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Impact of a Firearm Safety Device Distribution Intervention on Storage Practices After an Emergent Mental Health
Neil G Uspal1, Bonnie Strelitz2, Kaitlin Cappetto2
1Department of Pediatrics, University of Washington (NG Uspal, LE Rutman, and CA Paris), Seattle, Wash.
Insights
Providing firearm storage devices and training significantly improved safe firearm storage practices in households with children experiencing mental health emergencies. This intervention enhances pediatric safety and should be integrated into routine clinical care for high-risk families.
Area of Science:
- Pediatric Emergency Medicine
- Public Health
- Firearm Safety
Background:
- Children presenting with emergent mental health complaints may be exposed to household firearms.
- Safe firearm storage is crucial for preventing unintentional injuries and suicides.
- Current safe storage practices are often inadequate, necessitating interventions.
Purpose of the Study:
- To evaluate the effectiveness of providing firearm storage devices with training in improving safe storage practices.
- To assess the impact of this intervention on households of children with emergent mental health concerns.
- To determine if this intervention can be integrated into routine clinical care.
Main Methods:
- A prospective, pre-post study design was employed.
- Participants were enrolled in the emergency department or inpatient psychiatric unit.
- The intervention group received a firearm storage device at low cost and training, while the control group received usual care.
- Triple-safe storage (TSS) was assessed at baseline, 7, and 30 days post-visit.
Main Results:
- Triple-safe storage (TSS) increased from 32% to 56% at 7 and 30 days in the intervention group.
- In the observation group, TSS increased from 21% to 31% at 7 and 30 days.
- Among those not practicing TSS at baseline, 7-day TSS was significantly higher in the intervention group (38%) compared to the observation group (14%, P=.001).
Conclusions:
- Distribution and training in firearm storage devices effectively increased TSS.
- This intervention demonstrably improves pediatric safety in high-risk populations.
- Integrating firearm storage device provision and training into routine clinical care is recommended for these patients.
Objective:
To determine if providing firearm storage devices with training during clinical care improves safe storage practices in household members of children who present to a pediatric hospital with an emergent mental health complaint.
Methods:
Prospective, pre-post study. Enrollment occurred in the emergency department or the inpatient psychiatric unit. Participants in the observation phase received usual care. Participants in the intervention phase were randomized to be offered a firearm storage device at either no or low ($5) cost and trained in its use. We surveyed participants at enrollment, 7, & 30 days post visit. Our primary outcome was triple-safe storage (TSS) - storing firearms unloaded, locked, and with ammunition stored and locked separately.
Results:
About 256 participants enrolled. In the observation phase TSS increased from 21% (95% confidence interval [CI] 14%-30%) at baseline to 31% (95% CI 21%-42%) at 7 and 31% (95% CI 21%-43%) at 30 days. In the intervention phase, TSS increased from 32% (95% CI 25%-39%) at baseline to 56% (95% CI 48%-64%) at 7 and 56% (95% CI 47%-64%) at 30 days. Among those not practicing TSS at baseline, 7-day TSS was higher in the intervention (38%) versus the observation phase (14%, P = .001).
Conclusions:
Distribution and training in the use of firearm storage devices increased TSS in the study population, improves pediatric safety and should be part of the routine care of these high-risk patients.
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