Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 May 22:12:1352815.
doi: 10.3389/fpubh.2024.1352815. eCollection 2024.

Reducing firearm access for youth at risk for suicide in a pediatric emergency department

Sofia Chaudhary  1   2   3 , Kiesha Fraser Doh  1   2   3 , Emilie Morris  4 , Caroline Chivily  5 , Donnetta S Washington  3   6 , Scott E Gillespie  1 , Andrew Jergel  1 , Sarah Lazarus  3   7   8 , Angela Costa  3   7   8 , Nathan Call  1   3 , Jonathan Rupp  2 , Harold K Simon  1   2   3
Affiliations

Reducing firearm access for youth at risk for suicide in a pediatric emergency department

Sofia Chaudhary et al. Front Public Health. .

Abstract

Background: Firearm-related suicide is the second leading cause of pediatric firearm death. Lethal means counseling (LMC) can improve firearm safe-storage practices for families with youth at risk of suicide.

Objectives: This study aims to evaluate the feasibility of pediatric emergency department (ED) behavioral mental health (BMH) specialists providing LMC to caregivers of youth presenting with BMH complaints and to test for changes in firearm safety practices, pre-post ED LMC intervention, as measures of preliminary efficacy.

Methods: Prospective pilot feasibility study of caregivers of youth presenting to a pediatric ED with BMH complaints. Caregivers completed an electronic survey regarding demographics and firearm safe-storage knowledge/practices followed by BMH specialist LMC. Firearm owners were offered a free lockbox and/or trigger lock. One-week follow-up surveys gathered self-reported data on firearm safety practices and intervention acceptability. One-month interviews with randomly sampled firearm owners collected additional firearm safety data. Primary outcomes were feasibility measures, including participant accrual/attrition and LMC intervention acceptability. Secondary outcomes included self-reported firearm safety practice changes. Feasibility benchmarks were manually tabulated, and Likert-scale acceptability responses were dichotomized to strongly agree/agree vs. neutral/disagree/strongly disagree. Descriptive statistics were used for univariate and paired data responses.

Results: In total, 81 caregivers were approached; of which, 50 (81%) caregivers enrolled. A total of 44% reported having a firearm at home, 80% completed follow-up at one week. More than 80% affirmed that ED firearm safety education was useful and that the ED is an appropriate place for firearm safety discussions. In total, 58% of participants reported not having prior firearm safety education/counseling. Among firearm owners (n = 22), 18% reported rarely/never previously using a safe-storage device, and 59% of firearm owners requested safe storage devices.At 1-week follow-up (n = 40), a greater proportion of caregivers self-reported asking about firearms before their child visited other homes (+28%). Among firearm owners that completed follow-up (n = 19), 100% reported storing all firearms locked at one week (+23% post-intervention). In total, 10 caregivers reported temporarily/permanently removing firearms from the home.

Conclusion: It is feasible to provide LMC in the pediatric ED via BMH specialists to families of high-risk youth. Caregivers were receptive to LMC and reported finding this intervention useful, acceptable, and appropriate. Additionally, LMC and device distribution led to reported changes in safe storage practices.

Keywords: emergency department; firearm; lethal means; pediatrics; safe storage.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationship that could be construed as a potential conflict of interest. The handling editor DE declared a shared affiliation with the author(s) at the time of review.

Figures

Figure 1
Figure 1
Study enrollment and follow up. Caregivers are parents/legal guardians of a child or teen who presented to the pediatric emergency department with a behavioral mental health complaint.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. WISQARS (Web-based Injury Statistics Query and Reporting System) Injury Center CDC. (2023) Available at: https://www.cdc.gov/injury/wisqars/index.html
    1. Miller M, Azrael D, Hemenway D. The epidemiology of case fatality rates for suicide in the northeast. Ann Emerg Med. (2004) 43:723–30. doi: 10.1016/j.annemergmed.2004.01.018 - DOI - PubMed
    1. Brent DA. The presence and accessibility of firearms in the homes of adolescent suicides: A case-control study. JAMA. (1991) 266:2989–95. doi: 10.1001/jama.1991.03470210057032, PMID: - DOI - PubMed
    1. Dahlberg LL, Ikeda RM, Kresnow MJ. Guns in the home and risk of a violent death in the home: findings from a National Study. Am J Epidemiol. (2004) 160:929–36. doi: 10.1093/aje/kwh309, PMID: - DOI - PubMed
    1. Grossman DC, Mueller BA, Riedy C, Dowd MD, Villaveces A, Prodzinski J, et al. . Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. (2005) 293:707–14. doi: 10.1001/jama.293.6.707, PMID: - DOI - PubMed