Characteristics and Precipitating Circumstances of Preteen and Teen Suicide Decedents Who Died by Firearm in the United States, 2012-2021.

Objective: Youth suicide is a growing public health concern, and younger preteens have experienced notable increases in suicide rates. Suicide by firearm among preteens have increased more than all other suicide methods combined. The current study examined characteristics and precipitating circumstances associated with firearm suicides among preteens and teens ages 8 to 17 years. Method: This cross-sectional study analyzed data from the National Violent Death Reporting System from 2012 to 2021 on youth firearm suicide decedents (N = 3,768). Comparisons between preteens (8-12 years old) and teens (13-17 years old) were analyzed using linear mixed models that adjusted for sex, race, and ethnicity. Results: The sample included 229 preteen and 3,539 teen firearm suicide decedents (14.7% female; 9.4% Black; 8.1% other race; 82.5% White; 10.7% Hispanic). Preteens were more likely to be female (adjusted odds ratio [AOR] = 1.76; 95% CI, 1.26-2.46) and Black (AOR = 1.72; 95% CI, 1.14-2.58) compared with teens and more likely to experience family (AOR = 1.69; 95% CI, 1.27-2.23) and school (AOR = 2.04; 95% CI, 1.51-2.74) problems. Preteens were less likely than teens to have a current mental health problem (AOR = 0.47; 95% CI, 0.32-0.68), a depressed mood at time of death (AOR = 0.49; 95% CI, 0.33-0.72), and a history of suicidal thoughts (AOR = 0.60; 95% CI, 0.38-0.95) or attempts (AOR = 0.25; 95% CI, 0.08-0.81). Among cases with firearm-related information, most youth had access to a gun that was unlocked or loaded. Conclusion: Findings suggest that universal suicide risk screening and assessment is warranted, especially for younger preteens, and advocating for safe firearm storage practices remains a key component of prevention for this population.