A child’s history of mental health conditions appeared to have little impact on a parent’s decision on whether or not to have firearms in the home, or whether the firearms were stored safely, researchers found.
Data from a large survey indicated that guns were stored in accordance with American Academy of Pediatrics’ (AAP) guidelines in 34.9% (95% CI 20.2%-53.2%) of households with firearms where children in the house had a history of self-harm risk factors, such as depression, mental health conditions other than depression, or attention-deficit/hyperactivity disorder (ADHD), reported John Scott, of Northeastern University in Boston, and colleagues.
This compared to 31.8% (95% CI 25.9%-38.3%) of gun-owning households where children did not have such a history, the researchers reported in Pediatrics.
Firearms were present in about 44% of households with children who had a history of mental health issues, Scott and colleagues found.
While the AAP recommends that “the safest home for a child is one without firearms,” the group’s guidelines also assert that the risk can be reduced substantially by storing all firearms locked, unloaded and separate from ammunition which should also be kept locked.
However, “little is known about whether parents whose children have mental health conditions are any less likely to live in homes with firearms,” the authors wrote. Prior studies found that children or adolescents with mental health conditions were as likely to report access to firearms as those without mental health conditions, and were neither more or less likely to live in a home where “firearms were stored locked … loaded or all firearms were stored unlocked and unloaded.”
Scott’s group examined data from a nationally representative probability-based online survey conducted in 2015 by survey firm Growth for Knowledge in the U.S. to “assess firearm ownership, storage practices and use.” Some 3,950 adults completed the survey.
Overall, about a third of respondents said their household contained firearms, regardless of whether the household included children. About 42% of adults who identified themselves as a “caregiver or healthcare decision-maker for a child under the age of 18” had firearms in the household, which did not differ much if the child in the household had a history of self-harm risk factors, the authors said.
However, the proportion of gun-owning parents who stored at least one household firearm both loaded and unlocked was numerically lower for parents whose children had a history of these self-harm risk factors, compared with parents none of whose children had such a history, although wide 95% confident intervals made it impossible to tell whether the difference was real (11.6%, 95% CI 4.3%–27.6% versus 20.3%, 95% CI 15.3%–26.4%).
Similar proportions of gun-owning parents stored all their household firearms unloaded, regardless of whether their children had a history of mental health conditions or ADHD (about 58% to 59%).
In an accompanying editorial, David Grossman, MD, of Kaiser Permanente Washington Health Research Institute in Seattle, speculated on reasons why parents with children having mental issues might be careless with firearms. He noted that many cases of teenage depression are not recognized. Moreover, he wrote, parents may not know the magnitude or may downplay the risk of self-harm among youth who have access to firearms, or that parents have “overconfidence” in their ability to control gun access.
Grossman pointed to the role that pediatricians can play in preventing access to firearms by these high-risk teenagers, starting with routine screening for depression.
“When screening yields concerns of depression, a natural opportunity arises to ask about access to household firearms and provide intensive behavioral counseling on safe storage,” he wrote.
Scott and colleagues cited certain limitations to the study, including reliance on parent reports for most data and a sample size too small to address some topics of interest, such the relationship between children’s ages and firearm storage practices. The authors also conceded the possibility that participants completing the survey may not be representative of the general population.
This study was supported by the Fund for a Safer Future, the Joyce Foundation, and the U.S. Department of Veterans Affairs.
Scott and co-authors, as well as Grossman, disclosed no relevant relationships with industry.
Robert Jasmer, MD Associate Clinical Professor of Medicine, University of California, San Francisco