Gun Violence and Mental Health Clearly Explained

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    In this video, Roger Seheult, MD of MedCram explains the statistics of gun violence and discusses it as it relates to mental health and how health care professionals can approach and deal with the effects of gun violence.  

    Gun violence statistics

    In the U.S., deaths from guns are on par with deaths from car accidents which approaches almost 50,000 incidents each year respectively.  Combining gunshot injuries and deaths brings the number closer to 120,000 incidents a year.  Data shows that about 54% of the gun deaths were related to suicide and 43% were related to murder.  79% of U.S. murders in 2020 involved a firearm.  In suicide, 53% involved a gun in 2020. It is asked, is gun violence getting worse? Pew research shows that even though overall gun violence overall increased by 14% in 2020 from 2019, the actual rate of gun violence in relation to population growth has remained the same. Furthermore, only 3% of suicides and homicides are caused by assault-style weapons. 

    A paper in NEJM in May 2022 notes that as motor vehicle accidents have dramatically been reduced over the last few years as major causes of death in children and adolescents, firearm-related injury has increased and is now the number one cause of death in children and adolescents. Likewise, drug overdoses and poisonings in children and adolescents have exhibited a sharp increase.

    Gun deaths in the U.S are at a higher incidence when compared to Western Europe and Canada but it is noted that gun deaths in South America are at higher levels than in the U.S. When looking at firearm mortality in each state, it was found that Alaska has one of the highest rates and Hawaii one of the lowest. 

    Mass shootings

    Reflecting on the past 20 years, it is noted that active shooter incidents have become more common.  Jillian Peterson and James Densley are experts and a part of the Violence Project which addresses the prevalence and prevention of gun violence and also evaluates mass shootings. This project has reviewed all mass shooters since 1966 and reviewed every shooting incident that has taken place in a school, place of worship, or workplace since 1999. This involved about 180 different incidents and included interviews with five shooters that had remained alive from these incidents. 

    Mental health

    Common threads they found involving the shooters were early childhood trauma that led to feelings of hopelessness, despair, isolation, self-loathing, rejection, and then turned to suicidal ideation. However, these individuals then turned the hatred from self-hate to hate of other groups that involved racial, gender, religious, and classmates. They theorize that these mass shooters are individuals that are in effect planning their suicide as they also commit homicides.  

    In Psychiatry Online, an article notes that there has been an increase in depression, self-harm, and suicide after 2010 and it may be related to the amount of time a person spends on social media and smartphone use. There appears to be a correlation between the release of the iPhone and the increase in social media use around this time. However, it is noted that correlation does not necessarily mean causation.   

    Light and mental health

    Dr. Seheult’s references a prior MedCram video Light as Medicine, and discusses that exposing oneself to light and sunshine may reduce depression.  Likewise, exposure to light at night from computers and phones may reduce melatonin, and total sleep time and affect the circadian rhythm which can affect mood and overall health. 

    Medical Response

    He then turns to medical personnel and handling of mass casualties. From a medical standpoint, dealing with mass shooting episodes will be chaotic just by the very nature of the incidence.  Time is of the essence just as in a heart attack or stroke. The likelihood of death increases as time goes by.  For medical personnel, it is helpful and important to know the type of weapon and ammunition used in the shooting in order to anticipate the nature and extent of injuries that may be expected.  An article in 2013 discusses the initial management of mass casualties. They advocate for Tactical Emergency Medical Support (TEMS) teams which are specifically trained and equipped to work within the perimeter of a danger zone and work in conjunction with law enforcement. Unfortunately, there are still too few of these teams around the nation. 

    Dr. Seheult notes that gun violence is a mental health issue and that early recognition of warning signs and intervention is needed to save lives. 

     

    LINKS / REFERENCES:

    Initial management of mass-casualty incidents due to firearms: Improving survival (ACS) | https://bulletin.facs.org/2013/06/man…

    Firearm Mortality by State (CDC) | https://www.cdc.gov/nchs/pressroom/so…

    What the data says about gun deaths in the U.S. (Pew) | https://www.pewresearch.org/fact-tank…

    Key facts about Americans and guns (Pew) | https://www.pewresearch.org/fact-tank…

    GUN VIOLENCE BY THE NUMBERS (Brady) | https://www.bradyunited.org/key-stati…

    Gun laws where guns take the most lives (Latin America Reports) | https://latinamericareports.com/gun-l…

    Two Professors Found What Creates a Mass Shooter. Will Politicians Pay Attention? (Politico) | https://www.politico.com/news/magazin…

    Current Causes of Death in Children and Adolescents in the United States (NEJM) | https://www.nejm.org/doi/full/10.1056…

    Smartphones, social media use and youth mental health (NIH) | https://www.ncbi.nlm.nih.gov/pmc/arti…

    Increases in Depression, Self‐Harm, and Suicide Among U.S. Adolescents After 2012 and Links to Technology Use: Possible Mechanisms (Psychiatry Online) | https://prcp.psychiatryonline.org/doi…

    The Violence Project (The Violence Project) | https://www.theviolenceproject.org

    MedCram: Light as Medicine 

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