Firearm Storage Device Distribution to Families of Children With Mental Health Complaints

Firearm injuries are a significant cause of morbidity and mortality for children and teens.
Access to firearms has been associated with suicide completion in the pediatric mental health
population. Current practice in our pediatric Emergency Department (ED) and inpatient
psychiatric unit is to screen all mental health patients for firearm access, and to recommend
safe firearm storage practices. However, there is no data on the baseline rate of safe
firearm storage device use in the homes of these patients, or on the effectiveness of
providing these recommendations during hospitalization.

This study has two phases, a baseline and an intervention. During the baseline phase, the
research team will study whether there is an improvement in safe firearm storage device use
in the homes of participants 7 or 30 days after safe storage practices are recommended during
an ED or inpatient psychiatric visit. During the intervention phase, in addition to the
standard recommendation of safe storage practices during the visit, the research team will
distribute firearm safety storage devices such as a lock box, trigger lock, and and/or cable
lock to families at the time of study enrollment. The investigators will study whether there
is an improvement in safe firearm storage device use in the homes of intervention
participants after 7 or 30 days compared to the usual care group.

Inclusion Criteria:

- Age 0-17 years, inclusive

- Evaluated in the Emergency Department or inpatient psychiatric unit for a primary
mental health complaint

- Presence of a firearm in household where patient resides at least one day per week
and/or will reside for at least one of the 7 days following enrollment

- Accompanied by a parent or legal guardian

- Parent or legal guardian is proficient in English

- Parent or legal guardian is 18 years of age or older

Exclusion Criteria:

- Patient is 18 years of age or older

- Patient is not evaluated for a mental health complaint in the Emergency Department or
inpatient psychiatric unit

- The adult participant has previously enrolled in the intervention phase of the study.

- Patient is accompanied by a parent/legal guardian who has previously enrolled a
different child in the intervention phase of the study

- Patient is not accompanied by a parent or legal guardian during their PMBU or ED visit

- Parent or legal guardian accompanying patient does not reside and/or does not
anticipate residing in the household with patient for any of the 7 days following
enrollment and no other adult household member is present to consent Note: Adult
household members may only consent to participate in this study if a parent or legal
guardian is also present to provide informed consent.

For adult household members only:

Inclusion Criteria:

- 18 years of age or older

- Lives in same household as patient at least one day per week

- Has primary or shared responsibility for at least one firearm stored in the household

- Proficient in English

Exclusion Criteria:

- Resides in household with patient less than one day per week, and/or does not
anticipate residing in the household with patient for any of the 7 days following
enrollment

- Is not responsible for firearm storage in the home