Increase in Mental Health Diagnoses among Youth with Nonfatal Firearm Injuries

BACKGROUND AND OBJECTIVES: Firearm injury is a leading cause of mortality for US youth. For every youth who dies from a firearm injury, at least 4 more survive. Little is known about the mental health consequences of non-fatal firearm injury in youth. Our objective was to quantify new mental health diagnoses after nonfatal firearm injury. METHODS: MarketScan Medicaid and commercial data were used to identify youth age 0 to 17 years with an initial encounter for a nonfatal firearm injury in 2016 to 2017. The International Classification of Diseases, Tenth Revision codes determined the presence of mental health conditions in the 12 months preinjury, during the index encounter, and in the 12 months postinjury. Logistic regression analysis was performed to determine factors associated with new mental health diagnoses during the 12 months postinjury. RESULTS: About 2178 patients (1769 Medicaid, 409 commercial) were identified for inclusion. 844 (38.8%) patients had a mental health diagnosis identified during the 12-month preinjury period. During the index encounter, 184 (8.5%) patients had a newly diagnosed mental health disorder. In the 12 months postinjury, 559 (25.7%) patients had a newly diagnosed mental health disorder. The most common new diagnosis categories were trauma disorders, substance abuse, and disruptive disorders. Medicaid insurance and a prior complex chronic condition were predictors of new mental health diagnosis. CONCLUSION: Over a quarter of youth with nonfatal firearm injury were diagnosed with a new mental health condition in the 12 months after their injury. Health care providers should be vigilant about mental health screening and ensuring access to mental health care services in this population.