By Eric Feigen, NCL Health Policy Summer 2022 Intern
We live in a nation where children fear for their lives at school, racially motivated killings are pervasive, and mass shootings have become commonplace. The United States is in the midst of a gun violence epidemic. One promising avenue that could help address this crisis involves approaching gun violence from a public health perspective. By developing strategies aimed at protecting the health and safety of people and communities, we can develop a policy framework for reducing incidences of gun violence and suicide.
Of the 24,897 people who have died from gun violence in 2022, 13,530 people have lost their lives to suicide. To compound this loss, National Institutes of Health (NIH) estimates that 45 percent of people who take their own lives visit their primary care physicians within a month of their death. Many Americans are reaching out for support. However, due to the inaccessibility of mental health services, people cannot receive the help they desperately need. According to the American Psychological Association, in 2018, 39 percent of people could not afford the cost of receiving mental health services. Even for those with healthcare coverage, 26 percent choose to forgo treatment because their copays are too high.
There are a wide range of public health policies that could be implemented to remedy this issue. The first task is improving accessibility. A survey by the Health Resources and Services Administration indicates that the demand for mental health services far exceeds the number of professionals in the field and some primary care professionals receive no training in suicide assessment or management. In addition, many Americans have to travel immense distances to receive mental health treatment. The pandemic has illustrated the effectiveness of telehealth as a solution to this issue, however programs such as fellowships, outreach seminars, and more must be put into place to increase the number of health professionals in the field.
Gun violence in America is also an equity issue, disproportionately affecting communities of color. This has created a cycle of violence which places children at an increased risk for gun violence exposure earlier in life. A NIH study indicates that the prevalence of gun violence during childhood increases interactions with firearms later in life to a medium to large effect. This leads to the second policy issue that must be addressed: improving access to quality mental health services in order to break cycles of violence.
To accomplish this, policies designed to incentivize and increase the number of psychiatric practitioners of color must be put into effect. Not only do Black and Brown mental health professionals have a better understanding of the challenges their communities face, but studies indicate that white mental health workers often misdiagnose minority patients leading to counterproductive treatment. In 2019, racial/ethnic minorities made up only 17 percent of the psychologist workforce, illustrating how marginalized communities have disproportionately less access to quality mental health services in comparison to their white counterparts.
The social determinants of health; healthcare, housing, economic mobility, and more are inescapably linked to the root causes of gun violence. In addition to those listed above, policy solutions include:
- Expanding healthcare coverage to include mental health services
- Tightening regulations on opioids and other dangerous prescription drugs to create safe and healthy environments
- Including safeguards against measures intended to limit an individual’s right to treatment such as the lack of affordability of clinically prescribed medication
- Ensuring that for those currently receiving effective treatment, their medication is not switched to a less effective alternative just because it is cheaper
- Expanding Extreme Risk Protection Order laws
- Promoting health equity as those facing adverse health conditions are at higher risk for experiencing violence. This includes increasing access to:
- vaccines, including COVID-19
- treatment for chronic conditions, such as diabetes
- healthy fresh foods and vegetables
- Increasing research devoted to tackling gun violence as an investment in national public health
While many forms of gun control legislation have been written off as politically impossible, there are other solutions Congress can enact to mitigate the gun epidemic. Approaching the issue from a public health perspective is an effective avenue policymakers can take for ensuring that the gun-related tragedies, which now seem omnipresent in America, harm fewer people in the future.