Journal of Behavioral Medicine

, Volume 42, Issue 4, pp 584–590 | Cite as

Firearm suicide among youth in the United States, 2004–2015

  • Patricia G. SchnitzerEmail author
  • Heather K. Dykstra
  • Theodore E. Trigylidas
  • Richard Lichenstein


Suicide is a leading cause of death among children in the United States; firearms cause 37% of these deaths. Research is needed to better understand firearm accessibility among youth at risk for suicide. We reviewed data from the National Fatality Review Case Reporting System (NFR-CRS). Firearm suicide deaths of children ages 10–18 occurring 2004 through 2015 with completed suicide-specific section were included. Children who had talked about, threatened or attempted suicide were identified as “Greater Risk” (GR). Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated. Of the 2106 firearm suicide deaths, 1388 (66%) had a completed NFR-CRS suicide section. Of these, 36% (494/1388) met the criteria for GR. Firearms were less likely to be stored in a locked location for GR children [adjusted OR 0.62, (95%CI 0.49–0.98)]. Strategies to limit firearm access, particularly for GR youth, should be a focus of suicide prevention efforts.


Suicide Firearms Gun violence Pediatrics Prevention Child death review 



The National Center for Fatality Review and Prevention is funded in part by Cooperative Agreement (UG7MC28482) from the U.S. Department of Health and Human Services (HHS), Health Resources and Services Administration (HRSA), Maternal and Child Health Bureau (MCHB). The authors gratefully acknowledge Linda J Kesselring, MS, ELS for copyediting, Shaohui Zhai, Ph.D. for biostatistical advice, and the states that participate in the NFR-CRS.

Compliance with ethical standards

Conflict of interest

Patricia G. Schnitzer, Heather K. Dykstra, Theodore E. Trigylidas and Richard Lichenstein declare that they have no conflict of interest.

Human and animal rights and Informed consent

This study did not include living human participants or animals. For this type of study (retrospective analysis of secondary data on deceased children) formal consent is not required.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.National Center for Fatality Review and PreventionMichigan Public Health InstituteOkemosUSA
  2. 2.Division of Emergency Medicine, Department of Pediatrics, Children’s National Medical CenterGeorge Washington University School of Medicine and Health SciencesWashingtonUSA
  3. 3.Department of PediatricsUniversity of Maryland School of MedicineBaltimoreUSA

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