A new report by leading researchers and medical professionals argues that more doctors need training in how to speak with their patients about firearms suicide.

“Those who are engaged in curricula development for and training of healthcare providers have an opportunity to shift the landscape of firearm suicide prevention by developing, implementing, and evaluating lethal means safety training programs at every level and stage of clinical education and practice,” the report says.

The report was published by The Consortium for Risk-Based Firearm Policy, a group of more than two dozen leading gun violence and public health researchers, practitioners, and advocates.

Firearms account for about half of all suicides in the United States, or roughly 20,000 deaths each year. Guns are by far the most lethal means of suicide: More than 80 percent of attempts using a firearm result in death.

As the report notes, the total number of gun suicides has grown considerably over the last decade. Rates among white men and women, two groups that account for more than 90 percent of all deaths, have increased the most.

The presence of a gun in the home directly increases the odds of suicide. But surveys show that many healthcare providers avoid speaking to their patients about the risks a firearm can introduce.

“Notably, there is a persistent gap between clinician attitudes and reported behavior,” the report reads. The authors cite one study that found between 61–87 percent of clinicians surveyed believed that they should speak with their patients about guns. Among the same sample, however, only 12–59 percent actually did.

In some cases, lawmakers have attempted to prevent such discussions. In Florida, there was a six-year legal battle over a law that sought to forbid healthcare providers from discussing guns with their patients. In June, a federal judge struck down key parts of the law.

But the principal reason practitioners don’t talk about guns and suicide with their patients, the report says, is lack of training.

One study cited in the report found that more than 95 percent of emergency physicians had never received training on firearms safety counseling. Another survey of clinical psychologists found that just over 25 percent had “a routine system for identifying patients with access to firearms or routinely charted or kept record of whether patients had access to firearms.”

The report offers a set of provisional recommendations for training programs. They include teaching healthcare providers how to review gun storage options with patients; how to respond if patients refuse safety steps; and, importantly, how to emphasize that discussions about firearms are about a patient’s safety, not politics.

The report also stresses that healthcare providers should learn more about guns and how they work, in an effort to increase their comfort level with gun-owning patients. “This portion of training may be provided by an expert from the firearms community, as there are potential partners who are focused on firearm safety and responsibility,” it reads. The report highlights the Gun Shop Project, a multi-state collaborative suicide-prevention effort between gun stores and public health organizations, as a case study in success.

The report’s authors conclude with a call to action. “The Consortium for Risk-Based Firearm Policy endorses and supports efforts among training programs that will equip healthcare providers to deal tactfully, respectfully, and directly with the issue of firearms and suicide.”