased access to firearms during high-risk time periods​

Lock to Live, developed in 2018 at the University of Colorado, is a decision support tool designed to help individuals reduce access to potentially dangerous items in the home during times of high risk.

This tool provides a step-by-step assessment and generates tailored recommendations based on patient responses. While Lock to Live encompasses a range of health hazards—including medications, sharp objects, ropes or cables, and chemicals—its key focus is on firearm access.
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As part of the Lock to Live intervention, patients are first asked to identify trusted individuals who might be able to help with safe storage— such as a spouse, family member, friend, coworker, or another trusted person.
​
The firearm screening questions then ask the patient about:

  • Firearms in the home
  • Willingness to store firearms outside the home
  • Concerns about background checks
  • Cost considerations, using a sliding scale

Based on responses, in-home and off-site storage options are shared, alongside the cost, pros, and cons of each option. Patients are then prompted to select their next steps for secure storage. They also have the option to read short personal stories about individuals who made choices around secure storage. ​
​
Research has shown that users generally respond positively to the Lock to Live tool. They appreciate that the tool is anonymous, uses non-judgmental and normalizing language, and is respectful of values around firearms. It is also seen as accessible, realistic, and useful.1 Most users indicate they would recommend Lock to Live to others facing similar situations.

Resources

Background

  • 'Lock to Live': development of a firearm storage decision aid to enhance lethal means counselling and prevent suicide.
  • Reducing Firearm Access for Suicide Prevention: Implementation Evaluation of the Web-Based “Lock to Live” Decision Aid in Routine Health Care Encounters.

Tools

  • Lock To Live (on-line)
  • Lock To Live (paper-based)
Kaiser Permanente Center for Gun Violence Research
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