Conn. shooting prompts demands for gun control
Pina Violano, the injury prevention coordinator at Yale-New Haven Hospital in Connecticut, has worked to take many dangerous guns off the streets, including an AK-47, an Israeli-made Uzi, a TEC-9 semiautomatic pistol and two Bushmaster-made assault rifles like the one used in December in the Sandy Hook Elementary massacre.
Violano is among a national network of workers in trauma and emergency care who have long been spearheading efforts to decrease gun violence. Those efforts include Yale-New Haven's work in supporting gun “buy-back” initiatives that have taken 88 weapons off New Haven streets in the past year.
At $50 to $100 apiece for a gun, the buy-back price is a bargain compared to the $45,000 it costs to treat a gunshot victim in a hospital, she said.
Increasingly, many hospitals and healthcare providers are seeing gun violence as a pervasive public health concern that is calling them to action, whether through local outreach programs, policy statements from membership organizations, or demands for legislative change at the state and federal level.
The national sense of horror and outrage that followed from the murders of 26 people in the Newtown, Conn., elementary school—including 20 young children—prompted many organizations to trumpet their existing demands for gun control or to craft new statements.
Thirty-six interest groups for nurses led by the American Nurses Association signed a policy statement calling for greater access to mental health services, better healthcare and mental health services provided in schools, and gun-control efforts including a ban on assault weapons. Among the groups were state nursing associations for Colorado, Connecticut and Arizona—three states that have seen shocking mass shooting incidents in the past two years.
The American College of Emergency Physicians reiterated its stance for more control of firearms and better access to mental health services as national momentum for change seemed to be building in the wake of the Newtown shootings.
ACEP President Dr. Andrew Sama, who is chairman of the Department of Emergency Medicine at North Shore University Hospital in Manhasset, N.Y., said unequivocally that gun violence is a public health problem that healthcare providers are positioned to address in several ways.
In addition to pressing for national bans on assault weapons and high-capacity magazines, he supports physicians' rights to ask families about whether they keep guns in the home. Florida officials recently passed a law banning that practice, and several southern states are said to be debating similar laws.
“I think a doctor or any healthcare provider should be able to ask any question that would affect any public health issue, and if that's one, fine,” Sama said.
Dr. Michael Hirsh, the surgeon in chief of the UMass Memorial Children's Medical Center in Worcester, Mass., said physicians' right to ask about guns in the home is part of the “sacrosanct” relationship between patients and families, and that doctors should have the right to inform families about the importance of securing their guns from children and burglars.
Proponents of the Florida law said a physician had no right to ask about gun ownership, but Hirsh noted that a physician in Newtown might have been able to ask questions that could have presaged problems in the home of Sandy Hook shooter Adam Lanza.
“We hear about a mom who is a gun enthusiast who seems to have a child who was having some mental problems, and as a means of bonding with that child, she takes that child to the gun range. It's very distressing,” Hirsh said. A physician, he said, could ask a patient what they like to do for fun. “If the answer is, I go to a shooting range, that starts a whole range of questions.”
A wide swath of medical societies plunged into deliberations last week about how to respond to the Newtown shootings and enter the debate over gun violence in more forceful ways, Hirsh said.
Yale-New Haven Hospital has helped take 88 guns off the street in the past year.
He said he was involved in negotiations with three different organizations—the American Association for the Surgery of Trauma, the American Pediatric Surgical Association and the American Academy of Pediatrics—that were debating policy statements. The work comes as President Barack Obama on Dec. 19 said he would convene a task force to make gun-control policy recommendations by January.
Dr. Brendan Campbell, medical director of the trauma program at Connecticut Children's Medical Center in Hartford, said he's among a group of doctors who are in the final stages of developing a four-point policy statement that will be pitched to medical groups, lawmakers and hospital administrators as a way to gather momentum for what he called common-sense changes.
The statement will include a reinstatement of the 1990s-era ban on assault weapons, a ban on high-capacity ammunition magazines, allowing federal public health agencies to study firearm use and come up with evidence-based solutions to violence, and restrictions for gun purchases that include mandatory waiting periods, closing of gun-show loopholes, and mental health restrictions for gun purchasers.
“The (National Rifle Association) is so powerful that you need to get as broad support as you can so that lawmakers aren't afraid to get behind and support and vote for these things,” Hirsh said.
Meanwhile, representatives of mental healthcare clinics and hospitals say the shootings in Newtown, while tragic, have the potential to draw attention to funding and regulatory issues that hurt the country's capacity to provide mental healthcare. But translating that attention into change is a difficult proposition, said Chuck Ingoglia, senior vice president for the National Council for Community Behavioral Health.
The council would like to see the government stop funding cuts to mental healthcare, authorize the creation of the mental health version of Federally Qualified Health Centers to boost the mental healthcare infrastructure, and run a demonstration project for a mental health first-aid program in colleges and universities.
The president and members of Congress have mentioned improving mental health capabilities as part of the response, and “we're hopeful that that will actually happen,” Ingoglia said. Mental health should be a part of the conversation, he said, but “people have short memories.”