Mental health outcomes from direct and indirect exposure to firearm violence: A cohort study of nonfatal shooting survivors and family members

Magee, Lauren A.; Aalsma, Matthew C.; Fortenberry, J.Dennis; Gharbi, Sami; Wiehe, Sarah E.

doi:10.1016/j.jcrimjus.2022.101961

Cited by 19 publications

(25 citation statements)

References 53 publications

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“…This led several families to move residences and to live with other family members. These findings highlight the ripple effects of firearm injury beyond the direct survivor to family members, adding to the growing literature in this area …”

Section: Discussionmentioning

confidence: 66%

“…These findings highlight the ripple effects of firearm injury beyond the direct survivor to family members, adding to the growing literature in this area. 3,11,18 This study identified 3 main themes and barriers to survivors accessing mental health services: perceived lack of benefit of mental health services, distrust in practitioners, and fear of stigma and punitive backlash. Most importantly, firearm injury survivors overwhelmingly expressed their desire to navigate firearm injury recovery on their own, and half believed they were adequately coping without formal mental health services.…”

Section: Discussionmentioning

confidence: 99%

“…Future work should consider ways to raise awareness among family members regarding mental health resources and how best to connect their loved ones with effective services. Additionally, programs should expand mental health resources to family members …”

Section: Discussionmentioning

confidence: 99%

“…Additionally, programs should expand mental health resources to family members. 3,11 These findings also highlighted the importance of tailoring interventions to an individual's needs and cultural values, 42,43 such as incorporating culturally specific coping strategies into traumafocused treatment, which yield better outcomes. 44,45 Steps to achieve this include training more mental health professionals from underrepresented communities, strengthening community partnerships, and public health messaging campaigns to improve connection to care.…”

Section: Jama Network Open | Public Healthmentioning

confidence: 99%

“…Firearm injury is associated with increased severity of adverse health outcomes and mental health needs, further compounding existing health and racial inequities among survivors and communities . Adult and pediatric survivors experience high rates of posttraumatic stress disorder, anxiety, and depression . Several survivors have expressed the need for accessible mental health services, both for themselves and their families .…”

Section: Introductionmentioning

confidence: 99%

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Engagement With Mental Health Services Among Survivors of Firearm Injury

Magee,

Ortiz,

Adams

et al. 2023

JAMA Netw Open

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ImportanceDespite the prevalence of posttraumatic stress symptoms after firearm injury, little is known about how firearm injury survivors connect with mental health services.ObjectiveTo determine facilitators and barriers to mental health care engagement among firearm injury survivors.Design, Setting, and ParticipantsA qualitative study of 1-on-1, semistructured interviews conducted within a community setting in Indianapolis, Indiana, between June 2021 and January 2022. Participants were recruited via community partners and snowball sampling. Participants who survived an intentional firearm injury, were shot within Indianapolis, were aged 13 years or older, and were English speaking were eligible. Participants were asked to discuss their lives after firearm injury, the emotional consequences of their injury, and their utilization patterns of mental health services. Data were analyzed from August 2022 to June 2023.Main Outcomes and MeasuresSurvivors’ lived experience after firearm injury, sources of emotional support, mental health utilization, and their desired engagement with mental health care after firearm injury.ResultsA total of 18 participants (17 were Black [94%], 16 were male [89%], and 14 were aged between 13 and 24 years [77%]) who survived a firearm injury were interviewed. Survivors described family members, friends, and informal networks as their main source of emotional support. Barriers to mental health care utilization were perceived as a lack of benefit to services, distrust in practitioners, and fear of stigma. Credible messengers served as facilitators to mental health care. Survivors also described the emotional impact their shooting had on their families, particularly mothers, partners, and children.Conclusions and RelevanceIn this study of survivors of firearm injury, findings illustrated the consequences of stigma and fear when seeking mental health care, inadequate trusted resources, and the need for awareness of and access to mental health resources for family members and communities most impacted by firearm injury. Future studies should evaluate whether community capacity building, digital health delivery, and trauma-informed public health campaigns could overcome these barriers to mitigate the emotional trauma of firearm injuries to reduce health disparities and prevent future firearm violence.

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Section: Discussionmentioning

confidence: 66%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Jama Network Open | Public Healthmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Engagement With Mental Health Services Among Survivors of Firearm Injury

Magee,

Ortiz,

Adams

et al. 2023

JAMA Netw Open

Self Cite

View full text Add to dashboard Cite

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Gun Violence Exposure and Suicide Among Black Adults

Semenza,

Daruwala,

Brooks Stephens

et al. 2024

JAMA Netw Open

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ImportanceBlack individuals are disproportionately exposed to gun violence in the US. Suicide rates among Black US individuals have increased in recent years.ObjectiveTo evaluate whether gun violence exposures (GVEs) are associated with suicidal ideation and behaviors among Black adults.Design, Setting, and ParticipantsThis cross-sectional study used survey data collected from a nationally representative sample of self-identified Black or African American (hereafter, Black) adults in the US from April 12, 2023, through May 4, 2023.ExposuresEver being shot, being threatened with a gun, knowing someone who has been shot, and witnessing or hearing about a shooting.Main Outcomes and MeasuresOutcome variables were derived from the Self-Injurious Thoughts and Behaviors Interview, including suicidal ideation, suicide attempt preparation, and suicide attempt. A subsample of those exhibiting suicidal ideation was used to assess for suicidal behaviors.ResultsThe study sample included 3015 Black adults (1646 [55%] female; mean [SD] age, 46.34 [0.44] years [range, 18-94 years]). Most respondents were exposed to at least 1 type of gun violence (1693 [56%]), and 300 (12%) were exposed to at least 3 types of gun violence. Being threatened with a gun (odds ratio [OR], 1.44; 95% CI, 1.01-2.05) or knowing someone who has been shot (OR, 1.44; 95% CI, 1.05-1.97) was associated with reporting lifetime suicidal ideation. Being shot was associated with reporting ever planning a suicide (OR, 3.73; 95% CI, 1.10-12.64). Being threatened (OR, 2.41; 95% CI, 2.41-5.09) or knowing someone who has been shot (OR, 2.86; 95% CI, 1.42-5.74) was associated with reporting lifetime suicide attempts. Cumulative GVE was associated with reporting lifetime suicidal ideation (1 type: OR, 1.69 [95% CI, 1.19-2.39]; 2 types: OR, 1.69 [95% CI, 1.17-2.44]; ≥3 types: OR, 2.27 [95% CI, 1.48-3.48]), suicide attempt preparation (≥3 types; OR, 2.37; 95% CI, 2.37-5.63), and attempting suicide (2 types: OR, 4.78 [95% CI, 1.80-12.71]; ≥3 types: OR, 4.01 [95% CI, 1.41-11.44]).Conclusions and RelevanceIn this cross-sectional study, GVE among Black adults in the US was significantly associated with lifetime suicidal ideation and behavior. Public health efforts to substantially reduce interpersonal gun violence may yield additional benefits by decreasing suicide among Black individuals in the US.

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Associations between gun violence exposure and suicide mortality rates in US counties

Christopoulos

2024

Soc Psychiatry Psychiatr Epidemiol

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Mental health outcomes from direct and indirect exposure to firearm violence: A cohort study of nonfatal shooting survivors and family members

Cited by 19 publications

References 53 publications

Engagement With Mental Health Services Among Survivors of Firearm Injury

Engagement With Mental Health Services Among Survivors of Firearm Injury

Gun Violence Exposure and Suicide Among Black Adults

Associations between gun violence exposure and suicide mortality rates in US counties

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