ED-based lethal means counseling with parents of youth is a promising approach, but no RCTs have been conducted: Previous studies on LMC point to the need for fully powered RCTs in this area. A prospective follow-up study at a hospital ED where staff were instructed to deliver LMC messages to parents of all at-risk youth found that parents exposed to LMC were more likely to reduce the youth's access to lethal means than parents who were not exposed (75% vs. 48% for prescription drugs and 63% vs. 0% for firearms), but the number of gun- owning households (n=15) was very small. Promising evidence also comes from the pilot investigation that members of the study team conducted at Children's Hospital Colorado.