Crisis Services Strategy Library for Preventing Suicides and Homicides by Firearm

While the primary audience is 988 Lifeline Centers and other crisis-related lines, other applicable audiences include local behavioral health agencies (including those with afterhours), county crisis programs, suicide prevention coalitions, and mental health advocacy agencies.

Staff at the University of Wisconsin-Madison Population Health Institute (UWPHI)’s Evaluation and Engaged Research Group developed this strategy library by conducting an in-depth and systematic review of the available academic literature and best practice guides. From September 2024 through December 2024, staff conducted a literature review. Peer-reviewed articles and best practice guides from government, research, and other national expert sources published in the last 10 years (2014-2024) were included in the literature search. Inclusion criteria focused on various factors, including effectiveness, feasibility, cultural sensitivity, trauma-informed, evidence-based, and safety and risk management. From January 2025 through March 2025, the information was summarized with actionable strategies for crisis response providers to use in an effort to prevent suicides and homicides by firearms. 

The library was reviewed by content experts at the Wisconsin Department of Health Services and at Family Services of Northeast Wisconsin. External content reviewers also included firearm owners. Their input was incorporated into the final version of the library. 

The library was developed using funding awarded to the UWPHI from the Wisconsin Department of Justice’s State Crisis Intervention Program. Views expressed in this library are those of the authors based on available literature; views expressed do not reflect the views of the funder or other project partners (Wisconsin Department of Justice, Wisconsin Department of Health Services, and Family Services of Northeast Wisconsin). 

Authors are members of the Evaluation and Engaged Research Group at UWPHI, including Erin Skalitzky, Janae Goodrich, Mary Kate O’Leary, Laetitia Zeba, and Alisa Pykett.

Crisis lines: According to What Works for Health: “Crisis lines provide free and confidential counseling via telephone-based conversation, web-based chat, or text message to individuals in crisis, particularly those with severe mental health concerns such as suicidal thoughts. Crisis line counselors provide emotional support to helpseekers, assess suicide risk, and refer helpseekers to resources including counseling, social services, and emergency services. Counselors can be professionals or volunteers.” 

May include the 988 Suicide and Crisis Lifeline, county- or city-based crisis lines, and other related crisis intervention services. 

Helpseekers: Individuals who may be experiencing a crisis and contact an agency for crisis support (via call, text, chat, or other means). 

Crisis staff: Staff (professionals or volunteers) at the agency that provides crisis support. This includes answering a crisis line, providing mobile support, conducting assessments, providing de-escalation techniques, etc. 

Crisis staff conducting outreach: Staff (paid or volunteers) at the agency that provides crisis support who conduct outreach to share information or services. 

Staff trained in crisis support: Staff (professionals or volunteers) at the agency that provides crisis support who interact with helpseekers contacting the agency, also referred to as crisis counselors. 

Firearm access: The ability of individuals to obtain and use firearms.  

Lethal means: According to the Defense Suicide Prevention Office, “Any instrument or object (e.g. firearms, medicine, etc.) used to carry out a destructive act.” Note that this is broader area than strictly firearm access.