Access to Firearms Among People Assessed by Psychiatric Services in the Emergency Department
Bibliographic record
Abstract
Objective: In Canada, 80% of firearm-related deaths are suicides. Access to firearms is associated with increased suicide rates. This study examines the frequency and factors that influence assessment of firearm access in an emergency setting. Methods: A total of 15,847 consecutive adults seen for psychiatric consultation in two tertiary emergency departments (EDs) in Winnipeg, Manitoba were interviewed. Data captured whether access to firearms was assessed, and whether respondents endorsed access or not. Comparisons were done to determine group differences among those with and without and with known and unknown firearm access. Results: Access to firearms was unknown in 47% ( n = 7,363) of psychiatric ED consultations, including 43% ( n = 998) of individuals who presented with a suicide attempt. Female sex was associated with decreased odds of firearm access (odds ratio [ OR] 0.28; 95% CI, 0.22 to 0.35). Being single was associated with lower odds of known firearm access ( OR 0.83; 95% CI, 0.77 to 0.89) yet higher likelihood of firearm access ( OR 1.36; 95% CI, 1.11 to 1.68). Presenting with a suicide attempt ( OR 2.45; 95% CI, 1.80 to 3.34), preparatory acts ( OR 6.40; 95% CI, 4.38 to 9.36) and suicidal ideation ( OR 2.45; 95% CI, 1.87 to 3.21) were associated with increased odds of reporting access. When clinicians felt there was a high likelihood of future suicide, firearm access remained unknown in half of cases. Conclusion: Firearm ownership and access is an essential component of a suicide risk assessment and remains unknown in half of individuals seen by psychiatry in this tertiary care ED sample. People presenting with suicidal ideation and attempts were more likely to report access to firearms.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".