Presenter Profile
D. Shanté Washington, DSW, LCSW, LICSW, CCTP
Title IV-E Field Education Instructor
University of Georgia
donnetta.washington@choa.org
Dr. Washington is a licensed clinical social worker with over 15 years of experience liaising between families and their communities. She serves as the Field Education Coordinator for the Title IV-E Program at the University of Georgia. Dr. Washington brings an extensive background in child welfare, with experience as a frontline CPS investigator, foster care training and licensing specialist, supervisor, and DFCS State Office Treatment Care Coordinator. She also has extensive knowledge of pediatric mental health as she has served as a Behavioral Mental Health expert in a pediatric emergency department. Dr. Washington’s current research involves suicide prevention and lethal means counseling with families during their unexpected visits to the emergency department. Dr. Washington holds a Bachelor of Social Work from Clark Atlanta University, a Masters in Social Work from the University of Illinois at Chicago, and a Doctor of Social Work from Barry University in Miami, FL. This is in conjunction with numerous coinciding licenses, conducting formal presentations, and an inherent altruism that stems from a passion for seeing families thrive within their dwelling environment.
Presentations
Reducing Firearm Access for Youth at Risk for Suicide in a Pediatric Emergency Department
Sofia Chaudhary, MD
Caroline Chivily, MPH
Emily Morris, MD
Scott Gillespie, MS, MSPH
Donnetta Shanté Washington, DSW, LCSW, LICSW, CCTP
Kiesha Fraser, MD
Sarah Lazarus, DO
Angela Costa, DO
Nathan Call, PhD
Jonathan Rupp, PhD
Harold Simon, MD, MBA
Firearm-related suicide is the second leading cause of pediatric firearm death. Lethal means counseling (LMC) can improve firearm safe-storage practices and be a critical intervention for families with youth at-risk of suicide. Our study objectives were to evaluate feasibility and acceptability of pediatric emergency department (ED) behavioral health (BH) specialists providing LMC to caregivers of youth presenting with BH complaints and to investigate practice changes pre- to post-intervention.
Prospective feasibility study of caregivers of youth presenting to pediatric ED with BH complaints. Caregivers completed a self-administered electronic survey regarding self-reported demographics and firearm safe-storage knowledge/practices. All participants received LMC from BH specialist after primary BH concerns were addressed. Gun-owners were offered a free lockbox and/or trigger lock. 1-week follow-up electronic surveys gathered self-reported data on firearm-safety practices and intervention acceptability. Primary outcomes include proportion of gun-owning participants, follow-up survey response, and acceptability of LMC. Secondary outcomes include reported change in firearm-safety practices. Descriptive statistics were used for univariate and paired data responses. Likert-scale acceptability responses were dichotomized to strongly agree/agree (affirmative) vs. neutral/disagree/strongly disagree.
81 subjects were approached with 50 (62%) enrolling (96% female, 47% Black, mean age 40 years (SD± 8.3)). 60% had no prior gun-safety counseling/education; 44% had at least one gun at home. Among gun-owners (n=22), 81% had handguns and 45% had shotguns. 63% always used safe-storage device. 45% used gun-safe, 27% used lock box, and 23% used trigger lock. 59% of gun-owners requested safe-storage devices.
78% (n=39/50) of enrolled participants completed follow-up, where 69% of participants asked about household guns prior to child visiting other homes compared to 46% pre-intervention (+23%). More than 80% affirmed at intake and follow-up that ED gun-safety education was useful and 85% affirmed at intake and follow-up that ED is appropriate place for gun safety discussions. Among gun-owners that completed follow-up (n=19), 100% stored all guns locked at 1-week compared to 74% pre-intervention (+26%). Ten families removed guns temporarily or permanently after the ED intervention.
Pilot results show that it is feasible to provide LMC in the ED via BH specialists to families of high-risk youth. Caregivers report finding this intervention useful, acceptable, and appropriate. Additionally, LMC and device distribution led to reported changes in safe-storage practices.
1. Attendees will learn that lethal means counseling (LMC) is a critical intervention for caregivers of youth presenting with behavioral health complaints to a pediatric emergency department (ED).
2. Attendees will learn that pediatric caregivers find ED-based LMC acceptable.
3. Attendees will learn that pediatric caregiver gun owners demonstrate changes in self-reported secure storage practices after LMC intervention.