Quantitative Evaluation of the Veteran Crisis Line Lethal Means Safety Pilot

Background: The Veteran Crisis Line (VCL) Lethal Means Safety (LMS) Pilot offered cable gun locks or medication take-back envelopes to veteran callers at risk of suicide. Aims: We aimed to assess the acceptability of offering LMS interventions to these veterans and examined call outcomes, health care use, and mortality of veterans associated with acceptance of the intervention. Method: We assessed the acceptability of offering LMS interventions to eligible veterans who contacted the VCL between June 13, 2022, and March 31, 2023. To examine outcomes associated with acceptance of the intervention, we used inverse probability of treatment weights to balance veteran characteristics. Results: We found that 41.6% of veterans who were identified VHA enrollees accepted the intervention after being offered one, three times the rate of nonidentifiable veterans. Additionally, veterans who were offered any intervention, whether they accepted it or not, had a lower risk of having an emergency dispatch than those not offered one. Limitations: Veterans were not randomized to the intervention, so no causal inferences can be made. Conclusions: Our evaluation suggests that LMS interventions are acceptable to at-risk veterans. Further evaluation is needed to determine whether acceptance of an intervention has any long-term impacts on veteran outcomes.