Our Limited Knowledge of Youth Suicide Risk and Firearm Access

Fleegler, Eric W.

doi:10.1001/jamanetworkopen.2021.27965

Cited by 3 publications

(1 citation statement)

References 9 publications

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“…For example, holistic interventions that target middle-school and high-school age students could result in significant reductions in assault and intentional self-harm events. Recent efforts focused on establishing universal firearms risk injury screening in care settings for adolescents and youths [11], as well as developing a better understanding of firearm access among this group [12], may help drive preventative mechanisms in this area. Interventions that examine the underlying causes of the increasing rates of intentional self-harm among those aged 65+ [13], might lead to interventions such as increased health care provider communication and policies that address firearms access to those with signs of dementia and/or depression [14, 15].…”

Section: Resultsmentioning

confidence: 99%

EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina

Snyder,

Ising,

Waller

2023

Preprint

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BackgroundThe timeliness, accuracy, and completeness of data for firearm injury surveillance is crucial for public health surveillance efforts and informing injury prevention measures. While emergency department (ED) visit data can provide near real-time information on firearms injuries, there are concerns surrounding the accuracy of intent coding in these data. We examined whether emergency medical service (EMS) data provide more accurate firearm injury intent coding in comparison to ED data.MethodsWe applied a firearm injury definition to EMS encounter data in NC’s statewide syndromic surveillance system (NC DETECT), from January 1, 2021, through December 31, 2022. Each record was manually reviewed to determine shooter and intent, and the corresponding manual classifications were compared to the injury cause codes entered in the EMS data and to ED visit records, where linkage was possible.ResultsWe identified 9557 EMS encounters from January 1, 2021, through December 31, 2022 meeting our firearm injury definition. After removing false positives and duplicates, 8584 records were available for manual injury classification. Overall, our analysis demonstrated that manual and EMS injury cause code classification were comparable. However, for the 3401 EMS encounters that could be linked to an ED visit record, only 18.3% (n = 355) of the 1945 assaults and 22.2% (n = 38) of the 171 intentional self-harm suicide encounters we identified in the EMS records were identified as assault firearm injures in the ED visit data. This demonstrates a marked difference in the intent coding between the two data sources.ConclusionsThis study illustrates both the value of examining EMS encounters for firearm injury intent, and the challenges of accurate intent coding in the ED setting. The results also suggest the importance of developing better guidance around intent coding for firearm injuries in the ED.

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Section: Resultsmentioning

confidence: 99%

EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina

Snyder,

Ising,

Waller

2023

Preprint

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Equitable implementation of S.A.F.E. Firearm: A multi-method pilot study

Hoskins¹,

Linn²,

Ahmedani³

et al. 2022

Preventive Medicine

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Mental Health Comorbidities, Household Firearm Ownership, and Firearm Access Among Children

et al. 2023

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OBJECTIVES: To examine how youth and their caregivers’ mental health risk factors for suicide are associated with youth firearm access inside and outside the home. METHODS: This study examines a cross-section of the Adolescent Brain and Cognitive Development Social Development study data collected from 2016 to 2021. The sample included 2277 children aged 10 to 15 years from 5 study sites across the United States. We estimated multilevel generalized linear models of household firearm ownership and the child’s reported firearm access (hard access or easy access). The primary exposures were the child’s and their caregivers’ mental health risk factors for suicide. RESULTS: In the Adolescent Brain and Cognitive Development Social Development study sample, approximately 20% of children lived in a firearm-owning household and 5% of all children reported easy firearm access. In non–firearm-owning households, children with diagnosed lifetime suicidality were 2.48 times more likely (95% confidence interval [CI], 1.50–4.10) than their counterparts to report easy firearm access. In firearm-owning households, children of caregivers who self-reported any mental health history or externalizing problems were 1.67 times (95% CI, 1.10–2.54) and 2.28 times (95% CI, 1.55–3.37) more likely than their counterparts to report easy firearm access. CONCLUSIONS: Youths with mental health risk factors for suicide may be just as likely or more likely to report firearm access as those without such risk factors. Youth suicide prevention efforts should address youths’ firearm access outside the home and caregiver mental health.

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Our Limited Knowledge of Youth Suicide Risk and Firearm Access

Cited by 3 publications

References 9 publications

EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina

EMS injury cause codes more accurate than emergency department visit ICD-10-CM codes for firearm injury intent in North Carolina

Equitable implementation of S.A.F.E. Firearm: A multi-method pilot study

Mental Health Comorbidities, Household Firearm Ownership, and Firearm Access Among Children

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