DR. JOHN S. ROZEL
In the U.S., American citizens own more guns than the combined total of the next 24 countries with about 44%-50% of U.S. households having firearms. The U.S. also leads the developed world in firearm deaths, which have become the leading cause of death of children and adolescents.
While most firearms are owned and used safely, a small subset of them are used in acts of crime or violence, including suicide.
Violence from firearms is especially complex for Black Americans who are disproportionally affected.
Gun violence is also on the rise in the form of mass shootings which are often labeled as acts committed by “mentally ill” individuals. According to University of Pittsburgh’s Dr. John S. Rozel, Professor of Psychiatry and Adjunct Professor of Law, this label is misleading.
“The FBI has found that only about 25% of mass shooters had a diagnosed mental illness and only 5% had an acute mental illness that would have prevented the person from buying a gun,” he explains. “Labeling all mass shooters as ‘mentally ill’ perpetuates the stigma surrounding mental health.”
While mass shootings and homicides receive significant media coverage, 54% of gun-related deaths in the U.S. are suicides, according to the latest data from the Pew Research Center. “These deaths are devastating for families, friends, and communities because they’re often preventable and occur when a loved one is in a temporary crisis,” says Dr. Rozel.
To reduce gun violence, especially gun-related suicides, Dr. Rozel believes we must treat the violence as a public health challenge, including training medical professionals and other trusted authority figures to better identify and help individuals who are at risk of harming themselves or others with a firearm.
For example, an evidence-based approach called Behavioral Threat Assessment and Management (BTAM) can help authority figures, such as schoolteachers and principals, respond to information suggesting that someone is preparing to take part in serious violence. “Using BTAM, these figures can assess the risk and develop strategies to reduce it by connecting a person who’s in crisis with mental health programs,” explains Dr. Rozel.
To stop people from possessing a firearm while they’re in distress, some states have Extreme Risk Protection Orders (ERPOs), which are laws that prevent people who show signs of being a threat to themselves or others from buying or possessing a firearm. An ERPO is time limited and is not criminalizing in any way.
While there is currently no ERPO in Pennsylvania, there is a private organization called Hold My Guns that may be willing to store people’s weapons temporarily in a gun shop. “For example, when there’s a mental health or domestic violence issue, individuals and/or families can use Hold My Guns to keep guns out of the hands of an at-risk person until a crisis passes,” notes Dr. Rozel.
Scientific research also plays a vital role in preventing gun violence. Adequate funding for research should be provided at the federal level, as it is for automobile safety for example. “Unfortunately, that’s not the case,” says Dr. Rozel. “In the absence of sufficient federal money, academic medical centers could contribute to filling this gap.”
Health care professionals must also be trained and encouraged to advocate for evidence-based gun safety policies and interventions at the state and federal levels. “We’re talking about things like universal background checks, domestic violence restraining orders, waiting periods, and laws that keep guns away from children,” Dr. Rozel states. “We know from research that most people support these measures, including gun owners.”
Having open, non-threatening conversations about gun ownership, especially in healthcare settings, is also important. “Medical providers should discuss gun safety with patients just as they talk about other safety issues, such as using seatbelts, car seats, and bicycle helmets,” says Dr. Rozel. “We also need to be outspoken about and mindful of the fact that gun violence affects Black and Brown people unequally,” he adds.
For gun violence survivors, the conversations would include counseling that may help stop retaliatory responses.
These conversations should not be limited to medical settings. They would also take place in churches, barbershops, community centers, and schools. They would focus on proper firearm training, safe storage practices (trigger and cable locks, lock boxes, and gun safes) and how to recognize warning signs in at-risk family members and friends.
Dr. Rozel adds, “The regulations, research, and education — the important conversations that happen between people who legally own guns and people who don’t – must be respectful and come for a common desire to reduce gun violence while upholding people’s right to own guns.”
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