Many mental health care clinicians do not routinely ask all patients about firearm access, a key step in preventing firearm injuries, according to researchers from Rutgers Health.
The study, published in JAMA Network Open, analyzed reports by mental health care clinicians on screening for firearm access, barriers to such screenings, and the confidence of providers in conducting firearm safety discussions during clinical practice.
Taylor Rodriguez, a researcher at the New Jersey Gun Violence Research Center, emphasized the importance of supporting clinicians with training opportunities for secure firearm storage and standardized protocols. “Supporting clinicians with secure firearm storage training opportunities, and standardized protocols for proactively screening every patient for firearm access could be an important way to limit the subjectivity in screening and integrate firearm injury prevention into mental health care,” Rodriguez stated.
In the United States, approximately 42% of households possess at least one firearm. This presence poses risks of injury or death due to accidental shootings, suicides, or homicides. Screening for firearm access is recommended in healthcare settings to facilitate risk mitigation conversations. However, there is limited understanding of these practices within mental health care where clinicians can reach at-risk individuals.
Using self-reported data from 311 mental health care clinicians, researchers identified existing practices and perceptions regarding firearm screening. They discovered that most clinicians screen for access when there is a perceived risk of suicide or violence.
“However, many estimated screening less than half of all their clients and most clinicians are not asking all clients about firearm access,” said Taylor Rodriguez. The primary barrier cited was the belief that patients did not need to be asked about firearms.
“This is important because it tells us that clinicians are subjectively deciding who to screen,” Rodriguez noted. She highlighted that only screening when risk factors appear can miss many patients who have firearms and could benefit from discussions on security.
The study indicates that while clinicians recognize the importance of discussing secure storage in mental health contexts, they have moderate confidence in their ability to implement these practices effectively.
Rodriguez added that future research should explore how to implement consistent screenings and follow-up discussions as well as ways to increase overall screening frequency among practitioners.
Coauthors include Allison Bond and Shelby Bandel from Rutgers’ Department of Psychology; Michael Anestis from the New Jersey Gun Violence Research Center; Christopher Collins from Salem State University’s School of Social Work; and Joye Anestis from Rutgers School of Public Health.
