How sad that it took Newtown, Connecticut's horrific tragedy to finally focus the nation's attention on two pressing public health problems: the proliferation of guns in our society and the declining availability of mental health services. The healthcare community has much to offer during the national discussion that President Barack Obama promised to initiate in the wake of the senseless deaths of 20 children and six adults less than three weeks before Christmas. Let's make sure its voice is heard.
As the American College of Emergency Physicians and other physician groups pointed out last week, healthcare workers deal every day with the tragic consequences of unrestricted access to guns. Firearms were used in more than two-thirds of the 16,799 homicides in 2010, according to the Centers for Disease Control and Prevention. The carnage was actually far higher since the battlefield lessons learned over the past century's wars, especially the recent conflicts in Afghanistan and Iraq, allow medical personnel to save far more of the wounded than in previous eras.
But guns don't just take their toll through citizen-against-citizen violence. About half of the 38,364 people who killed themselves in 2010 used a gun, which is a far more effective means of taking one's life than other easily accessible methods. And it isn't just gun owners killing themselves. According to the American Foundation for Suicide Prevention, a high proportion of those turning guns on themselves, sometimes after inexplicable mayhem visited on innocent others, used weapons that belonged to someone at home—as happened in Newtown.
Investigators still don't know what triggered the deadly assault by Adam Lanza, the disturbed and ailing 20-year-old whose mother was trying to institutionalize him before his outburst, according to news reports. But some legislators are already pushing an aggressive agenda on Capitol Hill. Some want more mental health services in schools; others want higher standards and more money for community mental health providers. Mental Health America, a coalition of advocacy groups, wants to double spending on mental health services, which they say have been cut by $4 billion in recent years when one includes Medicaid cuts.
The nation appears ready for beefed up spending on mental health. A Gallup poll released last week found 84% of respondents felt more government spending on mental health services would help prevent mass shootings. Meanwhile, on Capitol Hill, even some long-time allies of the National Rifle Association are expressing support for reasonable gun regulation.
But to turn this shifting mood into meaningful legislation, it's imperative that the public health community and the relevant specialties—not just emergency-room doctors but psychiatrists, family practitioners, pediatricians and the systems that employ them—speak up loudly. They must go beyond articulating positions in a news release. They must tell legislators why stronger gun control measures are needed and explain how more money spent on mental health can be effectively used.
In the immediate aftermath of the shooting, officials at nearby Danbury Hospital, which had mobilized to treat the dozens of wounded children who never came, mounted a major outreach campaign to provide post-trauma counseling to families, members of the community, the first responders and its own staff, one of whom lost a child in the carnage. Last week, the hospital held memorial services and a systemwide meeting where even doctors and nurses broke into tears as they shared their collective grief. The outside psychiatrists reminded the entire staff that the aftershocks could show up at any time—for years.
In this season of holiday celebrations and New Year's resolutions, let us vow to put ending senseless violence at the top of our public health agenda.
Merrill Goozner, editor