A recent study estimated that over 40% of youth suicide victims were seen in the ED in the year preceding their death. EDs have been identified by the National Action Alliance for Suicide Prevention as one of two key arenas for improved services to reduce the proportion of at-risk youth who progress to suicide, yet LMC in emergency departments remains uncommon: ED clinicians often do not offer any lethal means counseling to at-risk patients and their families, and many do not counsel on reducing access to firearms in particular. For example, Grossman and colleagues reported that although 80% of emergency nurses in Illinois had recent experience with suicidal adolescents, only 28% provided LMC to parents. A record review found that psychiatric residents at a psychiatric emergency department assessed firearm access in only 3% of pediatric patients.