Pediatric Hospital Medicine Fellow Baylor College of Medicine/ Texas Children's Hospital Houston, Texas, United States
Background: Firearms are the leading cause of death in United States youth and are utilized in over half of youth suicides. The safe storage of firearms significantly decreases the risk of youth suicide. As hospitalizations for pediatric suicidal ideation or attempt (SI/SA) rise, there is a need to explore caregiver perspectives on in-hospital firearm storage guidance. Objective: We aimed to explore caregiver receptiveness to firearm safe storage counseling and free firearm locks while their child is hospitalized for SI/SA. Design/Methods: Using a cross-sectional study design, we surveyed caregivers of children ages 8-21 admitted to the Pediatric Hospital Medicine service for SI/SA at a quaternary children’s hospital in Houston, Texas. We report data from August-October 2023, and study recruitment is ongoing. We used the electronic medical record to identify caregivers of patients with a primary diagnosis of SI/SA and a primary spoken language of English or Spanish. We excluded caregivers who were not the child’s legal guardian. We developed a 26-item anonymous survey, administered using RedCap either in-person, through email, or over the phone after obtaining caregiver informed consent. The survey assessed caregiver demographics, firearm ownership and storage practices, firearm discussions with their child’s healthcare team, and willingness to receive firearm storage guidance and free firearm locks. We used Chi-squared or Fisher’s exact tests to compare responses between firearm owners and non-owners. Results: Of 59 caregivers approached, 42 (71%) enrolled. Of those enrolled, 31% were firearm owners, 59.5% were non-owners, and 9.5% did not disclose. 15% of firearm owners reported their firearms were unlocked. 36% of all caregivers reported being asked about the presence of home firearms by their healthcare team. 95% of all caregivers agreed it was important for their child’s hospital team to ask about firearm ownership, 90% felt it was important to distribute firearm locks in the hospital, and 69% wanted to receive a firearm lock. Compared to firearm owners, more firearm non-owners spoke Spanish and identified as Hispanic. Otherwise, demographics (Table 1) and perspectives on firearm storage counseling (Table 2) did not significantly differ across groups.
Conclusion(s): Caregivers of children hospitalized for SI/SA were not consistently counseled on safe storage by their healthcare team. However, most caregivers, including those with and without firearms, acknowledged the importance of firearm counseling and distribution of firearm locks during their child’s hospitalization.
