Your questions answered

As a clinician, you’re in a unique position to understand your patients’ risk for firearm injury and help keep them safe. Having clinically-relevant, risk-based, nonjudgmental conversations about risk and access to firearms can help prevent harm. Clinicians should frame inquiries about firearm access as relevant to patient health and inform the patient about their health concerns when inquiring about firearm access.

Click here to learn more about how to assess risk and counsel patients.

Register for our free, on-demand continuing education course, “Preventing Firearm Injury: What Clinicians Can Do.” This course teaches you how to reduce the risk of firearm-related injury and death in your patients, including suicide, dementia, intimate partner violence, unintentional injury, and mass shootings.

Yes! You can ask. There are no state or federal statutes prohibiting health care providers from asking about firearms access when the information is relevant to the patient’s or others’ health. For more information, see “Yes, You Can”, a commentary in the Annals of Internal Medicine on the clinician’s role in firearm injury prevention.

Having culturally appropriate and respectful conversations with patients and making evidence-based recommendations can increase the safety of everyone living in homes with guns. Make clear that your goal is to reduce access to firearms for those at risk.

The 3A’s Framework (Approach, Assess, Act) is designed to guide clinicians through the process of talking with patients about firearm injury prevention.

To help patients stay safe from firearm-related harm:

  1. Be informed and respectful
  2. Assess risk for firearm-related harm
  3. Establish context and ask about access
  4. Engage in risk-based, context-specific counseling
  5. Follow up with continued discussions

Click here for more details about how to counsel patients and watch this explainer video for helpful tips on how to start these conversations.

The following increase the risk for firearm injury in households with guns:

  • Certain psychiatric disorders like depression, bipolar disorder, or schizophrenia 
  • Substance misuse, especially alcohol and stimulants 
  • History of suicide attempts
  • History of violence
  • Intimate partner violence or domestic abuse
  • Dementia or other cognitive impairment
  • Recent relationship or job loss
  • Storing guns in a way that they are easily accessible to at-risk people 
  • Children in the home

Click here for more details about how to identify risk and counsel patients.

If your patient or someone in the home is at risk and has access to firearms, discuss with the patient steps they can take to safely store firearms. If it’s helpful, note the patient’s responses to firearm questions. Plan to follow up about firearms access and your recommendations at the next visit to find out whether the patient was or was not able to follow your firearm safety recommendations, and why or why not. Remember that the circumstances regarding firearms might change from one visit to the next.

Click the following links to find more information on specific clinical scenarios and interventions.

Clinicians can discuss the importance of safe storage and the variety of locking devices available to firearm owners. Some types of lock boxes allow quick access to firearms using biometric technology, making them a preferred safe storage method for those who own guns for protection and want to store them securely while keeping them quickly accessible.

Click here to learn more about lock boxes and other safe storage devices and watch this explainer video on safe firearm storage.

Parents and caregivers should assume that children know the location of guns in the home and should keep all guns unloaded and locked up, with keys and combinations to locking devices inaccessible to children. Click here for more information on safe storage.

In addition to discussing safe gun storage options at home, clinicians can guide parents through having these conversations with other parents. Before their children go to another home to play, parents and caregivers can ask about unlocked firearms along with any other safety questions they might ask. They can say, “Is there an unlocked gun in your house?,” making clear that this is a safety question and avoiding passing judgment. If the answer is yes, the parent or caregiver can talk about his or her concerns and see if the firearm owner is willing to store the firearms safely. Parents should not let their children play where there are firearms that are not safely stored.

The BulletPoints team is happy to present on clinical strategies for preventing firearm injury to groups of clinicians, medical trainees, and medical educators. Currently, we are available to give talks via videoconferencing, and in some cases, we are available for in-person presentations. Please email us at hs-bulletpoints@ucdavis.edu for further information. 

Knowing what a firearm is, what they look like, and how they vary can inform your conversations with patients who have firearms in their homes and help reduce risk.

Click here to explore the basics of firearm types, common uses, and how they work.

If you’re interested in participating in general firearms safety training, get in touch with your local gun range to see what training is offered and to sign up.

You can learn more about firearm ownership here and here.

Understanding relevant firearm laws can help clinicians have informed conversations with patients.

Federal and state firearms laws are available online at the Giffords Law Center website.

Additionally, the RAND Corporation has compiled a State Firearm Law Database, a downloadable file detailing firearm laws by state. Users can filter the database by state and by type of law and can view each law’s text.

The majority of clinicians feel that preventing firearm injury is within the scope of their practice, and patients are generally receptive to having these conversations with their doctors. But most clinicians say they don’t routinely counsel patients, citing lack of education on how to do so as one of the main reasons. Many also said they wouldn’t know what to do if they discovered someone at risk had access to a gun. Although several major medical societies have endorsed clinicians’ role in reducing firearm injury, the topic remains largely absent from medical and nursing school curricula. To fill this gap, we work closely with health care providers, researchers, legal experts, medical educators, and firearm owners to provide clinical tools for firearm injury prevention on the BulletPoints website.

The BulletPoints project is funded by the State of California and developed by the California Firearm Violence Research Center (CA FVRC). California Assembly Bill 521 authorized three years of funding for the project. Additional support for BulletPoints comes from private foundations. Click here to learn more about Assembly Bill 521.

The California Firearm Violence Research Center (CA FVRC) takes a long-term view of the role of scientific research in addressing major health and social problems, emphasizing applied, actionable research.

BulletPoints is a project of CA FVRC that researches, develops, implements, and evaluates an education and training program for health care providers to prevent firearm-related harm in their patients.

We welcome contributions from interdisciplinary experts working to reduce firearm injury. If you’re interested in writing a blog post, please contact the BulletPoints team at hs-bulletpoints@ucdavis.edu with a brief description of your proposed blog post.

If you have additional questions, please email us at  hs-bulletpoints@ucdavis.edu. For further information regarding firearm violence prevention, sign up for our newsletter to get updates on new BulletPoints content, blog posts, and more on clinical strategies for reducing firearm injury. Follow us!

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