Counseling on Gun Safety in the Home

According to research published in the American Journal of Public Health up to one-third of U.S. homes with children under age 18 report having a firearm, making gun safety in the home an important topic for every parent. In a world where children will likely be exposed to guns, parents need to know how to keep their children safe from harm. Thus, it’s important that healthcare professionals that interact with families on a regular basis counsel parents about why and how to prevent their child from accessing guns.

Gun violence is a complex and polarizing public health issue in the U.S. and healthc are professionals should avoid discussing personal preferences about gun rights and control. However, do not avoid educating about safe gun storage practices. The focus should be on the “why” and the “how” to keep children safe-- a goal for all parents. 

Helpful Information to Guide the Conversation

Why Guns in the Home Are a Risk For Children

If children have the access and means to a gun, they may act on natural curiosity or a momentary impulse that is hard to grasp by an adult’s common sense.

Research tells us that one half of all U.S. handgun owners keep their guns loaded at least some of the time and that 40 percent of gun owners store guns in a bedroom or closet, NOT in a locked case, cabinet, or vault. Most adolescent suicides occur in the home and the firearm is owned by a parent. Additionally, many of these suicides are impulsive with a time of idea-to-action of less than 5 minutes. In youth suicides, the use of a firearm results in fatality in 95 percent of attempts. This is a much higher rate than the use of other means such as drugs or cutting. Note that 90 percent of those that survive an attempt do not ultimately die from suicide. So if youth are prevented from accessing a gun in a moment of perceived crisis, they can survive to get the mental health support they need. Read more about youth suicide and self-harm.

Younger children are also at risk of accessing a gun. Seventy-five percent of 5-14 year olds know where the guns are kept in the home – even if the parent thinks they don’t.

Despite pervasive misperceptions, it is not against the law for health care providers to ask about guns in the home or to provide guidance about gun safety and safe storage of guns and ammunition. 

Counsel at Developmental Milestones

Birth – Ask about guns in the home at a time when a family will be open to changes that would increase the safety of their home for their child. Here is why: Healthcare providers play an important role in keeping families educated on gun safety for children. Ideally, gun safety should be addressed at multiple touch points during childhood, and when certain extra risks become evident.

Toddler (12-24 months) – Children are developing motor skills rapidly and love to walk and explore. They also love to problem solve. Therefore, figuring out how parts of a gun move can be as interesting to them as opening cabinets and drawers. However, they do not understand concept of danger and often ignore “no” or quickly forget.

Preschool/Young School Age – At this age, children have good motor development but lack probability judgment about the consequences of actions (if-then). They are curious and can find everything in their home. This is also the age that children tend to play at their friend’s homes. Thus, parents knowing whether guns are present and safely secured in others’ homes becomes highly relevant.

Older School Age – These children are concrete thinkers but still don’t consider cause and effect very well. At this time, they are not as closely supervised and are developing some independence. Exposure to violence in the media increases and this may affect their curiosity about guns.

Adolescence – Risk-taking increases as adolescents underestimate the danger to themselves and want to explore independence. They are more likely to experience peer pressure and want to show no fear. They may perceive their peers to be carrying guns. Due to natural physiologic changes, they can have mood swings, be impulsive, more prone to settling disputes with violence, and to consider suicide as a solution.

Counsel If Certain Risk Factors Are Present

When any of these risk factors are identified in a child’s home or life, it’s time to counsel again about gun safety:

• ADHD
• Family violence
• Depression
• Suicide ideation
• Drug alcohol/drug abuse
• Bullying

How To Frame the Conversation For Parents

It’s not possible to “gun proof” children due to many factors including the cognitive immaturity in younger kids and the invulnerability in adolescence. Parents and caregivers should be encouraged to consider firearm safety within anticipatory guidance about protecting children from other dangers in home, such as cigarette smoke, stairs, electric sockets, hot stoves, etc. The conversation should be approached free of judgment, with the facts, and confidentiality assured.

Counsel parents early and often. If they answer “yes” to having a gun in the home, first recommend removing the gun from the home for the safety of their family and the reasons mentioned above. If parents plan to keep guns in the home, advise that they store guns unloaded and locked, with no access to keys, and ideally in a gun safe. Explain they need to store guns disassembled and separated from ammunition.

How Parents Can Safely Ask About Guns In Others’ Homes

This is an awkward but important conversation parents need to have with other parents as their child gets older and visits other children’s homes without Mom or Dad present. Recommend to parents that they ask about a gun in the home in a non-judgmental way.  Parents can say it’s really about their child:  “I have to be extra careful because my son/daughter gets into everything!”

Click here to view a CHOP fact sheet on gun safety tips created by experts at CHOP.

Recommended Resources

Watch this webinar for health care providers about Counseling Families About Gun Safety in the Home: