Thursday, February 22, 2018

Only 35% of Parents With Child At Risk of Self-Harm Properly Store Firearms, Survey Finds

A child’s history of risk factors for self-harm does not appear to influence caretaker decisions about whether to keep firearms in the home, or whether those firearms are kept unloaded and in locked storage.

That’s the finding from an analysis of data from an online survey published in Pediatrics.

“Given the prevalence of household firearms in the United States, our findings suggest that millions of U.S. children are placed at substantially higher risk of fatal firearm injury, especially suicide, than would be the case were parents to follow guidelines first put forward by the AAP [American Academy of Pediatrics] more than a quarter century ago,” wrote John Scott, B.S., Deborah Azrael, Ph.D., and Matthew Miller, M.D., M.Sc., of Northeastern University and Harvard University.

The researchers used data from a Web-based survey conducted by the survey firm Growth for Knowledge (GfK) to assess firearm ownership, storage practices, and use among a nationally representative sample of U.S. adults. Respondents were asked about gun ownership and about various storage practices for their household guns, including the number of guns stored and whether they were locked and unloaded. Participants were also asked if there were children living in the household and if so, what their relationship was to these children.

Respondents who reported to be the caregiver or health care decision-maker (“parent”) of a child under 18, were also asked if this child had attention-deficit/hyperactivity disorder (ADHD), depression, or mental health conditions other than depression. Respondents who answered “yes” to any of these were said to have a child with a self-harm risk factor. (Respondents were not asked whether children ever received a formal diagnosis.)

Of 3,949 respondents, approximately 1 in 3 U.S. households contained firearms (34.8%), irrespective of whether the household included children. Among the subset of adults who self-identified as parents, approximately 2 in 5 households contained firearms (42.4%).

Among parents who own guns, 34.9% stored all guns locked and unloaded when they had a child with a history of self-harm risk factors, compared with 31.8% when none of their children had such a history.

In an accompanying editorial, David C. Grossman, M.D., M.P.H., of the Kaiser Permanente Washington Health Research Institute, said clinicians caring for teenagers play a critical role in preventing youth suicide, including routine screening of adolescents for depression and ascertaining information about firearms in the household and their storage.

“When screening yields concerns of depression, a natural opportunity arises to ask about access to household firearms and provide intensive behavioral counseling on safe storage,” Grossman wrote. “Ongoing treatment of teenage depression involves systematic monitoring of treatment effectiveness, possibly including message reinforcement about firearm storage. Clinicians may need to engage other family members to ensure that treatment and storage recommendations are followed.”

For related information, see the Psychiatric News article “Firearms and Suicide: Risk Assessment and Management,” by Liza Gold, M.D.

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