Safe firearm storage in homes with children is an important focus for all of us, as underscored by the policy statements and articles appearing in our journal. While no one wants a child to gain access to a firearm stored in a home, wouldn’t having a child at risk for a self-harm behavior such as depression or other mental health conditions make you think even more about storing firearms safely? While you might say “of course,” Scott et al. (10.1542/peds.2017-2600) in an article released this week identified surprising findings related to storage practices in homes of children with and without self-harm or suicide-risk behaviors. The authors analyzed data from a national online survey of adults who self-reported whether they lived with a child, whether that child had a history of self-harm risk factors such as those noted above, whether there were firearms in the home, and if so, how they were stored. Sadly, 43.5% of homes with children at risk of self-harm had a firearm in the home compared to 42.3% of those with children with no self-harm risk—meaning there was no statistical difference between the groups. Only a third of parents had firearms locked away and unloaded in both groups as recommended by the AAP. This is disappointing given the risk that presents itself to children at risk of self-harm living in homes where firearms are not stored safely. Of course, there were also many children without these risk factors with potential access to firearms.
What can be done about this? We asked firearm injury prevention specialist Dr. David Grossman (10.1542/peds.2017-3884) to share his thoughts in an accompanying commentary. He notes that this study emphasizes that we have an opportunity before us to do far more when it comes to taking our best shot at reducing firearm injuries to children in the home—particularly the high-risk population identified in the study by Scott et al. He points out that parents self-reported their lack of safe storage might imply the problem may be even worse for those families who opted not to share their unsafe practices for firearm storage. Self-report also indicated that parents were aware of their child’s self-risk of harming themselves and again, these data may be an underreporting for those families who did not recognize the mental health signs of depression or other mental health disorders in their child or teenager. Dr. Grossman offers several thoughts as to why the data is so concerning in this study as well as the role we can play as pediatricians in doing even more to screen for mental illness in our patients, and if identified, then directly inquire as to firearm storage at home and how that is done. Both the study and commentary should trigger some reflection on our part of what else we can do to reduce the potential of a child or teen, whether or not they are at risk for self-harm, gaining access to a firearm in their home.