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So if my colleagues and I evaluate a patient who owns a gun and wants to self-harm, or more rarely harm others, what do we do?

We can pursue a range of options, from handing out gun locks to requesting family or friends temporarily hold onto firearms to asking that local police to perform a welfare check at the patient's home.
That usually works out to the detriment of the person being checked on. Cops are not trained mental health professionals. Introducing roided up guys with guns who are more than willing to use them into this situation is not a good solution.
 
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