There’s no doubt that gun control is a hotly debated topic today. Supporters of tight gun control argue that access to guns is too easy. Those on the opposition believe it is unconstitutional and that despite a rise in gun ownership, gun homicide rates have dropped. Irrespective of this debate, the statistics are staggering. There have been over 200 mass killings (defined as four or more victims) in the United States since 20061
. The rate of people killed by guns in the U.S., is almost 20 times higher compared to similar socio-economic countries in the world. It is clear that Americans experience too many senseless deaths associated with firearm violence and that we need to work harder to find a solution to this devastating problem.
According to the Centers for Disease Control and Prevention (CDC), in 2013 there were 33,636 deaths attributed to firearms or 10.6 deaths per 100,000 Americans2
. That same year, there were 33,804 motor vehicle traffic deaths or 10.7 deaths per 100,0002
. Auto accidents have declined over the last several decades largely due to mandatory education and government regulations. You cannot drive without first taking a driver’s test, acquiring a license and paying for car insurance. In addition, your car must pass emissions and inspection testing on a regular basis. Guns manufactured in the U.S. do not need to pass federal safety standards.
Last week President Obama proposed “executive actions” on gun violence, a set of recommendations to close loopholes in gun control legislation in an effort to prevent future mass shootings. A few of the initiatives include increasing mental health treatment, improving universal background checks, requiring gun dealers to be licensed and keep formal sales records, and advancing technology on safety locks and “smart guns” that can only be fired by the registered owner. The presidential proposal will likely meet resistance and possible reversal should Americans elect a Republican in the upcoming election.
Regardless of the outcome of the new gun control initiatives, what role can healthcare providers play? Nurses, who often treat victims of violent crimes and their family members, are uniquely trained to promote safety, public health and education. Several nursing organizations have issued position statements on gun control, including the American Nurses Association (ANA)
and the National League for Nursing
. In addition, over 30 nursing organizations signed a call-to-action letter
to national, state, and local governments requesting better access to mental health services, a ban on assault weapons, and other gun control reforms.
The following recommendations could help us come closer to finding a cure for gun violence.
- Increase access to mental health programs for individuals, families, and students from elementary school through college:
a. While the majority of people with mental illness are not violent, serious psychosis and schizophrenia combined with substance abuse could lead to erratic behavior. Funding should be increased to train nurses and health professionals to recognize signs of violent tendencies, as well as community and hospital based psychiatric care, housing, and access to medications.3
- Include a gun safety assessment as part of routine health screenings for all patients:4
a. Several states continue to propose legislation to ban practitioners from documenting gun ownership in the patient’s record. However, the American Academy of Pediatrics endorses counseling parents on gun safety measures.5 This philosophy is also supported in adult dementia and elderly patient populations.
- Develop and implement Evidence-based Hospital Violence Intervention Programs focusing on:
a. Intimate partner violence
b. Behavioral health including anti-bullying
c. Substance use
- Improve Community engagement/outreach and education programs with initiatives targeting:
a. Life skills
b. Anger management
c. Conflict resolution
d. Suicide prevention
e. Violence prevention programs: successful research-based community programs that have proven to decrease homicide rates include Cure Violence, Aim4Peace and Wraparound Project.6
- Gather more data, conduct research and educate families on how to best protect themselves and their families from gun injuries:4
a. Keep guns away from household members who would not safely use them such as children or people with dementia.
One measure alone is not the answer. Rather multiple strategies implemented in our local communities, within the mental health system, and ultimately at the federal level are needed to make an impact on the number of gun-related fatalities. We as a society need to strike a balance between maintaining individual constitutional rights and protecting the lives of each and every American. Perhaps by focusing on empathy, public health, and education we can change our culture, protect our freedoms, and save lives.
Overberg, P., Hoyer, M., Hannan, M., Upton, J., Hansen, B., & Durkin, E. (2013) Behind the Bloodshed: The Untold Story of America’s Mass Killings. USA Today. Retrieved from http://www.gannett-cdn.com/GDContent/mass-killings/index.html#title
Centers for Disease Control and Prevention (2016) FastStats; All Injuries; Motor vehicle traffic deaths; All firearm deaths. Retrieved from http://www.cdc.gov/nchs/fastats/injury.htm
Graziano, M. & Pulcini, J. (2013) Policy & Politics: Gun violence and the role of healthcare: A confusing state of affairs (2013). The American Journal of Nursing. 113(9). Retrieved from /JournalArticle?Article_ID=1590663&Journal_ID=54030&Issue_ID=1590611
Myrna B. Schnur, RN, MSN