Lethal Means Availability Among Youth with Recent Depression or Suicidality: Examining Firearm Ownership and Access Among a Nationally Representative Sample

Background: Limiting access to firearms, the most lethal means of suicide, is essential to decreasing suicide rates in youth. Efforts to date have focused on counseling parents about safe firearm storage and temporary removal of firearms from the home, yet little is known about rates of firearm ownership and access among adolescents, including those at higher risk for suicide. Our goal is to differentiate firearm ownership and access characteristics among youth with and without recent depression (past 2 weeks) and/or lifetime history of suicidality (DLHS). Methods: This was a probability-based cross-sectional web survey of 1531 US parent-teen dyads conducted between 06/24/2020 and 07/22/2020. Data was weighted to generate a nationally representative sample of U.S. teenagers (age 14-18). Outcomes of interest were characteristics of firearm ownership and access among youth reporting DLHS. Dependent variables include firearm ownership (ownership status, method obtained, and from whom obtained) and access (any access, access at home, access off property, and points of access) characteristics. Results: Of the total sample, 24.4% (95% CI 20.8, 28.1) reported DLHS, with 11.9% (95% CI 8.7, 15.1) of all youth endorsing personal firearm ownership and 45.4% (95% CI 40.9-49.9) endorsing on- or off-property firearm access. While personal firearm ownership rates were similar between youth with and without DLHS, youth with DLHS had increased perceived firearm access overall (AOR: 1.72; 95%CI: 1.36, 2.19), at home (AOR: 1.91; 95%CI: 1.35, 2.7) and off-property (AOR: 1.52; 95%CI: 1.16, 1.99). Among youth who owned a personal firearm, those with DLHS were more likely to have bought it or traded something for it (AOR: 22.95; 95%CI: 4.96, 106.23) and less likely to have obtained it from family (OR: 0.11; 95%CI: 0.03, 0.40) than those without DLHS when adjusted for demographic and socioeconomic characteristics. Conclusion: Teens with DLHS had firearm ownership rates similar to teens without DLHS but increased perceived access to firearms. This contrasts with an expected decrease in firearm access in this higher-risk population. Providers should speak directly to youth at higher risk for suicide about their firearm access in addition to counseling parents about reducing access to lethal means.