Adolescents who had access to firearms had about 1.5 times higher odds for prior suicide attempt and current suicidal ideation, according to a study published in the journal Academic Pediatrics. The study also found that one-third of adolescents coming to the Emergency Department (ED) for any reason had moderate to severe depressive symptoms, and over 40 percent of this group had access to a gun. This data was collected before the pandemic, during which EDs across the country saw an overwhelming increase in mental health burden in youth.

"Our findings underscore the importance of screening all adolescents who present to the ED for suicide risk and access to firearms," said lead author Samaa Kemal, MD, MPH, Pediatric Emergency Medicine Fellow at Ann & Robert H. Lurie Children's Hospital of Chicago. "This is even more critical now that we are in the midst of a youth mental health crisis."

Currently, the Joint Commission mandates that all children over 12 years old should be screened for suicide risk, and if this risk is identified, screening for access to lethal means is recommended. However, screening for firearm access tends to be inconsistent in the ED.

Suicide is the second leading cause of death among adolescents in the United States, and adolescent suicide death rates have almost doubled over the past 10 years. Firearms accounted for 44 percent of suicide deaths among adolescents ages 14 to 18 between 2015 and 2020, with an estimated 70 percent of firearm-related suicide attempts involving weapons that were obtained within the victim's household.

Dr. Kemal and colleagues analyzed data from over 15,000 patients ages 14-18 years seen at a tertiary children's hospital ED between June 2013 and March 2020. Fourteen percent of the overall sample reported access to a firearm in the home or ability to access one within the next 24 hours. A history of sexual assault significantly increased the odds of a participant reporting a prior suicide attempt. Participants reporting verbal bullying, intimate partner violence, and/or abuse by a caregiver also had significantly increased odds of reporting current suicidal ideation and prior suicide attempt.

"Universal mental health screening of adolescents is particularly important in the wake of the COVID-19 pandemic, which has led to both increased firearm availability and worsening indicators of youth mental health," said Dr. Kemal. "Proper screening for both suicidality and firearm access can create the opportunity to offer effective firearm safety counseling, such as keeping all firearms locked, unloaded and separate from ammunition, as well as linkage to mental health resources. We must do everything possible to prevent tragic deaths among teens who are struggling."