MedicalResearch.com Interview with:
Joseph A Simonetti, MD MPH
Harborview Injury Prevention & Research Center
University of Washington Seattle, WA, USA
Medical Research: What is the background for this study? What are the main findings?
Dr. Simonetti: Studies have consistently shown that children living in households where firearms are stored safely have a lower risk of suffering firearm injuries, including lethal firearm injuries, compared to those living in households where firearms are stored unlocked and/or loaded. Safe firearm storage is widely recommended by public health experts, professional medical societies, and gun rights organizations, especially for households where children might be suffering from mental heath and substance abuse issues that put them at increased risk for suicide or unintentional injury. Our goal was to find out if those recommendations were being effectively implemented in the community. To do this, we used survey data that assessed mental health conditions and firearm access among a nationally representative sample of US adolescents.
Medical Research: What are the main findings?
Dr. Simonetti: First, we confirmed previous findings that a large proportion of US adolescents have access to a firearm in the home. Of those who reported living in a home with a firearm, 40% said they could immediately access and shoot the firearm.
Second, the prevalence of most mental health diagnoses was similar between adolescents who did and did not report firearm access. However, a greater proportion of adolescents with firearm access had drug and alcohol disorders compared to adolescents who reported living in a home with a firearm but did not have access to the firearm.
The main finding was that children with mental health risk factors for suicide were just as likely to report in-home firearm access as those without identified risk factors. This finding held true even when comparing firearm access between children with no identified risk factors and those who reported a recent suicide attempt, who arguably have the highest suicide risk in this sample.
Medical Research: What should clinicians and patients take away from your report?
Dr. Simonetti: For clinicians – this study shows that a large proportion of US adolescents have access to firearms in the home, and those with mental health risk factors for suicide were just as likely to report in-home firearm access as those without identified risk factors. A number of studies have demonstrated effective ways to promote safe firearm storage in clinical settings. Importantly, several studies have shown that parents are not offended when providers ask about safe firearm storage during clinical encounters.
For parents – Safe firearm storage includes keeping firearms locked, unloaded, separate from locked ammunition, and ensuring that children don’t know how to access those firearms. Studies have consistently shown that children living in homes with safely-stored firearms are less likely to be shot, and safe firearm storage is widely recommended by gun rights organizations and public health officials. Trigger locks and gun lockboxes can be purchased for less than $10 online, and in common stores such as Walmart and Costco.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Simonetti: There is an obvious disconnect between generally agreed upon recommendations for firearm safety practices and what we’re actually doing in the community. Additional studies are needed to determine how best to promote safe firearm storage in US households through clinical and community-based interventions, especially for households with children and children with mental illness.
Studies of physicians have shown that not all clinicians are asking about guns in the home, or how those guns are stored. Future studies are needed to identify ways to address barriers to asking about firearm ownership and storage in clinical settings, especially for clinicians caring for children with increased risk of self-inflicted injuries.