Adolescent suicide and household access to firearms in Colorado: results of a case-control study

Shah, Seema; Hoffman, Richard E.; Wake, Lane; Marine, William M.

doi:10.1016/s1054-139x(99)00064-6

Cited by 94 publications

(67 citation statements)

References 18 publications

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“…No studies have examined the benefits or risks of a safety contract. Some studies have suggested that limiting access to firearms or other lethal means can decrease suicide by those methods, [72][73][74][75] but the evidence is still unclear as to whether, on a broader population level, restricting access to certain lethal methods results in an overall decrease of suicide rates. In addition, a study by Brent et al 76 found that families of depressed adolescents are frequently noncompliant with recommendations to remove firearms from the house.…”

Section: Safety Planningmentioning

confidence: 99%

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

et al. 2007

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OBJECTIVES. To develop clinical practice guidelines to assist primary care clinicians in the management of adolescent depression. This first part of the guidelines addresses identification, assessment, and initial management of adolescent depression in primary care settings.METHODS. By using a combination of evidence-and consensus-based methodologies, guidelines were developed by an expert steering committee in 5 phases, as informed by (1) current scientific evidence (published and unpublished), (2) a series of focus groups, (3) a formal survey, (4) an expert consensus workshop, and (5) draft revision and iteration among members of the steering committee.RESULTS. Guidelines were developed for youth aged 10 to 21 years and correspond to initial phases of adolescent depression management in primary care, including identification of at-risk youth, assessment and diagnosis, and initial management. The strength of each recommendation and its evidence base are summarized. The identification, assessment, and initial management section of the guidelines includes recommendations for (1) identification of depression in youth at high risk, (2) systematic assessment procedures using reliable depression scales, patient and caregiver interviews, and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, (3) patient and family psychoeducation, (4) establishing relevant links in the community, and (5) the establishment of a safety plan.CONCLUSIONS. This part of the guidelines is intended to assist primary care clinicians in the identification and initial management of depressed adolescents in an era of great clinical need and a shortage of mental health specialists but cannot replace clinical judgment; these guidelines are not meant to be the sole source of guidance for adolescent depression management. Additional research that addresses the identification and initial management of depressed youth in primary care is needed, including empirical testing of these guidelines. 4,5 Even when diagnosed by PC physicians, only half of these patients are treated appropriately. 3 Furthermore, rates of completion of specialty mental health referral for youth with a recognized emotional disorder from general medical settings are quite low (J. V. Campo, MD, written communication, 2006).In view of the shortage of mental health clinicians and barriers to children having access to mental health professionals, the well-documented need for PC clinicians to learn how to manage this condition, the increasing evidence base available to guide clinical practice, increased selective serotonin reuptake inhibitor-prescribing rates in pediatric PC, 6,7 and new evidence that a multifaceted approach with mental health consultation may improve the management of depression in PC settings, [8][9][10][11] guidelines may be a necessary first step in the identification and management of depression in adolescents in PC. Unfortunately, no depression-management guidelines have been developed for use in the PC setting in the United S...

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Section: Safety Planningmentioning

confidence: 99%

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

et al. 2007

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“…confer a degree of protection in the risks for suicide and unintentional injury. [5][6][7][8] In keeping with these findings, professional organizations, including the American Academy of Pediatrics 9 and the Society for Adolescent Medicine, 10 recommend that parents keep firearms stored unloaded and locked up.In the United States, 14% to 30% of households with guns and young or adolescent children (aged <18 years) have at least 1 loaded firearm, and about 43% contain an unlocked firearm. 1,3,4,11,12 A recent study 13 estimated that nearly 2 million US children live in homes with loaded, unlocked firearms.…”

mentioning

confidence: 99%

“…[5][6][7][8] In keeping with these findings, professional organizations, including the American Academy of Pediatrics 9 and the Society for Adolescent Medicine, 10 recommend that parents keep firearms stored unloaded and locked up.…”

mentioning

confidence: 99%

Are Household Firearms Stored Less Safely in Homes With Adolescents?

Johnson

Miller

Vriniotis

et al. 2006

Arch Pediatr Adolesc Med

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Objective-To examine whether firearms are more frequently stored loaded, unlocked, or both in households with adolescents only (aged 13-17 years) compared with households with younger children only (aged 0-12 years).Design-Random-digit-dial survey on firearms (n=2770). We computed bivariate associations between the presence of adolescents and firearm storage practices. Statistical significance was assessed using prevalence ratios with 95% confidence intervals. Setting-United States.Participants-Survey respondents with children (aged <18 years) who reported the presence of a household firearm.Main Outcome Measures-Prevalence of firearms in the home stored loaded and/or unlocked.Results-Of the 392 respondents, 22% had a loaded firearm, 32% had an unlocked firearm, and 8% had a firearm stored loaded and unlocked. Compared with households with younger children, households with adolescents only were somewhat more likely to store a firearm unlocked (42% vs 29%; prevalence ratio, 1.48; 95% confidence interval, 1.04-2.02), loaded (26% vs 20%; prevalence ratio, 1.25; 95% confidence interval, 0.82-1.91), or both (10% vs 8%; prevalence ratio, 1.43; 95% confidence interval, 0.64-3.19).Conclusions-Parents of adolescents appear to be more likely to keep household firearms stored unsafely, especially with regard to keeping firearms unlocked. This is of concern because most youth firearm injuries happen to adolescents. Firearm injury prevention programs should directly target parents of adolescents to promote safe firearm storage.Firearms are present in about one third of US households with children and youth. [1][2][3][4] Therefore, safe firearm storage practices-including keeping firearms stored unloaded and locked up-represent important safety behaviors. confer a degree of protection in the risks for suicide and unintentional injury. [5][6][7][8] In keeping with these findings, professional organizations, including the American Academy of Pediatrics 9 and the Society for Adolescent Medicine, 10 recommend that parents keep firearms stored unloaded and locked up.In the United States, 14% to 30% of households with guns and young or adolescent children (aged <18 years) have at least 1 loaded firearm, and about 43% contain an unlocked firearm. 1,3,4,11,12 A recent study 13 estimated that nearly 2 million US children live in homes with loaded, unlocked firearms. The home is the primary place from which young people obtain firearms that are used in unintentional and violent injuries, as well as a primary setting in which pediatric firearm injuries, especially suicides, take place. 7,8,[14][15][16] Keeping children and youth safe represents a strong motivation for parents to not have firearms in the home or to store them locked up and unloaded. [2][3][4]17,18 However, parents' perceptions of how likely their children are to get hurt with a firearm may vary based on characteristics of the child. Qualitative research shows that parents' expectations that their children will not play with or touch guns are based on beliefs abou...

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“…As previously discussed, impulsiveness may play a key role in suicide death but this may be particularly true for adolescents who may contemplate suicide. In a study by Shah, Hoffman, Wake and Marine (2000) of 36 adolescents who committed suicide, 67% did so with a gun obtained from their own home. Therefore, a recommendation to decrease the risk of suicide for adults and adolescents would be to limit household access to guns (Shah et al, 2000).…”

Section: Firearm Suicidesmentioning

confidence: 99%

Gun Violence in the United States: A Public Health Epidemic

2012

Public Health - Social and Behavioral Health

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Adolescent suicide and household access to firearms in Colorado: results of a case-control study

Cited by 94 publications

References 18 publications

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

Are Household Firearms Stored Less Safely in Homes With Adolescents?

Gun Violence in the United States: A Public Health Epidemic

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