Depression, suicide risk, and declining to answer firearm-related survey items among military personnel and veterans

To describe the characteristics of military personnel and veterans who decline to answer survey items asking about firearm availability at home, and to determine how these characteristics compare to those of military personnel and veterans who answered these items.

Self-report surveys were administered to 2025 military personnel and veterans visiting a primary care clinic located at five military installations across the United States for a routine visit. Multinomial logistic regression was used to identify factors that distinguished participants with firearms at home, participants without firearms at home, and participants who declined answering.

In univariate analyses, participants who selected "refuse to answer" in response to an item asking about firearm access at home did not differ demographically from participants who selected "yes," but were significantly more likely to screen positive for depression and recent thoughts of death or self-harm. These differences were not statistically significant in multivariate analyses, however. Participants who selected "refuse to answer" or "yes" were significantly more likely than participants who selected "no" to be male, white, and previously deployed.

Military personnel and veterans who decline answering firearm-related survey items are indistinguishable from those who report having a firearm at home. Declining to answer firearm-related items is more common among those who screen positive for depression or recent thoughts of death or self-harm, but this association is statistically accounted for by demographic factors (i.e., male gender, white race).