Access to Firearms and Youth Suicide in the US: Implications for Clinical Interventions. In: Lee L.K., Fleegler E.W. (eds) Pediatric Firearm Injuries and Fatalities.

Suicide is among the leading causes of death of 5–24-year-olds in the US, and rates of suicide in this age group have increased over the past 10 years. Almost half of suicides among youth involve a firearm. Substantial evidence indicates that a firearm in the home increases the risk of dying by suicide by making it more likely that suicidal acts will involve firearms. Evidence also suggests that suicide risk among youth living in households with firearms depends on how household firearms are stored (locked is safer than unlocked; unloaded safer than loaded; stored separately from ammunition safer than together with ammunition). Despite the elevated risk that household firearms impose on youth, and the ability to reduce risk by storing guns in ways that make them less accessible, millions of youth live in homes with readily accessible firearms. Approaches to preventing youth suicide by reducing access to firearms have relied largely on efforts to inform personal decision-making by adults in gun-owning homes through interventions at the community level, in primary care practices, and, more recently, in acute care settings. Despite endorsement of counseling parents to reduce access to potentially lethal suicide methods by several US medical societies and parents’ willingness to discuss firearm safety with their child’s pediatrician, few clinicians routinely counsel parents to reduce access to firearms, even for youth acutely at risk for suicide. The limited number of evaluations of clinical interventions to date suggests, though not uniformly, that clinician counseling supplemented with provision of firearm storage devices encourages some parents to store their firearms more safely.