UTMB Medical Students “Lock” Firearm Safety into Community Minds
By Alisa Pierce

With help from the Texas Medical Association Foundation (TMAF), members of TMA’s Medical Student Section at the University of Texas Medical Branch at Galveston (UTMB) are promoting firearm education in their community through a student-led Firearm Safety Intervention Program. 

UTMB medical students provide firearm intervention and education twice a month to patients of the psychiatry clinic within St. Vincent’s Medical Student-Run Clinic at UTMB. The “five Ls” mnemonic for firearm access (locked, loaded, little children, feeling low, learned owner) guides the conversations. 

Each patient is given a questionnaire with the following questions: 

  • Do you own a firearm or is there a firearm in your household? If yes, how many? 
  • Are the firearm(s) loaded with ammunition? 
  • Are the firearm(s) locked (trigger lock, gun lock, in a safe, etc.)? 
  • Do any children under nineteen live with you? 
  • Are you feeling down or depressed today? 
  • Have you ever been educated on firearm safety?  

All information shared during the patient interview is entered into a note in the patient’s electronic medical record, permitting future physicians to access the information and allow patients who may be “high-risk” for firearm-related injury or violence to be tracked over time by their care team. 

“We use the five Ls framework so patients feel more comfortable talking to health care professionals about firearms,” said second-year UTMB medical student and program volunteering coordinator Shilpa Rajagopal. “Once we initiate that conversation, we follow up with their physician to discuss concerns or intervention options.” 

Ms. Rajagopal and fellow UTMB students Jaya Thyagarajan, Christopher Doan, Veronica Schlidt-Hernandez, and Kevin Chen saw a need for the program after Galveston County surpassed the state average for firearm-related deaths and suicides in 2020. 

“In Galveston County, firearm deaths and suicides are significantly greater than in both the state and nearby Harris County,” Ms. Thyagarajan, third-year UTMB medical student and program director said. “We wanted to bring this firearm safety education into clinical spaces in our community, where gun deaths and injuries are rampant, to decrease harm.”  

Funded by a TMA Foundation Medical Community Grant, which supports TMA priorities, including family violence, suicide prevention, educational resources, community outreach events, and health improvement initiatives across Texas, the program services all English and Spanish-speaking patients seen for psychiatric care at St. Vincent’s.  

There, patients are provided complimentary gun cable locks along with educational resources on safe storage practices, firearm safety education for children, and resources for recognizing mental health crises and seeking help. 

“A big part of what we do is distributing gun locks to patients,” Ms. Rajagopal said. “It’s a very tangible thing that can implement change away from the clinic and where, realistically, the danger lies. And we've seen patients who, after six months, are still using the locks.” 

According to a 2021 study by the Academic Pediatric Association, providing a locking device in a health care setting has been shown to increase safe gun storage practices, with a 38% improvement in storage behaviors for psychiatric patients. providing a locking device in a health care setting has been shown to increase safe gun storage practices, with a 38% improvement in storage behaviors for psychiatric patients. 

Moreover, per a 2019 study in the Journal of the American Medical Association (JAMA), promoting safe firearm storage has been demonstrated to effectively lower gun fatalities, and researchers estimate that locking all guns would decrease accidental deaths and youth suicides by one-third. 

TMA firearm policy agrees and states: 

“TMA calls on physicians to support … Providing anticipatory guidance in the clinical setting on the dangers of firearm ownership in an informational, nonjudgmental manner, encouraging firearm owners to adhere to best practices for reducing the risk of accidental or intentional injuries or deaths by ensuring firearms are not accessible to children; adolescents; or people with mental, behavioral, or substance use disorders.” 

In the past, the program used TMAF funds to conduct gun safety training with a community clinic for adolescents, where gun locks and pamphlets were distributed. 

Ms. Thyagarajan says to continue to embody TMA policy and address Galveston County firearm safety, the program will use further funding to conduct training with internal medicine and pediatric residents. The medical student members internally funded lectures and presentations on firearm safety for psychiatry residents earlier this year. 

“My goal as director of this program is to bring firearm education into more clinics, because I believe speaking about firearm safety is an essential part of patient safety,” Ms. Thyagarajan said. “I want to increase competency surrounding firearm safety in our community. Help from the TMAF grant allows us to implement our protocols into additional clinics, which is helping us to achieve that goal and to save patients’ lives.” 

Last Updated On

July 25, 2023

Originally Published On

July 25, 2023

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Alisa Pierce

Reporter, Division of Communications and Marketing

(512) 370-1469
Alisa Pierce

Alisa Pierce is a reporter for Texas Medicine. After graduating from Texas State University, she worked in local news, covering state politics, public health, and education. Alongside her news writing, Alisa covered up-and-coming artists in Central Texas and abroad as a music journalist. As a Texas native, she enjoys capturing the landscape on her film camera while hiking her way across the Lonestar State.

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