This is an important public health concern that warrants a discussion apart from political stance. Violence from firearms accounts for almost 4,000 deaths and over 15,000 injuries in children and adolescents yearly. The rate of firearm-related deaths in children in the United States is nearly 16 times greater than the rate in 25 other industrialized countries combined. The thought is that this is partially related to the higher level of gun ownership in the United States compared to other developed countries.
There is a greater risk of homicides and suicides in homes where firearms are present (3x greater risk of homicide and 5x greater risk of suicide). Firearms account for 44% of adolescent suicides and 88% of adolescent homicides so it makes sense that access to a firearm increases the risk of these events occurring. Firearms used in youth suicide unusually belong to a parent. It is important to keep in mind that while intent matters when it comes to a suicide attempt, the means also matters, and a firearm is one of the most lethal means by which to attempt suicide. There is also a correlation with presence of firearms in the home and rates of substance abuse and rates of depression among adolescents, both of which increase the risk of suicidal ideation. The combination of depression, substance misuse and access to a firearm is a very dangerous combination.
Many deaths related to gun violence are a result of accidental shootings. 8% of accidental deaths result from shots fired from young children (ages 6 and younger). This is why it is important for parents to talk with their children, even young children, about gun safety. Many parents who keep firearms in their homes believe the firearms are well hidden and/or that the children do not handle the firearms. In one study, among firearm-owning parents who reported that their children never handled the firearms, 22% of the children reported they had when questioned separately. Studies show that 1/5 of gun owners with children store their guns loaded, 1/3 store them unlocked and 1/10 store them loaded and unlocked.
The American Academy of Child and Adolescent Psychiatry has some important recommendations as well. The safest thing to protect children is to keep firearms out of the home. If there is a firearm in the home, they should be stored unloaded and uncocked in a locked hidden container. Ammunition should be stored separated in a different locked hidden container. A firearm should never be left unattended. Parents should check to make sure gun safety is being followed if their children are playing in other homes. These practices have been found to be helpful to prevent accidental shootings as well as gun-related suicide attempts.
There are other helpful guidelines for parents of young children around pretend gun play. If a parent is considering buying a toy gun, it is helpful to buy something that looks like a toy and not like a real gun. Parents can encourage “target practice” rather than aiming at each other when they are playing. It is important to limit exposure to violent television and movies and violent video games. Studies have shown that as exposure to violence in video games increases, it increases expression of aggression, and the effect is steeper for physical aggression than verbal aggression.
With the increase in school shootings over the last two decades, more attention is being placed on identifying at risk youth as early as possible. Some risk factors for violence include: history of bullying from a young age, social isolation, history of maltreatment and/or violence in the home, history of violence, and anger management concerns.
As primary care and behavioral health providers, it is important to be asking about the presence of firearms in the home, in a non-judgmental way, so that parents are comfortable telling the truth. For parents who are keeping firearms in the home, the next step is to provide education about these data points, being as specific as possible with the facts, so they can make sure they are being safe about their gun ownership and keeping their children safe. It is also important to continue to work with youth on educating them on constructive coping skills to deal with anger and conflict resolution.