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Data on 153 youth suicides in Arizona (1994-1999) were used to explore demographic, behavioral, and experiential factors that distinguish between firearm suicide and suicide by other means. In bivariate analyses, White youths were more likely than non-White youths to use a firearm to commit suicide as were youths who had not experienced a life crisis or expressed suicidal thoughts in the past, relationships that hold in multivariate analyses at the p < 0.2 level. Targeted suicide prevention activities should supplement interventions focused on restricting access to highly lethal means of suicide such as firearms.

A look at the toll of firearm violence internationally is instructive: in 1992, 38 people died in England from gun homicides,[1] about 100 in Australia,[2] 214 in Canada,[3] and 17,790 […]

Young men under 19 years of age treated by emergency departments in Massachusetts appear most likely to be injured by guns. The Weapon-Related Injury Surveillance System requires the attending physician to furnish information about the patient's type of injury, the circumstances and the location. The physician is also required to provide information on how the patient arrived at emergency, whether offender and victim knew each other, and suspected substance abuse. Seventy-one percent of the 1,860 cases surveyed in 1992 were violence related. Eighty-five percent of the victims were male and those between 15 and 19 years of age were at the highest risk for weapon wounds, especially those caused by guns.

Introduction: To address youth suicide, we recruited seven emergency departments (EDs) for what we believe is the first controlled trial of an intervention to promote safer firearm and medication storage after a child was seen in an ED by a behavioural health clinician. We provided training and a common protocol that required behavioural health clinicians to counsel about reducing access to household firearms and medication and provide locking devices. This paper examines how we addressed implementation challenges and considers how lessons learnt might inform future studies and interventions., Methods: We tracked enrolment numbers and documented, through project records, the challenges in recruiting and developing partnerships with hospitals, as well as implementing the intervention and carrying out data collection., Results: We encountered challenges identifying hospitals with sufficient patient volumes to meet our analytic requirements, obtaining contact information from families in the ED and providing supplies to the sites. These challenges were compounded by lack of uniformity in data systems, making it difficult to estimate total ED encounters meeting our eligibility criteria, and by differences in patterns of behavioural healthcare delivery across sites. The strategies we devised to address these challenges included creating visual materials that appealed to parents' altruistic desire to help other families, laminated 'cheat sheets' and hang tags for clinician badges reminding them of the key points of the intervention and contracting with a distribution centre to coordinate shipping., Discussion: Despite the challenges noted, we found that the behavioural health clinicians in the EDs followed the protocol and found it useful in engaging families in discussions about both firearm and medication storage. Several hospitals intend to continue the intervention on their own as the new usual care, suggesting that the challenges encountered can be and are worth tackling., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: Firearm safety instructors and public health professionals are natural allies in the quest to prevent firearm injuries. We audited basic firearm classes to provide information that can help familiarise public health professionals and others with the content covered., Methods: With the advice of expert instructors, we created an audit form. Volunteers audited 20 basic firearm classes in seven north-eastern states., Results: All trainers covered a wide variety of safety issues. Some specific basics were covered in 90+% of the classes, including how to safely load/unload a gun, keeping your finger off the trigger until ready to shoot, and being aware of your target and what is behind it. In 50%-75% of the classes, the trainer covered topics such as operating a safety, clearing jams and cartridge malfunctions, and recommended storing guns unloaded and locked when not in use. Few instructors covered firearm suicide prevention (10%) or domestic violence (10%). Most encouraged gun ownership, gun carrying, gun use in self-defence and membership in a gun rights group., Discussion: From a public health standpoint, we would like to see more instructors covering topics such as firearm suicide and alternatives to gun use in self-defence, and to recommend safer storage of firearms., Competing Interests: Competing interests: None declared., (© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2019. All rights reserved. No commercial use is permitted unless otherwise expressly granted.)