How to keep guns — and troubled teens — safe

Dr. Grossman’s team has studied safe gun storage. And they found parents of adolescents with mental illness were no more likely to store guns safely.

By David C. Grossman, MD, MPH, a senior investigator at Kaiser Permanente Washington Health Research Institute (KPWHRI), senior associate medical director for market strategy & public policy at Kaiser Permanente Washington, and a pediatrician at Washington Permanente Medical Group.

Whenever a mass shooting happens, people discuss gun safety, mental health, and how they intersect. Our team has done research in this area. As a pediatrician-researcher, I focus on keeping children and adolescents safe.

With colleagues including Evette J. Ludman, PhD, a KPWHRI research associate, and Kay Theis, MA, MS, a programmer/analyst, we recently published results from survey and administrative data as “Firearm Storage Practices in Households of Adolescents With and Without Mental Illness” in the Journal of Adolescent Health.

And years ago, we analyzed the protective effects of gun storage practices: “Gun Storage Practice and Risk of Youth Suicide and Unintentional Firearm Injuries,” published in JAMA. Based on those results, we made the following recommendations.

How to keep guns safe at home

We found each of the following four gun storage practices protective against suicide and accidental gun injuries among children and teens. So if you own a gun and keep it in a household where adolescents (and children) live or visit, you can significantly reduce the risk that they will use the gun for suicide or unintentional injury if you use one or more of these four storage practices:

• Keep the gun locked.
• Keep the gun unloaded.
• Keep the ammunition locked.
• Store the ammunition in a location separate from the gun.

The first two practices each had a protective effect of around 70 percent. That’s about as effective in protecting children and teens as wearing a seat belt in a car. The last two practices were slightly less protective, at 61 percent and 55 percent, respectively.

These findings were consistent for handguns, rifles, and shotguns. And they were similar for preventing both suicide attempts and unintentional injuries. Using more than one locking device was not associated with any additional protective effect beyond that of one locking device.

That study lacked the statistical power to distinguish which locking devices (safes, lock boxes, trigger locks, gun racks, and gun cabinets) were most effective. But lock boxes seemed to have a lower risk compared to trigger locks.

What about families whose teens have mental illness?

Ideally all households would store guns safely. But we concluded that these gun-safety strategies are particularly important for families with teenagers who have high-risk conditions such as depression or substance abuse, because they are at higher risk for suicide and killing others.

So we were disappointed to find that firearm storage practices were similar among parents with — and without — teens who had been diagnosed with depression or bipolar disorder. Survey and administrative data showed that about 3 in 10 Kaiser Permanente Washington households did not store all their firearms locked and unloaded — regardless of whether adolescents with mental illness lived there.

Our other coauthors for this KPWHRI Development Fund-supported work were Joseph Simonetti, MD, MPH, now at the Denver VA Medical Center but then a fellow at the Harborview Injury Prevention & Research Center (HIPRC) and Ali Rowhani-Rahbar, MD, PhD, MPH, of the University of Washington and HIPRC.

Reuters ran a news story about these findings: Parents of mentally ill teens aren’t more likely to store guns safely.

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