Guns and psychiatry: what psychiatrists need to know

The private ownership of firearms for participation in shooting sports, subject to a rigorous process of certification by the police, is not uncommon in the UK. Primary care medical involvement in this process is currently a contentious issue. The mental health of firearms owners is clearly germane to public safety: suicide is by far the greatest concern, alongside security breaches. Homicide committed with legally held firearms is very rare: there is very little cross-over between legitimate shooting sports and crime involving firearms. The perpetrators of family annihilation and single-incident mass killings using firearms in the UK have not been known to psychiatry, although a minority have been found to be mentally disordered post hoc. Regarding suicidality, there is little if any difference between those at risk who own firearms and those who do not, excepting that firearm suicide attempts are highly likely to be fatal. Guidance is offered in this article on the identification of patients who own firearms, the evaluation of risks and how to manage these in practical terms. LEARNING OBJECTIVES After reading this article you will be able to: demonstrate a basic knowledge of varieties of sporting firearms and understand the differences between legitimate and criminal use of firearms in the UK appreciate mental health problems related to the private ownership of firearms and the risks of suicidality understand the role of the police in certification and how to raise concerns when a patient's access to firearms is an issue.