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2.Key Point of how gun violence can be prevented
Barry et al., (2013) highlighted the connection between mental illness and gun violence citing some real-life examples. The four events of gun violence cited in the paper shared two common features. Firstly, all the four shooters were suffering from mental illness, and secondly, all of them used guns with large-capacity magazines. As policymakers strive to consider options for reducing gun violence, there has to be an understanding of the public attitudes regarding different violence-prevention proposals, including policies that have a deep impact on the people suffering from mental illness.
Koplewicz (2013) pointed out that in the wake of multiple tragedies occurring in the US, the focus of lawmakers has shifted towards the issue of gun control. However, the national is missing out the opportunity to understand the adverse results of untreated mental illness in adolescents and children that result in gun violence. Adolescent and mental health need particular attention as silence on this aspect is a key contributor to violence and pervasive tragedy overall. Shame and stigma have been connected to mental illness at the primary level. The lack of innovative treatments further adds to the high prevalence of mental illness in the country. Schildkraut and Hernandez (2014) in this regard have stated that people have an inclination to purchase weapons when there are criminal convictions or mental issues. There have been millions of cases reported of diagnosed mental illness and purchase of weapons. However, it is not possible practically to check the background of each individual every time and continue to do so every year after purchase of a firearm. The gun control Acts must expand the licensing requirements for the prohibition of sales to people who are mentally incompetent.
Appelbaum and Swanson (2010) highlighted that when a person with mental illness engages in a crime of violence, more precisely that with a firearm, the focus is on the restriction of gun access and not on legislation for a mental disorder. People who take part in such crime are often in need of psychiatric treatment but avoid accessing services due to fear. This is of prime importance since shooting sports is a part of lives of people in the US, and people do not access services for fear of losing the right to have firearms. Moreover, stereotypes reinforce people with the certain mental condition as dangerous and mentally defective. Since people with mental illness internalize the undesirable and negative perceptions of others, their inclination to cause harm to others is inflicted. The negative stereotypes lead to social avoidance and poor self-esteem, becoming a cause of harm to others.
Background of gun violence
Kangas and Calvert (2014) highlighted that the United States is one of the most noted countries in the world for high rate of firearm ownership and firearm-related suicide, homicide, and unintentional death. The National Survey of the Private Ownership of Firearms has reported that American Adults own approximately 192 million working firearms. This implies an average of one firearm per adult. Though there has been a decline in the rate of gun-related injuries since the year 1993, the same remains a major cause of premature death and injury at present. Almost 4.5 million new firearms are sold every year in the country. The total number of firearm transactions can reach up to 9.5 million per year, and half of these are unregulated. This is noteworthy since the laws set in place for influencing firearms do not influence half of the annual transactions.
According to Goss (2015), the US has an increased number of gun violence than any other advanced industrial democratic country of the world like UK, Canada, and Australia. While these nations have given a satisfactory response to mass shootings as evident by the dramatic strengthening of gun laws, the US has moved in a slow manner. The American gun laws have always been criticised to be far weaker than those of other parts of the world. At present, the firearm laws are weaker than those prevalent in the country in the past. Gun laws are to be made stronger since the present political environment is highly polarised.
In recent years, the frequent mass shootings in the US has become the cause of open dialogue regarding mental illness and gun violence (McGinty et al., 2014). The two of the most noted ones were that at Virginia Tech and that in Tuscan. In addition, the shooting at Connecticut 2012 also highlighted the importance of controlling gun violence.
Post-Traumatic Stress Syndrome
Slovac (2002) studied the factors underpinning gun violence and trauma experienced by children after exposure. Males were reported to have more exposure to gun violence than women in the US. Further, children in rural communities have more access to guns due to parental influence. The study illustrated that exposure to gun violence places adolescents and youth ar risk of physical harm as well as poor mental health. Gun violence is responsible for psychological havoc for the young population. Exposure to violence as victim contributes to trauma in a stronger manner than a witness to violence. In this regard, it was mentioned that gender was a major variable for prediction of trauma as girls suffer more trauma than boys.
Nardi (2015) highlighted the impact of violence exposure on the individual, stating that the consequences of exposure to violence on child development are rooted in reality. The author pointed out that youth and children who are exposed to chronic trauma experiences inhibited brain development which has a long-lasting impact on life outcomes. Due to such an exposure, the individuals suffer skill deficits and lead to high rate of crime in later life. Children experience issues with aggression and violence as they do not possess nonviolent skills for conflict-resolution. Children to violence face immense stress, and struggle to control their emotions. Wolpert and Gimpel (1998) had studied the public attitude towards gun control and impact of gun violence. The public attitude towards the impact of gun violence is mostly negative, with minimal support provided to those who have undergone or witnessed violence. Price et al., (2002) had stated in this regard that until exposure to violence is completely eliminated, the growth of mental health issues is likely to grow. Since there is the dramatic growth of incidence of post-traumatic disorder due to gun violence, service providers need to actively educate the public on this aspect.
Appelbaum and Swanson (2010) conducted a study that provided evidence for implementation of stringent restrictions were reinforced on use of firearms with implementation of the National Instant Criminal Background Check System (NICS). Furthermore, this study also recognized initiatives taken by individual states in the form of databases that resulted in implementation of restrictions on access of firearms.
Goss (2015) documented essential exceptions to conventional wisdom that focus on the fact that most politicians fail to demonstrate behavior related to tightening gun laws. It emphasized on the role of background check systems that licensed gun sellers to use firearms without any difficulty, while transferring them to private individuals. It illustrated the role of National Instant Criminal Background Check System (NICS) Improvement Amendments Act (2007) in bringing about reforms in gun rights.
Public support for preventing widespread gun usage by individuals was demonstrated by another study that identified the need of background check for gun dealers, thereby reducing and banning use of semiautomatic weapons (Barry et al., 2013).
Mental health and HIPPA
The Health Insurance Portability and Accountability Act (HIPAA) refer to a federal law protecting privacy of individual health related information. A study identified mentally ill people at an increased susceptibility of developing risk of violence. Furthermore, disorders such as depression was found to increase suicidal ideations that directly contribute to more than 50% gun deaths in the USA (McGinty et al., 2014).
Similar findings were reported by Appelbaum & Swanson (2010) that established correlation between mental illness and gun ownership. It identified the effectiveness of Gun Control Act (1968) and Omnibus Crime Control and Safe Streets Act that helped in banning purchase and possession of firearms by individuals adjudicated as mentally ill.
Correlation between mental health and such gun violence were identified by another study that recognized three events responsible for the problem, namely, stigma associated with mental disorders, institutional barriers in limiting healthcare access and lack of evidence based treatments. The study focused on the fact that there are inadequate treatment facilities available for psychiatric illness, which worsens the symptoms and increases risk if resorting to violence (Koplewicz, 2013).
Similar findings were supported by surveys conducted by another study that suggested majority of Americans support spending of government funds on mental treatment for reducing gun violence. Thus, the study established the need of carefully implementing effective gun violence elimination strategies without discouraging mental health treatment or exacerbating associated stigma (Barry et al., 2013).
Healthcare providers obligation to disclose
According to Nardi (2015) most healthcare providers stay at an increased risk of becoming paralyzed, numb, and hesitant, of the way by which they can differentiate between safety of an individual and violating their rights of keeping arms. This phenomenon, commonly called the ‘bystander effect’ refers to demonstration of numbness towards violence. Incidents involving mass shootings have begun to be accepted as an act of nature that cannot be prevented or eliminated. The study emphasized on several factors that can be incorporated into general practice by healthcare professionals. Some of the most common strategies that were recognized as effective include learning lethal means counseling, developing comprehensive collaboration and partnership with other providers, schools, churches, hospitals, criminal justice system and gun owners for formulating problem solving strategies that will help in reducing access to such lethal objects. In addition, the study also identified the importance of educating parents on preventing isolative behavior among children. It further illustrated the importance of building financial incentives for gun manufacturers on following adequate safety measures.
Role of mental healthcare providers working in pediatric settings in educating families on gun safety was illustrated by another study. It suggested that these providers can influence the youth in abstaining from involvement in gun violence. Most providers view gun violence as a major public threat. However, they most often feel hesitant to discuss issues on gun safety with their patients. (Williamson, Guerra & Tynan, 2014).
Reporting about high risk violent patient in the database
Findings demonstrated by another study suggested an increase in stigmatizing attitude towards mentally ill patients on use of lunatic database. These databases stigmatize people with mental illness by dehumanize them, compromising their privacy, and threatening their confidentiality (Gold, 2013).
Inclusion of mental health background check information in databases is debatable. Several studies have been carried out that investigated effectiveness of such inclusion in treating mental illness and preventing gun violence. The study suggested that such databases could be detrimental to the mentally ill people by reinforcing stigmatizing attitudes towards them by several members of the society. It also stated that such databases would hinder people from seeking treatment (Kangas & Calvert, 2014).
Furthermore, findings from another study also suggested that although majority of people suffering from serious mental illnesses have been found to be least violent, maintaining their information in database and disclosing it for the purpose of reducing violence results in development of a negative attitude, thereby stigmatizing the patients (Swanson et al., 2015).
To conclude, it can be suggested that parental supervision, treatment of violent patients with social withdrawal symptoms, reducing firearm donations and imposing appropriate legislations will be able to lower rates of gun violence.
The issue of mass shootings and overall gun violence in the United States of America is to be addressed on an immediate basis, as opined by a number of scholars in the country. Events of mass violence have repeatedly brought mental illness and gun violence into the national and international discussion. The reason behind gun violence has often been linked to mental illness, a concern that raises challenges in setting up national policies. Media coverage and events reinforce the belief that people suffering from mental illness are dangerous and violent, especially when there is access to firearms. The primary public belief is that serious mental illness is the prime cause of gun violence in the US, and these individuals have more chances of perpetrating violent crime than becoming a victim of such crime. There is substantial literature to support this belief.
Appelbaum, P. S., & Swanson, J. W. (2010). Law & psychiatry: gun laws and mental illness: how sensible are the current restrictions?. Psychiatric Services, 61(7), 652-654.
Barry, C. L., McGinty, E. E., Vernick, J. S., & Webster, D. W. (2013). After Newtown—public opinion on gun policy and mental illness. New England journal of medicine, 368(12), 1077-1081.
Gold, L. H. (2013). Gun violence: Psychiatry, risk assessment, and social policy. Journal of the American Academy of Psychiatry and the Law, 41(3), 337-343.
Goss, K. A. (2015). Defying the odds on gun regulation: The passage of bipartisan mental health laws across the States. American journal of orthopsychiatry, 85(3), 203.
Hemenway, D., & Miller, M. (2013). Public health approach to the prevention of gun violence. N Engl J Med, 368(21), 2033-2035.
Kangas, J. L., & Calvert, J. D. (2014). Ethical issues in mental health background checks for firearm ownership. Professional psychology: research and practice, 45(1), 76.
Koplewicz, H. S. (2013). Call to action. Journal of Child and Adolescent Psychopharmacology, 23(1), 2.
McGinty, E. E., Frattaroli, S., Appelbaum, P. S., Bonnie, R. J., Grilley, A., Horwitz, J., ... & Webster, D. W. (2014). Using research evidence to reframe the policy debate around mental illness and guns: process and recommendations. American journal of public health, 104(11), e22-e26.
Nardi, D. (2015). Decreasing Risk for Mass Shootings in the United States. Journal of psychosocial nursing and mental health services, 53(12), 3-5.
Price, J. H., Dake, J. A., & Thompson, A. J. (2002). Congressional voting behavior on firearm control legislation: 1993–2000. Journal of community health, 27(6), 419-432.
Schildkraut, J., & Hernandez, T. C. (2014). Laws that bit the bullet: A review of legislative responses to school shootings. American Journal of Criminal Justice, 39(2), 358-374.
Slovak, K. (2002). Gun violence and children: Factors related to exposure and trauma. Health & Social Work, 27(2), 104-112.
Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Annals of epidemiology, 25(5), 366-376.
Williamson, A. A., Guerra, N. G., & Tynan, W. D. (2014). The role of health and mental health care providers in gun violence prevention. Clinical Practice in Pediatric Psychology, 2(1), 88.
Wolpert, R. M., & Gimpel, J. G. (1998). Self-interest, symbolic politics, and public attitudes toward gun control. Political Behavior, 20(3), 241-262.
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