The Aftermath of Gun Violence: Inadequate Mental Health Care for Injured Kids

There is an urgent need for mental health care in injured children after firearm injuries.

A recent study published in the journal Paediatrics revealed that more than three out of every five children (63 percent) who are enrolled in Medicaid do not obtain mental health services within six months of being injured by a firearm ().

In the United States in 2020, a shocking 11,258 young people suffered nonfatal gunshot injuries. Surviving such experiences increases children's chances of developing bad mental health outcomes, such as newly identified trauma-related disorders, substance misuse problems, and disruptive disorders.

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‘Mental health is being neglected in more than 60% of children who have been injured by gun violence, depriving them of crucial care. #GunViolence #MentalHealth’

Furthermore, the study found a nearly doubling in the rate of children diagnosed with bipolar illness, schizophrenia spectrum disorders, and suicidal thoughts/self-harm following an accident.

“In our study, we found that while too many children did not receive mental health care follow-up, children with a new mental health diagnosis identified during the firearm injury encounter had over twice the odds of timely connection to outpatient mental healthcare,” said lead author Jennifer Hoffmann, MD, MS, Emergency Medicine physician at Ann & Robert H. Lurie Children’s Hospital of Chicago and Assistant Professor of Pediatrics at Northwestern University Feinberg School of Medicine.

“This shows that after a firearm injury, mental health screening and referral for youth at high risk are essential, as well as required by the 2022 American College of Surgeons standards for pediatric trauma centers. This best practice still needs wider implementation.”

The Link Between Mental Healthcare Access after Firearm Injury

The study also detected inequities in mental healthcare access after a firearm injury, with Black youth less likely to have any mental health follow-up than White youth.

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“Mechanisms underlying these inequities may include stigma and costs related to accessing care, limited diversity in the mental health workforce, and shortages of mental health professionals in areas where Black children live,” said Dr. Hoffmann.

“Attention is needed to address barriers at the individual, health system, and societal levels that may prevent Black youth from accessing mental health services.”

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For the study, Dr. Hoffmann and colleagues examined Medicaid data of children aged 5-17 years with a nonfatal firearm injury, living in 11 geographically dispersed states from 2010-2018. They identified 2,613 children with firearm injuries.

The objective was to analyze how the timing of the first outpatient mental health visit after a firearm injury varies by sociodemographic and clinical characteristics. They found that the first outpatient mental health visit after the injury occurred sooner among children with prior mental health service use.

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“For children without prior mental health service use, greater efforts are needed to connect them to mental health providers,” said Dr. Hoffmann. “To improve outcomes, it is important to prioritize early detection of mental health needs, equitable access to mental healthcare, and timeliness of care.”

Research at Ann & Robert H. Lurie Children’s Hospital of Chicago is conducted through Stanley Manne Children’s Research Institute. The Manne Research Institute is focused on improving child health, transforming pediatric medicine, and ensuring healthier futures through the relentless pursuit of knowledge. Lurie Children’s is a nonprofit organization committed to providing access to exceptional care for every child.

It is ranked as one of the nation’s top children’s hospitals by U.S. News & World Report. Lurie Children’s is the pediatric training ground for Northwestern University Feinberg School of Medicine. Emergency medicine-focused research at Lurie Children’s is conducted through the Grainger Research Program in Pediatric Emergency Medicine.

Reference:

Increase in Mental Health Diagnoses Among Youth With Nonfatal Firearm Injuries - (https://pubmed.ncbi.nlm.nih.gov/34119719/)

Source-Eurekalert