Display options
Cite
Uspal NG, Jensen J, Sanchez-Erebia L, et al. Emergent Mental Health Visits to a Pediatric Hospital: Impact on Firearm Storage Practices. Pediatr Emerg Care. 2021;37(12):e1382-e1387doi: 10.1097/PEC.0000000000002056.
Uspal, N. G., Jensen, J., Sanchez-Erebia, L., Strelitz, B., Schloredt, K., Gallagher, C., Bradford, M. C., Bennett, E., & Paris, C. A. (2021). Emergent Mental Health Visits to a Pediatric Hospital: Impact on Firearm Storage Practices. Pediatric emergency care, 37(12), e1382-e1387. https://doi.org/10.1097/PEC.0000000000002056
Uspal, Neil G, et al. "Emergent Mental Health Visits to a Pediatric Hospital: Impact on Firearm Storage Practices." Pediatric emergency care vol. 37,12 (2021): e1382-e1387. doi: https://doi.org/10.1097/PEC.0000000000002056
Uspal NG, Jensen J, Sanchez-Erebia L, Strelitz B, Schloredt K, Gallagher C, Bradford MC, Bennett E, Paris CA. Emergent Mental Health Visits to a Pediatric Hospital: Impact on Firearm Storage Practices. Pediatr Emerg Care. 2021 Dec 01;37(12):e1382-e1387. doi: 10.1097/PEC.0000000000002056. PMID: 32205798.
Copy Download .nbib Format: NLM
Share it on

Pediatr Emerg Care. 2021 Dec 01;37(12):e1382-e1387. doi: 10.1097/PEC.0000000000002056.

Emergent Mental Health Visits to a Pediatric Hospital: Impact on Firearm Storage Practices.

Pediatric emergency care

Neil G Uspal, Jennifer Jensen, Luis Sanchez-Erebia, Bonnie Strelitz, Kelly Schloredt, Chelsie Gallagher, Miranda C Bradford, Elizabeth Bennett, Carolyn A Paris

Affiliations

  1. From the Department of Pediatrics, University of Washington.
  2. Center for Clinical and Translational Research, Seattle Children's Hospital.
  3. Department of Family Medicine, University of Washington.
  4. External Affairs, Seattle Children's Hospital.
  5. Children's Core for Biomedical Statistics, Center for Clinical and Translational Research, Seattle Children's Research Institute, Seattle, WA.

PMID: 32205798 DOI: 10.1097/PEC.0000000000002056

Abstract

OBJECTIVE: The aims of this study were to describe firearm storage practices in homes of patients evaluated for mental health (MH) complaints at a tertiary care children's hospital and to describe storage practice changes after treatment.

METHODS: We surveyed families of children with MH complaints presenting to the emergency department or psychiatry unit who stored firearms in their homes between February 12, 2016, and January 14, 2017. Patients and families received standard care, including routine counseling on limiting access to methods of suicide. Participants completed surveys at baseline, 7, and 30 days after discharge. The primary outcome was triple safe firearm storage-storage of firearms unloaded, locked, and with ammunition stored and locked separately.

RESULTS: Ninety-one household members of MH patients who stated they had firearms were enrolled at baseline. Seventy-seven (85%) completed at least 1 follow-up survey, and 63 (69%) completed both. At baseline, 21% (19/91) of participants reported engaging in triple safe firearm storage, 26% had an unlocked firearm, 23% had a loaded firearm, and 65% stored ammunition either unlocked or with their firearm. Triple safe storage rates increased to 31% at both 7 days and 30 days. Ten (17%) of 59 (P < 0.01) participants who did not report triple safe storage at baseline and completed a follow-up survey changed to reporting triple safe storage on follow-up.

CONCLUSIONS: The majority of firearm-storing family members of children with MH complaints do not follow triple safe storage practices. Storage practices modestly improved after an emergent MH visit, but over two thirds of participants reported unsecured or partially secured firearms 7 and 30 days later.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

Conflict of interest statement

Disclosure: The authors declare no conflict of interest.

References

  1. National Center for Injury Prevention and Control, Centers for Disease Control and Prevention. Leading Causes of Death Reports, 1981–2017. Available at: https://webappa.cdc.gov/sasweb/ncipc/leadcause.html. Accessed May 30, 2019. - PubMed
  2. Curtin SC, Heron M, Miniño AM, et al. Recent increases in injury mortality among children and adolescents aged 10–19 years in the United States: 1999-2016. Natl Vital Stat Rep. 2018;67:1–16. - PubMed
  3. Miller M, Azrael D, Hemenway D. The epidemiology of case fatality rates for suicide in the northeast. Ann Emerg Med. 2004;43:723–730. - PubMed
  4. Shenassa ED, Catlin SN, Buka SL. Lethality of firearms relative to other suicide methods: a population based study. J Epidemiol Community Health. 2003;57:120–124. - PubMed
  5. Brent DA, Perper JA, Allman CJ, et al. The presence and accessibility of firearms in the homes of adolescent suicides. A case-control study. JAMA. 1991;266:2989–2995. - PubMed
  6. Brent DA, Perper JA, Moritz G, et al. Firearms and adolescent suicide. A community case-control study. Am J Dis Child. 1993;147:1066–1071. - PubMed
  7. Shah S, Hoffman RE, Wake L, et al. Adolescent suicide and household access to firearms in Colorado: results of a case-control study. J Adolesc Health. 2000;26:157–163. - PubMed
  8. Grossman DC, Mueller BA, Riedy C, et al. Gun storage practices and risk of youth suicide and unintentional firearm injuries. JAMA. 2005;293:707–714. - PubMed
  9. Shenassa ED, Rogers ML, Spalding KL, et al. Safer storage of firearms at home and risk of suicide: a study of protective factors in a nationally representative sample. J Epidemiol Community Health. 2004;58:841–848. - PubMed
  10. Kellermann AL, Rivara FP, Somes G, et al. Suicide in the home in relation to gun ownership. N Engl J Med. 1992;327:467–472. - PubMed
  11. Cooper H. Just ask: are your firearms stored safely? Seattle Children's Hospital. Available at: http://pulse.seattlechildrens.org/just-ask-are-your-firearms-stored-safely/. Accessed December 4, 2017. - PubMed
  12. Safe storage. Project ChildSafe. Available at: http://www.projectchildsafe.org/safety/safe-storage. Accessed December 4, 2017. - PubMed
  13. Plemmons G, Hall M, Doupnik S, et al. Hospitalization for suicide ideation or attempt: 2008–2015. Pediatrics. 2018;141:e20172426. - PubMed
  14. Kalb LG, Stapp EK, Ballard ED, et al. Trends in psychiatric emergency department visits among youth and young adults in the US. Pediatrics. 2019;143:e20182192. - PubMed
  15. Hawton K, Bergen H, Kapur N, et al. Repetition of self-harm and suicide following self-harm in children and adolescents: findings from the multicentre study of self-harm in England. J Child Psychol Psychiatry. 2012;53:1212–1219. - PubMed
  16. Rosenbaum Asarnow J, Berk M, Zhang L, et al. Emergency department youth patients with suicidal ideation or attempts: predicting suicide attempts through 18 months of follow-up. Suicide Life Threat Behav. 2017;47:551–556. - PubMed
  17. Harris PA, Taylor R, Thielke R, et al. Research electronic data capture (REDCap) - a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2009;42:377–381. - PubMed
  18. Kind AJ, Jencks S, Brock J, et al. Neighborhood socioeconomic disadvantage and 30-day rehospitalization: a retrospective cohort study. Ann Intern Med. 2014;161:765–774. - PubMed
  19. Health Innovation Program. Area Deprivation Index. UW Health Innovation Program. 2014. Available at: http://www.hipxchange.org/ADI. Accessed December 27, 2017. - PubMed
  20. Simonetti JA, Mackelprang JL, Rowhani-Rahbar A, et al. Psychiatric comorbidity, suicidality, and in-home firearm access among a nationally representative sample of adolescents. JAMA Psychiat. 2015;72:152–159. - PubMed
  21. Gittelman MA, Pomerantz WJ, Fitzgerald MR, et al. Injury prevention in the emergency department: a caregiver's perspective. Pediatr Emerg Care. 2008;24:524–528. - PubMed
  22. Claudius IA, Nager AL. The utility of safety counseling in a pediatric emergency department. Pediatrics. 2005;115:e423–e427. - PubMed
  23. Johnston BD, Rivara FP, Droesch RM, et al. Behavior change counseling in the emergency department to reduce injury risk: a randomized, controlled trial. Pediatrics. 2002;110:267–274. - PubMed
  24. Stanley B, Brown GK. Safety planning intervention: a brief intervention to mitigate suicide risk. Cogn Behav Pract. 2012;19:256–264. - PubMed
  25. Daigle MS. Suicide prevention through means restriction: assessing the risk of substitution. A critical review and synthesis. Accid Anal Prev. 2005;37:625–632. - PubMed
  26. Yip PS, Caine E, Yousuf S, et al. Means restriction for suicide prevention. Lancet. 2012;379:2393–2399. - PubMed
  27. Simon RI. Gun safety management with patients at risk for suicide. Suicide Life Threat Behav. 2007;37:518–526. - PubMed
  28. Gunnell D, Hawton K, Ho D, et al. Hospital admissions for self harm after discharge from psychiatric inpatient care: cohort study. BMJ. 2008;337:a2278. - PubMed
  29. Chung DT, Ryan CJ, Hadzi-Pavlovic D, et al. Suicide rates after discharge from psychiatric facilities: a systematic review and meta-analysis. JAMA Psychiat. 2017;74:694–702. - PubMed
  30. Borowsky IW, Ireland M. National survey of pediatricians' violence prevention counseling. Arch Pediatr Adolesc Med. 1999;153:1170–1176. - PubMed
  31. Olson LM, Christoffel KK, O'Connor KG. Pediatricians' involvement in gun injury prevention. Inj Prev. 2007;12:99–104. - PubMed
  32. Solomon BS, Duggan AK, Webster D, et al. Pediatric residents' attitudes and behaviors related to counseling adolescents and their parents about firearm safety. Arch Pediatr Adolesc Med. 2002;156:769–775. - PubMed
  33. Brent DA, Baugher M, Birmaher B, et al. Compliance with recommendations to remove firearms in families participating in a clinical trial for adolescent depression. J Am Acad Child Adolesc Psychiatry. 2000;39:1220–1226. - PubMed
  34. Simonetti JA, Rowhani-Rahbar A, King C, et al. Evaluation of a community-based safe firearm and ammunition storage intervention. Inj Prev. 2018;24:218–223. - PubMed
  35. Carbone PS, Clemens CJ, Ball TM. Effectiveness of gun-safety counseling and a gun lock giveaway in a Hispanic community. Arch Pediatr Adolesc Med. 2005;159:1049–1054. - PubMed
  36. Barkin SL, Finch SA, Ip EH, et al. Is office-based counseling about media use, timeouts, and firearm storage effective? Results from a cluster-randomized, controlled trial. Pediatrics. 2008;122:e15–e25. - PubMed
  37. Albright TL, Burge SK. Improving firearm storage habits: impact of brief office counseling by family physicians. J Am Board Fam Pract. 2003;16:40–46. - PubMed
  38. Grossman DC, Cummings P, Koepsell TD, et al. Firearm safety counseling in primary care pediatrics: a randomized, controlled trial. Pediatrics. 2000;106:22–26. - PubMed
  39. Stevens MM, Olson AL, Gaffney CA, et al. A pediatric, practice-based, randomized trial of drinking and smoking prevention and bicycle helmet, gun, and seatbelt safety promotion. Pediatrics. 2002;109:490–497. - PubMed
  40. Rowhani-Rahbar A, Simonetti JA, Rivara FP. Effectiveness of interventions to promote safe firearm storage. Epidemiol Rev. 2016;38:111–124. - PubMed

Publication Types