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Mental Health Outcomes in Children after Parental Firearm Injury
George Karandinos1,2,3, Mia Giuriato4, José R Zubizarreta4,5,6,7
1MGH Gun Violence Prevention Center, Mongan Institute, Massachusetts General Hospital, Boston.
The New England Journal of Medicine
|January 28, 2026
Summary
Parental firearm injuries significantly increased psychiatric diagnoses and mental health visits in children. This study highlights the profound impact of firearm violence on youth mental health and healthcare needs.
Area of Science:
- Public Health
- Pediatric Mental Health
- Trauma Studies
Background:
- Firearm injuries affect approximately 20,000 U.S. youths annually due to parental injury.
- The impact of parental firearm injuries on children's health and healthcare utilization is not well understood.
Purpose of the Study:
- To investigate the association between parental firearm injuries and subsequent psychiatric disorders in children.
- To examine the impact on children's healthcare utilization and spending following parental firearm injuries.
Main Methods:
- Analysis of U.S. commercial health insurance claims data (2007-2022) for youths (1-19 years) with parents treated for firearm injury.
- Matched control group design balancing on demographic and health risk factors.
- Difference-in-differences analysis to compare outcomes before and after parental injury.
Main Results:
- Parental firearm injury was linked to an increase of 8.4 psychiatric diagnoses per 1000 youths and 23.1 mental health visits per 1000 youths.
- Trauma-related disorders, including PTSD, showed the most significant increase in diagnoses.
- No significant changes were observed in other diagnoses, medical spending, or overall healthcare utilization.
Conclusions:
- Parental firearm injuries are associated with elevated rates of psychiatric disorders and mental health service use in children.
- Findings underscore the critical need for mental health support for children exposed to parental firearm violence.
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