Stop gun violence

When it comes to preventing gun violence, good intentions aren't always successful. According to a 2013 report from the Institute of Medicine and National Research Council, for example, school-based interventions that teach children firearm safety are largely ineffective. "Buy-back" programs that encourage gun owners to trade in their firearms for cash have not reduced firearm deaths either, the report found.

And while cries for improvements in mental health care are not unwarranted, "it would be bad public policy with little impact if we were to view the problem solely through the lens of mental illness," since people with mental illness are far more likely to use guns to harm themselves than others, says Robert Kinscherff, PhD, JD, a clinical/forensic psychologist and attorney at the Massachusetts School of Professional Psychology.

Fortunately, psychologists and other researchers are exploring what does work to reduce gun violence — and taking that evidence to Capitol Hill through APA's Resolution on Firearm Violence Research and Prevention, adopted by the association's Council of Representatives in February. The resolution takes into account the past 20 years of research on gun violence and replaces APA's 1994 Policy Statement on Firearm Safety and Youth.

"We're hoping that one major outcome of this policy statement will be to encourage Congress and policymakers to appreciate the value of research-driven policy making and law," says Kinscherff, who chaired the seven-member task force that developed the resolution.

For example, research has shown that laws that hold adults criminally liable for unsafe storage of firearms around children can reduce adolescent suicides (JAMA, 2004). Community, family and individual interventions that promote healthy social development and reduce aggressive behavior among children and adolescents are also promising, according to APA's Panel of Experts Report Gun Violence: Prediction, Prevention and Policy, released last year. And empirically derived risk-assessment actuarial tools and structured clinical judgment approaches can improve violence risk assessment and management, while behavioral threat assessment approaches involving case-specific responses when someone makes or poses a threat of violence are also evidence-based ways to prevent violence (see article in the December Monitor).

But there's still much unknown about what works to prevent gun violence. That's why the resolution calls for policy changes that make studying it easier, such as by lifting state and federal restrictions on collecting data on incidents of firearm violence. In 1996, for example, Congress restricted the Centers for Disease Control and Prevention from funding any research that may be construed as promoting gun control. That stipulation was expanded to the National Institutes of Health in 2012. What's more, there's no universal system for collecting data on U.S. gun violence; the National Violent Death Reporting System includes data from only 16 states.

"We don't know what might be possible, what psychology might do to prevent gun violence because the research hasn't been done to develop and evaluate those types of interventions," says Clinton Anderson, PhD, director of APA's Lesbian, Gay, Bisexual, and Transgender Concerns Office, who served as the task force's staff liaison.

The resolution also addresses how firearm violence affects different populations. For example, adolescent males and older white men have high rates of suicide by guns, young black males in lower-income urban areas are at the greatest risk of gun-related homicides and women are most likely to be victims of firearm violence by intimate partners.

To address such disparities, the resolution calls for interventions at multiple levels. Among higher-risk groups such as those with depressive symptoms, for example, treatment that promotes coping skills can be helpful. Among populations most at risk for gun violence, such as young gang members, interventions that teach conflict resolution strategies can help solve problems before they escalate into violence, the resolution suggests.

Addressing mental health issues among people with both severe mental illness and immediate intense psychological crises is also key, the resolution states, since firearm-related suicides account for most U.S. gun deaths. This contrasts with the public perception that mass shootings cause a significant portion of gun-related deaths. While a 2013 Congressional Research Service report estimates that 547 people have died in public mass shootings over the past 30 years, 19,766 died from gun-related suicides in 2011 alone, according to the National Center for Vital Statistics.

"There's a good research basis for advocating for mental health services that meet the needs not only of people with severe mental illness, but also people who don't have a severe mental illness but who might be in an intense emotional crisis and may have access to firearms," Kinscherff says.

Ultimately, the resolution emphasizes a science-based, comprehensive public health approach to firearm violence prevention. Task force member Susan B. Sorenson, PhD, of the University of Pennsylvania, hopes taking that approach will make gun violence prevention a future public health success story, similar to reductions in car crashes due to a combination of factors, including improved roads, better motor vehicle engineering and modified traffic laws. "When people say, ‘Shall we do this? Shall we do that?' the answer is probably [yes to] all of them," she says.

Read the resolution online.

Read the APA report, Gun Violence: Prediction, Prevention and Policy.