‘Just Ask’ Applies to Pediatricians – Talk With Families About Safe Firearm Storage

Ruth McDonald, MD
Vice President and Associate Chief Medical Officer, Medical Operations
Seattle Children’s

Firearms in the home pose an increased risk of both unintentional injuries and intentional shootings.

  • 36% of Washington households have at least one firearm.
  • 18% of Washington households contain an unlocked firearm.
  • When firearms are present in a household it is more likely that someone living there will be injured than that an intruder will be.
  • Youth suicide is the most common firearm-related injury.
  • 78% of gun deaths in Washington are death by suicide, not homicide.

Pediatricians can save lives by providing guidance to families about safe, evidence-based firearm storage. Research shows that 93% of parents – including those who own firearms – would be comfortable with being asked about a firearm in their home. (Interviews and focus groups indicate that families who owned firearms prefer that term to guns.)

Parents who attended recent safe firearm storage events indicated they feel more comfortable with physicians screening for the presence of firearms within the context of other routine safety questions, so it could be helpful to include questions about safe firearm storage on existing patient safety questionnaires.

Asking “What questions do you have about safe firearm storage?” can be a general entry point for discussing the topic. If you know they own firearms, you might ask “How are you storing firearms to keep your child safe?”

If firearms are present in your patient’s home, teach triple safe storage, which is the safest way to store a firearm:

  1. Use a gun safe, lock box or trigger lock to store firearms. (These can be opened quickly when needed.)
  2. Store firearms unloaded and locked.
  3. Store and lock ammunition in a separate place.

If possible, families should avoid locking devices that only use keys because children and teens often know where the keys are kept. It’s also important to lock guns up at all times – even if the child or teen has had safety training.

Safe firearm storage – and possibly removing firearms from a home – is critical to discuss whenever there is a diagnosis of depression, anxiety, suicidal ideation, prior suicide attempts or substance abuse.