How to talk with parents about access to a firearm when in crisis

Why it's important

Adolescents may be especially prone to taking risks and acting impulsively. Their brains continue to mature and develop into their mid-twenties so they often aren’t able to assess risk well. In particular, the frontal lobes of the brain, which are responsible for decision-making and understanding consequences, are not fully developed until early adulthood (Source: National Library of Medicine).  Additionally, the risk for violence increases if they use alcohol or drugs and have access to a firearm. This makes access to firearms particularly dangerous for children and adolescents. 

Because youth suicide attempts are often impulsive, any barriers to accessing lethal means (anything that can be used to attempt suicide) can prevent a permanent tragedy. Firearm suicide attempts are fatal 90% of the time (Source: ACP Journals). Compare that to other means of suicide, such as medicinal overdose, where the survival rate is 95% (Source: JAMA Network). 

Health care professionals can help reduce firearm injuries and deaths among children and teens by talking with parents about secure firearm storage and screening for depression, anxiety, and self-harm.

---

The risk of firearm injury

These conversations are most urgent when a parent or child mentions that they or someone in their household is depressed or experiencing high stress, substance abuse, increased isolation, behavioral changes, thoughts of suicide, or other mental health struggles. But it’s worth having these conversations with all families, because anything that delays or prevents access to a gun can be lifesaving. 

In 75% of youth firearm suicides for which the gun storage method could be identified, the gun was stored loaded and unlocked. Additionally, 76% of youth under the age of 18 who were involved in a school shooting used a gun they accessed from the home of family or friends. 

As a health care professional, you can encourage parents to learn the warning signs. To educate patients and their families, familiarize yourself with secure firearm storage methods, temporary off-site firearm storage facilities in your community, and the local, state and federal firearm laws. 

While the focus of this guide is on parents and caregivers having conversations regarding the youth and teens in their life, if you are concerned that there’s an imminent risk that an adult patient or an adult close to them will harm themselves or others, consider talking with the adult about a voluntary, temporary surrender of a firearm to authorized parties. Emphasize the importance of keeping their family and other loved ones safe. Laws around firearm surrendering—whether temporary or permanent—vary based on state and locality, so it may be helpful to direct the adult to their local law enforcement or public health agency for more information.

---

How to start the conversation

Health care professionals can address the topic of firearm access while discussing other common safety issues. For example, when talking with parents of a teen patient, you may ask if the teen is learning to drive, smokes or vapes, or wears a bike helmet. Then move onto firearm injury prevention conversations in the context of keeping young people safe.

“I care about your child’s health and safety. Is it OK if I ask a few routine questions about common safety concerns?”

“How do you store the firearms in your home? If your child were in crisis, how would you prevent them from accessing a firearm?”

“Could I share a handout with you on best practices for secure firearm storage when there are kids in your home?”

---

What to say

Gun storage may look different for different patients, so approach the conversation with respect and keep the focus on preventing injuries. Tailor your approach based on what you know about the patient and their family. People keep firearms in their home for many reasons, including personal protection, hunting, or because they participate in shooting sports—and how people use guns may inform how they store them. 

You may hear patients or their parents express the belief that hunting rifles and shotguns can’t be used in a suicide. But that is not true. One multi-state study found that long guns were used in nearly a third of firearm suicides—and they were disproportionately used by young people. (Source: BulletPoints Project) If a patient or their parent/caregiver shares that there are unsecured firearms at home, they may not have considered the potential risks when someone is in crisis. 

Young people sometimes have strong emotional responses to life changes, such as a relationship breakup, an argument with a close friend, or getting cut from a sports team, and they may consider harming themselves or others. A moment of crisis can lead to an impulsive action with devastating results.  

Why this works

Talking with parents about secure firearm storage normalizes these conversations as being part of a discussion about safety and raises their awareness of the potential risks.

“It seems like things are going well, and that’s great. But it’s possible that your child could experience something that sparks a crisis. In that moment, having access to a firearm could be lethal to them or even someone else.”

"Securing all of your firearms helps prevent unauthorized or unsupervised access. When your child is having a tough time, they shouldn’t have access, even if they know how to safely operate a gun, so that they don’t hurt themselves or others."

“Sometimes romantic relationships—even among young people—can feel unsafe or controlling, and access to firearms makes these concerns even more serious. Has your child ever mentioned feeling scared, pressured, or controlled by their partner? And do you know if their partner has access to firearms?”

“Anyone can experience a moment of crisis, so it’s important to put time and space between a person in crisis and a firearm. Storing all firearms securely—and making sure people in crisis don’t have access—is a straightforward way to keep loved ones and your community safe.”

Why this works

Talking with parents about how to recognize the signs that someone may be in crisis equips them to make informed choices about their family’s safety.

"If your child’s behavior changes, and they seem angry, aggressive, or more isolated, they may be at risk of hurting themselves or others. The warning signs can be hard to recognize, so it’s urgent to make sure they don’t have access to a firearm."

"Suicidal impulses are often temporary and involve little planning. Reducing someone’s access to firearms while they are in crisis can add time and space for them to cool down and seek help."

"Have you considered additional methods to secure your firearms to prevent unauthorized access? Locking firearms with a cable lock is an easy first step, while lock boxes or safes may provide more protection. Unloading your firearms and storing ammunition separately adds another layer of protection to ensure your loved ones stay safe."

Link

Guide

Know the warning signs

When a child or teen is in crisis, it’s dangerous for them to have access to a gun because they might use it to harm themselves or others.

---

After the chat

• Include secure firearm storage best practices in the after-visit summary.
• If a patient asks questions you aren’t sure how to answer, let them know you will try to find answers and get back to them. For example, they may want more details about secure firearm storage options or statistics about firearm-related injuries and young people. Check our resources page to learn more.