Findings Show Child Access Prevention (CAP) Firearm Storage Policies Reduce Youth Gun Suicide Rates

A new study led by researchers at the Johns Hopkins Center for Gun Violence Solutions at the Bloomberg School of Public Health found that the presence of child access prevention (CAP) firearm storage policies was associated with reductions in youth gun suicide rates.  

CAP policies impose criminal liability on adults if a child gains access to an unsecured firearm or the gun is stored in a manner where a child is likely to gain access to it. As of January 2025, 27 states and Washington, D.C. have CAP or safe storage laws in effect.  

The study found that CAP firearm storage policies effectively reduce firearm suicide deaths, as well as firearm-related unintentional injuries and homicide in youth ages 1-17. Researchers found CAP laws lowered suicide rates by up to 14%. The policies were found to be most effective in reducing youth suicide by firearms when they required parents or guardians of children ages 16 and younger to store firearms unloaded and locked in a secure device. 

Suicide is a leading cause of death for young people in the United States. Guns are used in about half of all youth suicides. Nearly one-third of firearm-injury related deaths among youth are due to suicide. As children increasingly have access to firearms in their home, a thorough analysis of states’ CAP firearm storage policies is paramount to effectively address the concerning epidemic of youth gun suicides. 

For their study, the researchers examined nationally representative mortality data from the Centers for Disease Control and Prevention Web-based Injury Statistics Query and Reporting System (WISQARS) Injury Mortality Report, for youth ages 1-17 from 1990 to 2020. The study analyzed mortality rates for firearm suicide, non-firearm suicide, unintentional firearm deaths, and firearm homicides, amongst this age group, as indicated by International Classification Disease codes.  

The researchers used the RAND State Firearm Law Database to determine the presence of child access prevention reckless provision and firearm storage laws by state and year. States with CAP firearm storage laws did not concurrently have CAP reckless provision laws, allowing the study to analyze the effect of each policy. 

“Firearms are the deadliest method of suicide, with a fatality rate close to 90%. Access to firearms is a serious risk factor for youth suicide due to its sheer lethality,” says Paul Nestadt, MD, associate professor at the Johns Hopkins Bloomberg School of Public Health and co-author of the study. “States that have high rates of gun ownership, increases in rates of gun ownership during the COVID-19 pandemic, and/or a strong gun culture should consider enacting or updating their child access prevention firearm storage policies.” 

The study was published online November 18 in the Journal of the American Academy of Child & Adolescent Psychiatry. 

The authors note that the study has limitations due to varying state policies. Other limitations include data completeness, consistency in contextual facets of state policies, and social determinants at the individual level. 

“A National Evaluation of the Impact of Child Access Prevention Laws on Rates of Youth Suicide and Other Youth Firearm Deaths” was authored by Alison Athey, PhD, Paul Nestadt, MD, Megan L. Rogers, PhD, Zachary Dunton, MD, MPH, Alexander McCourt, PhD, and Holly C. Wilcox, PhD. 

The study was funded by a SPARK Award from the Bloomberg American Health Initiative. Dr. Athey was supported by a grant from the National Institute of Mental Health (NIMH) at the time of data collection for this study. Dr. Nestadt was supported by a grant from the American Foundation for Suicide Prevention at the time of manuscript preparation. Dr. Nestadt is currently supported by the National Institutes on Drug Abuse. Dr. Wilcox is supported by NIMH. Drs. Athey, Nestadt, and Wilcox are supported by a grant from the American Foundation for Suicide Prevention.