Gun violence is an “urgent” public health crisis, says U.S. Surgeon General Dr. Vivek Murthy in a new public health advisory talking about gun-related deaths. More than half of suicides in the United States involve firearms, and suicides account for more than half of all firearm deaths. Weapons are also a main cause of unintentional injury – and death – in American children aged 17 and under.
But despite this deadly link, many primary care doctors still don’t address gun safety with patients. Several recent studies have highlighted this fact, along with how more lives could be saved if gun safety were a regular topic in doctors’ offices. “Only about a quarter of people who die by suicide go to a mental health professional, but they go to their primary care provider,” Allison Bond, a firearms safety researcher at Rutgers University, tells Yahoo Life. “We’re missing an opportunity to talk about things like suicide risk and gun safety.”
Why aren’t more doctors talking about this and how much does it really matter? Experts analyze this.
Why aren’t more doctors talking about gun safety?
There are currently no federal regulations on doctors talking to their patients about gun safety, but several medical organizations recommend the practice. O American Academy of Pediatrics (AAP) suggests that pediatricians “routinely” talk about firearm safety with patients and families, and the American Medical Association (AMA) recommends that health care providers ask patients if they have firearms at home and advise them about the risks and safe storage.
But ultimately it’s up to the doctor and the medical practice to actually do this, Dr.researcher and resident at Michigan Medicine, told Yahoo Life — and many don’t.
Ladines-Lim conducted a to study published earlier this year that surveyed 109 health care providers at 10 sites, asking whether they provided gun safety advice during new patient visits. It found that only 36% of health care providers said they felt comfortable talking to patients about gun safety.
“Many of us tend to be a little reluctant to broach the subject because it can be very politicized and sensitive,” says Ladines-Lim. “We don’t want to do anything that offends or rejects the patient.” Her research also found that doctors are often time-poor and may not feel this is as important a topic to discuss as others.
Talking about firearms can also feel very personal — and it’s just another intimate question to add to the list doctors already ask, says Bond. “But this perpetuates the notion that we can’t talk about firearms in a healthcare setting, which is not true,” she says.
Many doctors also don’t bring up the subject because they don’t know what to say, Dr., an expert on gun law and mental illness and director of the BulletPoints project at UC Davis Health, told Yahoo Life. “Some also fear that if they find out that a patient at risk of suicide has a gun in the home, they won’t be able to do anything – that’s not true,” she says. (Red flag laws (Some states allow authorities to temporarily remove firearms from people who have been identified as a danger to themselves or others, she points out.)
What can you say about firearms? security per doctors to do?
These conversations can help reduce the risk of accidental shootings and suicide, Lauren Khazem, research assistant professor and clinical psychologist in the Department of Psychiatry and Behavioral Health at Ohio State University Wexner Medical Center, tells Yahoo Life. People who die by gun suicide tend to act impulsively and generally haven’t attempted suicide in the past, she says. “If we don’t ask about firearms, we are missing opportunities for suicide prevention efforts for these individuals,” says Khazem.
Some patients may simply not know about safe firearm storage, says Barnhorst. “Patients rely on us for a lot of health and safety information for them and their families,” she says. “They often have risks that they wouldn’t otherwise be aware of. With firearms it’s no different.”
Research has found that advising people about safe gun storage can lead to consistent changes. One to study of Mississippi National Guard members who owned firearms found that 55% of those who were advised about safe gun storage were still following the recommendations three months later, compared to just 39% of those who were not advised.
This can also help reduce the risk of intentional gun violence. Easy access to a firearm creates a five times greater risk that a woman will be killed by a domestic abuser, according to Everytown for Gun Safety.
Finally, Bond says conversations can also just remind people about safe gun storage. “If a patient has children or grandchildren coming to visit, patients may be reminded to unload their weapons and store them in a gun safe,” she says.
What are these conversations like?
Ladines-Lim says it varies by practice and provider. “There is no set, uniform way to do this,” he says. Many will have a general questionnaire that patients fill out in advance that includes a question about guns, although Ladines-Lim says his research has found that some people purposefully ignore the issue of guns.
If the patient responds that they have guns at home or fills out a questionnaire, Ladines-Lim says he will typically follow up to ask if it is locked or loaded and where it is stored before going into gun safety. That largely means talking to patients about how to unload, lock and store guns separately from ammunition, he says.
“When I talk about gun safety with a patient, most will think about it,” he says. “But I’ve heard some colleagues say that their patients aren’t interested in discussing the topic. It varies a lot.”
Bond says there needs to be more research into this. “We don’t know what this should look like and how a gun owner wants this addressed,” she says. “We need more research.”
Barnhorst says medical training programs across the country are now focusing more on gun safety. “There is a big movement to incorporate this teaching into classrooms and clinical settings so that doctors are aware of interventions that can help,” she says.
Ultimately, Barnhorst says it’s important for doctors to try to work with patients. “The people most at risk for gunshot injuries are firearm owners,” she says. “It’s important to engage them in a thoughtful conversation and work with them on solutions rather than taking an absolute approach that guns are bad and we shouldn’t have them.”
This article was originally published on March 8, 2024 and has been updated.
