Parents Open to Firearms Counseling From Doctors; Ensuring Secure Storage Remains a Challenge

In survey, Houston parents of teenagers with suicidal ideation or suicidal attempts agree doctors should discuss secure gun storage with parents; 20% of gun-owning families report they aren’t storing firearms securely

ORLANDO, Fla.— Firearms are the leading cause of death in children in the United States and are linked to over half of youth suicides. Secure storage of firearms (stored locked, unloaded, and separate from the ammunition) can significantly decrease the rates of child and adolescent firearm-related suicides.

According to research presented during the American Academy of Pediatrics 2024 National Conference & Exhibition at the Orange County Convention Center from Sept. 27-Oct. 1, “Caregiver Perspectives on Firearm Safety Guidance for Children Hospitalized for Suicidal Ideation or Attempt,” parents—both firearm-owners and non-owners—overwhelmingly agree that doctors should be discussing secure firearms storage with parents. However, 19% of firearm owning caregivers reported that they were not storing their firearms securely.

“The health and safety of children are the top priority for pediatricians. Previous studies confirm that firearm secure storage can decrease the risk of youth suicide and that pediatricians’ discussions with families can increase the likelihood of firearm secure storage practices,” said Taylor Rosenbaum, MD, MA, lead author.

Authors surveyed 100 caregivers of children and young people, ages 8-21 years, who were admitted to the hospital for suicidal ideation or suicide attempt. Families were questioned about their attitudes toward firearm counseling and were offered secure storage counseling and a free firearm lock. The survey results show that parents were receptive to talking about firearms in the home with their doctors.

This is an ongoing study. Since the abstract was submitted to the AAP, the researchers have continued the study and are providing updated data that is not included in the abstract. (The original data is included in the abstract below.) According to the updated data including 100 parents, of the parents surveyed:

• Only half (51%) reported being asked about the presence of home firearms by their healthcare team
• 96% agreed it was important for their child’s hospital team to ask about firearm ownership
• 96% thought secure firearm storage counseling by the healthcare team was important
• 89% felt it was important to distribute firearm locks in the hospital
• Firearm non-owners were more likely to think firearm lock distribution was “very important,” however both groups recognized the importance. 

“As a result of our recent efforts, we have also confirmed that parents of children hospitalized for suicidal thoughts or actions want to have firearm secure storage discussions with their healthcare team during the hospitalization and benefited from a free firearm lock,” Dr. Rosenbaum said. “This insight gives pediatricians actionable ways to make a positive difference in the safety of these children.”

The research was completed at Baylor College of Medicine / Texas Children’s Hospital.

Study author Dr. Rosenbaum, MD, MA, is scheduled to present the research, which is below, from 8:48 - 8:58 a.m. on Sunday, Sept. 29, during the Section on Hospital Medicine program at the Orange County Convention Center. To request an interview with the authors, contact Dr. Rosenbaum at [email protected], 973-476-8216.

In addition, Dr. Rosenbaum, along with other featured research abstract authors, will give a brief presentation and be available for interviews during a press conference from noon to 1:30 p.m. Saturday, Sept. 28, in the National Conference Press Room W208 AB. During the meeting, you may reach AAP media relations staff in the press room at 407-685-5401.

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal.  

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

Program Name: 2024 AAP National Conference-Abstracts

Submission Type: Section on Hospital Medicine

Abstract Title: Caregiver Perspectives on Firearm Safety Guidance for Children Hospitalized for Suicidal Ideation or Attempt

Firearms are the leading cause of death in United States youth and are utilized in over half of youth suicides. The safe storage of firearms significantly decreases the risk of youth suicide. As hospitalizations for pediatric suicidal ideation or attempt (SI/SA) rise, there is a need to explore caregiver perspectives on in-hospital firearm storage guidance. We aimed to explore caregiver receptiveness to firearm safe storage counseling and free firearm locks while their child is hospitalized for SI/SA.

Using a cross-sectional study design, we surveyed caregivers of children ages 8-21 admitted to the Pediatric Hospital Medicine service for SI/SA at a quaternary children’s hospital in Houston, Texas from June 2023 - March 2024. We used the electronic medical record to identify caregivers of patients with a primary diagnosis of SI/SA and a primary spoken language of English or Spanish. We excluded caregivers who were not the legal guardian. We developed a 26-item anonymous survey, administered using RedCap either in-person, through email, or over the phone after obtaining informed consent. The survey assessed caregiver demographics, firearm ownership and storage practices, firearm discussions with their child’s healthcare team, and willingness to receive firearm storage guidance and free firearm locks. We used Chi-squared or Fisher’s exact tests to compare responses between firearm owners and non-owners.

Of 120 caregivers approached, 84 (70%) enrolled. 29% were firearm owners, 64% were non-owners, and 7% did not disclose. Of all caregivers, 46% reported being asked about the presence of home firearms by their healthcare team; 96% agreed it was important for their child’s hospital team to ask about firearm ownership; 96% thought safe firearm storage counseling by the healthcare team was important; and 87% felt it was important to distribute firearm locks in the hospital. Of firearm owners, 21% reported their firearms were not securely stored. Compared to firearm owners, more firearm non-owners spoke Spanish and identified as other race and Hispanic ethnicity. Firearm non-owners were more likely to think firearm lock distribution was “very important”, however both groups recognized the importance (74% vs 67%, p-value 0.034).

Caregivers of children hospitalized for SI/SA were not consistently counseled on safe storage by their healthcare team. However, most caregivers, both with and without firearms, acknowledged the importance of firearm counseling and distribution of firearm locks during their child’s hospitalization.

Table 1

Caregiver demographics of children admitted for suicidal ideation or attempt. Six participants did not disclose firearm ownership and are not described in this table.

Table 2

Caregivers of children admitted for suicidal ideation or attempt (SI/SA) firearm ownership and home storage practices, firearm discussions with their child’s healthcare team, and willingness to receive firearm storage guidance and free firearm locks. Six participants did not disclose firearm ownership and are not described in this table.