Beliefs Among Veteran Firearm Owners Regarding Whether Clinicians Should Discuss Firearm Safety With Patients

IMPORTANCE: Veterans are at increased risk of suicide, and guidelines recommend assessing firearm access and counseling to reduce access among patients with elevated suicide risk. How veterans view such discussions is critical to the effectiveness of these interactions. OBJECTIVE: To assess whether veteran firearm owners believe clinicians should deliver firearm counseling when patients or their family members are being cared for in specific clinical contexts that suggest heightened risk of firearm injury. DESIGN, SETTING, AND PARTICIPANTS: In this cross-sectional study, data were from a probability-based online survey of self-identified veterans who reported owning at least 1 firearm (National Firearms Survey, July 1 to August 31, 2019) and were weighted to generate nationally representative estimates. Data were analyzed from June 2022 to March 2023. MAIN OUTCOMES AND MEASURES: Participants were asked, “As part of routine care, should physicians and/or other health care professionals talk with their patients about firearms and firearm safety if their patient or their patient’s family member (is at risk of suicide; has mental health or behavioral problems; is abusing or addicted to alcohol or drugs; is a victim of domestic violence; has Alzheimer’s disease or another dementia; or is going through a hard time).” Response options included “No,” “Yes, sometimes,” and “Yes, always.” In addition, responses were dichotomized as “Yes, at least sometimes” and “No.” RESULTS: Of 4030 adults who completed the survey (65% completion rate), 678 (mean [SD] age, 64.7 [13.1] years; 638 [92.9%] male) identified as veteran firearm owners. Across the 6 clinical contexts, support for clinicians “at least sometimes” discussing firearm safety as part of routine care ranged from 73.4% (95% CI, 69.1%-77.3%) when someone is “going through a hard time” to 88.2% (95% CI, 84.8%-90.9%) when someone has “mental health or behavioral problems.” When a patient or family member is at risk for suicide, 79.4% (95% CI, 75.5%-82.8%) of veteran firearm owners responded that clinicians should “at least sometimes” discuss firearms and firearm safety. CONCLUSIONS AND RELEVANCE: This study’s findings suggest that most veteran firearm owners believe that clinicians should provide firearm counseling during routine care when a patient or family member is at heightened risk of firearm injury. These findings belie concerns that discussing firearm access with veteran firearm owners is an unacceptable practice.