Youth Hospitalized for Suicidality: Caregiver Perspectives on Firearm Safety Guidance

Firearms are the leading cause of death for US youth and are used in over half of youth suicides. Safe firearm storage decreases this risk. We aimed to explore caregiver receptiveness to firearm storage counseling and free firearm locks during their child's hospitalization for suicidal ideation (SI) or suicidal attempt (SA).

Using a cross-sectional study, we surveyed caregivers of patients aged 8 to 21 years admitted to a quaternary children's hospital with a primary diagnosis of SI/SA between June 2023 and May 2024. A 22-item questionnaire assessed firearm ownership and storage, risk screening by the health care team, and willingness to receive storage guidance and locks. Enrolled families were provided free firearm locks and education. We used χ2 or Fisher's exact tests to compare responses from firearm owners and nonowners.

Of the 150 caregivers approached, 100 enrolled (26% firearm owners, 68% nonowners, 6% undisclosed). While only 51% of caregivers were asked about firearms by the health care team, 96% agreed with the importance of firearm screening and storage counseling during hospitalization, and 89% agreed it was important to distribute firearm locks prior to discharge. Furthermore, 77% would listen to their health care team if advised to remove firearms from their home, and none would be offended by the advice. Firearm owners and nonowners had similar perceptions on the importance of firearm screening and storage counseling.

All caregivers acknowledged the importance of firearm safe storage counseling and firearm lock distribution during their child's hospitalization for SI/SA. Future studies should target improving the rate of screening and storage counseling by hospital teams.