Frequently Asked Questions
If your question isn't answered here, don't hesitate to reach out to the What You Can Do team by sending an email to hs-WYCD@ucdavis.edu.
- As a health care provider, can I ask patients about firearms?
- Why should I counsel patients on firearms?
- How do I explain the health risks of having firearms in the home?
- How do I approach the topic of firearms with my patients?
- What questions can I ask to open the conversation about firearms with patients?
- My patient has risk factors for firearm injury but is not in an acute emergency. What should I do?
- How can I advise a patient who is worried about someone else's access to firearms?
- How can I advise parents to discuss firearms in homes where their children play?
- What laws exist for temporary removal of firearms in crisis situations?
- What do I do with the information patients give me about firearm access?
- How can my patient get rid of an unwanted firearm?
- Where can I view state and federal firearms laws?
- What materials about risk for firearm injury and death and firearm safety can I give my patients?
- Will giving up firearms temporarily affect my patient's ability to own firearms in the future?
- I want to give a talk about the provider's role in preventing firearm injury and death. What resources might help?
- Where can I learn more about firearm injury and death, risk factors, and counseling?
- How do I make the commitment to ask my patients about firearms?
- I need more materials on firearm injury and death. What can I do?
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: Physicians, Patients, and Firearms.
As a health care provider, you are in a unique position to understand your patients’ risk for firearm injury and death. As Dr. Wintemute explains in his commentary, you can approach firearm counseling as “a focused intervention, because violence is not distributed at random."1
People who commit firearm violence—whether against others or themselves—and people who sustain it often have well-recognized risk factors. As a result, firearm violence can to some extent be predicted. What's more, these factors often bring high-risk individuals into contact with physicians.
You can screen for access to firearms, the same way that you may selectively screen patients for access to other hazards.
For more on assessing risk and counseling patients, view, download, or print the What You Can Do provider handout.
Start by explaining that having firearms in the home is a risk for everyone in the home.2
Members of households with firearms are at increased risk of violent death compared to those living in households without firearms. Furthermore, firearms in homes with at-risk members, such as those who misuse alcohol or drugs, are less likely to practice safe storage.3,4
39,773 people died from firearms in 2017. For comparison, 38,659 people died in motor vehicle crashes.5 Firearm safety is important both for the health of your patients and for public health.
After discussing the health risks of firearms and safety strategies with patients, you can give them the What You Can Do patient handout, developed to help patients further understand the risks of having firearms and how to minimize that risk.
Assess your patient’s unique risk factors for firearm violence and use that assessment to inform your firearm counseling. Explain why you’re asking about firearms and highlight the risk that comes with having firearms in the home.
We recommend an approach to counseling that:6
- Relates clearly to the patient’s health and wellbeing
- Is unique to the patient and context-specific
- Is respectful
- Opens a conversation
- Recognizes that changing circumstances in the home can change risk of firearm injury and death
- Acknowledges local customs related to firearms and firearm ownership
- Happens within an established patient-physician relationship, when possible
- Is educational, rather than strictly for information gathering
- Includes appropriate follow-up
See more about preparing to counsel patients.
For a guide on assessing risk and counseling patients, view, download, or print the What You Can Do provider handout.
After you’ve assessed the patient’s risk factors and determined that access to firearms is clinically relevant, you might start the conversation by saying: “Now I want to ask you a couple of questions about firearms. Are there any firearms in or around your home?”
If the patient answers with a yes, you should probe: “Do any of these firearms belong to you?” and “Who has access to them?”
More detail is often helpful. If there are firearms in the home, find out more by asking, “Are all the guns and ammunition locked up in some way?” and “Are all of the firearms stored so they can’t be accessed by unauthorized users?”6
If it’s helpful, you can incorporate the questions on firearm ownership and access into other screening questions you ask during the patient’s visit.
Be prepared to take further action when your firearm counseling leads you to believe someone is at imminent risk of perpetrating or sustaining firearm violence.
For a guide on assessing risk and counseling patients, view, download, or print the What You Can Do provider handout.
6. My patient has risk factors for firearm injury but is not in an acute emergency. What should I do?
If your at-risk patient has access to firearms and is not safely storing or handling them, discuss measures the patient can take to improve her firearm safety habits. 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.
If a patient is worried about someone else’s access to firearms and unsure of how to address it, have a conversation with the patient about the risk of firearms in the home, answer the patient’s questions, and provide him or her with the information he or she might need to present to the at-risk person. Recommend that the patient take a non-confrontational, non-judgmental approach to discussing firearm access.
If your assessment of the patient’s situation leads you to believe that someone is at extreme risk of firearm injury, it is an emergency, and you should get in touch with local law enforcement or mental health services.
Parents can ask about unlocked firearms along with any of the other safety questions they ask before their children go to another home to play. 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 should 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 safety stored.
Some states have provisions for temporary removal of firearms from people experiencing times of crisis, called Extreme Risk Protection Orders (ERPOs) or Gun Violence Restraining Orders. Generally, these laws allow a law enforcement officer, an immediate family member, or a household member to petition for a court order to recover firearms from an individual in crisis and to prevent temporarily them from purchasing firearms, citing specific evidence of extreme risk to self or others. If the order is issued, law enforcement will collect the firearms and temporarily hold them.
When no extension is issued and the order expires, the person can ask the court to return the firearms, often pending clearance of a background check.
Providers should know if ERPOs are in option in their state. Although providers may not be able to petition directly for such an order (the exception in Maryland), but they can consider contacting local law enforcement or a family member in situations of imminent risk.
Follow up on firearm access at the patient's next visit and ask the questions again. The risk of firearms in the home changes as circumstances change. This is especially true if, for example, a child comes into the home, or someone in the home is having suicidal thoughts. Continuous evaluation of whether or not everyone in the home is safe with firearms is important for assessing and addressing risk when necessary.
No law prohibits you from including in the medical record the information patients give you about access to firearms. Be prepared to answer patients’ questions about how you will use the information they give you on their access to firearms.
Firearms can usually be sold to licensed firearms dealers, and in some places, unwanted firearms can be turned in to local law enforcement or given up in a buy-back program. The patient should check with local law enforcement to learn about the options in your area.
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.
Many laws vary by state. Some states, for example, have provisions for temporary removal of firearms from people experiencing times of crisis, called Emergency Risk Protection Orders or Gun Violence Restraining Orders. Providers should know whether they live in a state where this is an option in situations of imminent risk.
13. What materials about risk for firearm injury and death and firearm safety can I give my patients?
We encourage you to send your patients home with the What You Can Do patient handout, available in English or in Spanish. It discusses risk of firearm injury, steps patients can take to reduce that risk, facts, and answers a list of firearm-related FAQs for patients.
You can print the handouts single- or double-sided and staple them in the upper left corner.
If a patient gives up firearms temporarily because he or she, or someone else in the home, is at extreme risk of firearm injury or death, his or her ability to own a firearm in the future should not be affected as long as no prohibiting event is involved. In some states, a background check may be required to verify that the person who temporarily gave up the firearms is not a prohibited person before the firearms are returned.
15. I want to give a talk about the provider's role in preventing firearm injury and death. What resources might help?
If you're planning to present about clinical prevention of firearm injury and death--to students, residents, faculty, staff, the community, or another group--you might find these slides from the What You Can Do team helpful.
Remember that there are also What You Can Do educational materials that you can distribute and encourage your audience to use.
If you have additional questions, don't hesitate to get in touch by emailing us at hs-WYCD@ucdavis.edu.
Our new video, Preventing Firearm-Related Injury and Death: A Targeted Intervention, walks through steps for identifying risk and talking with patients. Providers can earn AMA PRA Category 1 Credits™ by completing this video course on the CME California online platform.
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.
Health care providers can make the commitment online at Annals of Internal Medicine. You can also read the commentary on which the commitment is based—What You Can Do to Stop Firearm Violence—at the Annals website.
If you can’t find the information you’re looking for regarding risk for firearm injury and death, counseling, safe storage, or another topic, or if you have a question or comment about the What You Can Do initiative, please get in touch with our team.
Send us an email at hs-WYCD@ucdavis.edu to let us know what you need from us.