Firearm-related experiences and perceptions among United States male veterans: A qualitative interview study

Abstract

Background/Objective Male veterans ages 55-74 comprise a disproportionate number of suicide deaths among United States veterans, for whom a majority of suicides are firearm-related. Little is known about the firearm-related experiences and beliefs of veterans, which could be informative for firearm-related lethal means safety interventions. The aim of this qualitative study was to identify themes relevant to developing such interventions among older male veterans. Methods We conducted semi-structured qualitative interviews with seventeen United States male veterans, ages 50-70, who were eligible to receive Veterans Health Administration services, and were current or former firearm owners or users. Transcripts were analyzed via thematic analysis using an inductive approach. Results Six themes were identified: 1) Firearm experiences were usually facilitated by male family members and occurred at an early age; 2) Safety lessons during early firearm encounters focused on preventing unintentional injuries through safe firearm handling and using "common sense;" 3) Firearms serve an important social function across veterans' lifespans (e.g., hunting with friends); 4) Veterans perceive firearms as useful for protection; 5) Veterans believe that not everyone should have access to firearms, and some described scenarios in

Veterans Are Agreeable to Discussions About Firearms Safety in Primary Care

“…Our interview findings also underscore the unique relationship and experiences veterans have with firearms, the impact of military service on their perspectives, and the need for this to be acknowledged and affirmed by clinicians during firearms discussions, which closely parallels recent findings by Simonetti et al 25 Our findings also align with other prior literature that suggests that, if done in a respectful and transparent manner, patients are comfortable discussing firearms safety in clinical settings, 12,17,18 including those receiving mental health care. 38 Contextualizing the question (ie, "firearm storage" is preferred over "firearm safety") as well as relating that questions are for the purpose of suicide prevention have also been recognized as helpful strategies.…”

“…38 Contextualizing the question (ie, "firearm storage" is preferred over "firearm safety") as well as relating that questions are for the purpose of suicide prevention have also been recognized as helpful strategies. 25 However, participants also described veteran-specific concerns of which primary care providers and teams should be aware, including recognition of veterans' history, relationship, and expertise with firearms. Notably, while the majority of participants preferred personalized discussions with providers, a few preferred that structured firearm safety questions be used, such that everyone be asked in the same, less personal way.…”

“…20 Other studies suggest that the credibility of physicians as messengers regarding firearms safety may be limited. [21][22][23] Recently published work 24,25 indicates veterans may have unique attitudes and experiences related to firearms that may impact firearms safety discussions with providers, and that trust and rapport between patients and providers is an important pretext for acceptable firearm discussions. However, the perspectives of patients, particularly veterans, on discussing firearms safety with staff during primary care visits are unknown.…”

Clinical strategies for reducing firearm suicide

“…"Temporary" emphasizes that such transfers are not permanent and also serves as a reminder of the often temporary nature of suicidal crises; "voluntary" may help the patient retain a sense of agency [65]. As with keeping firearms stored locked up and unloaded, consider that willingness to temporarily transfer firearms may be affected by the perception that doing so would make the home more vulnerable to outside threats [82]. Clinicians should be prepared to discuss balancing riskreducing storage strategies with perceived decreases in feelings of personal safety for patients who own firearms for self-protection.…”

Development and Preliminary Evaluation of an Education Program for Primary Care Teams on Discussing Firearms Storage Safety with Veterans

“…In this study, military veterans were ranked as one of the best groups of messengers. Alternatively, our and others' prior work on rearms safety (20,24,26,46) suggests that rearms safety messaging by clinical staff is acceptable to veterans, when done respectfully.…”