Although I try not to get too political on this blog, today is an exception. There have been many things I've wanted to write and share since the tragic school shooting in Newton, Connecticut and the ensuing national argument about gun control. I have very strong opinions on the subject, and personally feel our government leaders need to take immediate, strong action to strengthen gun control laws. My reasons for thinking this way are perhaps different than many others, and are very personal. I work to prevent suicide. Guns are overwhelmingly the weapon of choice in a large number of suicides, including suicides-by-cop and murder-suicides. In an email received the other day from the QPR Institute for Suicide Prevention, its President and CEO, Dr. Paul Quintett, said this:
"We at the QPR Institute are concerned that the national debate following the Sandy Hook tragedy is veering off course.
"We at the QPR Institute are concerned that the national debate following the Sandy Hook tragedy is veering off course.
Almost no one has noticed that most mass murderers take their own lives or are killed by police gunfire (suicide-by-cop).
So long as America remains uninformed about the role suicidal self-directed violence plays in these tragedies, and in domestic violence murder-suicides as well, our debate will not lead to new possible solutions."
Last week, The QPR Institute was asked by the American Psychological Association for recommendations to reduce gun violence in America. The APA will share these recommendations with federal officials as they discuss new gun violence prevention strategies. The recommendations, which I fully endorse, are below. My hope is that by sharing them, others will read them and perhaps change their perspective on gun control and the need to reduce gun violence in this country. Gun violence is a serious national health issue, as is suicide. I believe both can be reduced by following the common sense, evidence based recommendations outlined below.
Prevention Strategies to Deter Mass Shootings and
Reduce Gun Violence: Recommendations and Resources
© 2013, Paul
Quinnett, Ph.D., President and CEO, QPR Institute, Inc.
(This document may be
widely shared, reprinted and distributed without permission.)
To prevent the next gun violence
tragedy we believe America needs science-based, constitutionally-appropriate,
community-based interventions which are available now for immediate
implementation. For each recommendation below, web sites or links to best
practice programs are included.
Following the tragedy at Newtown,
the premise for these recommendations is the observation that most mass
murderers either take their own lives or expect to be killed by police
(“suicide-by-cop”) after committing multiple homicides, e.g., Lanza, Cho,
Harris, Klebold, and others. In addition, among the far more common
“simple” suicides (those not involving a homicide—approximately 39,000 deaths a
year), over half are by firearm.
These evidence-based recommendations
target several sectors of our society: the general public, health professionals,
gun dealers, gun owners and law enforcement professionals.
For the General Public, Health Professionals,
Gun Dealers and Citizen Gun Owners:
1. Train
the general public to recognize suicide/homicide warning signs among their
family members, friends, students, co-workers and throughout their social
networks.
Then teach
them to intervene as follows:
-Clarify the
meaning of the warning sign(s) with the person
-If in distress,
intervene to get the person immediate help
-Restrict access
to firearms, e.g., immediate removal, off-site storage, key gun part removal,
locks
-Train all gun
owners in the“11th Commandment” of responsible firearm ownership: Keep
firearms from distressed persons
2. Train
firearm dealers to recognize distressed persons attempting to purchase guns,
how to delay or deny the sale and how to make a referral for assistance or
secure a mental health evaluation when warning signs are present.
3. Educate
mental health and health professionals on the overlap of suicidal/homicidal
desire and intent, and legally mandate training in how to detect, assess, and
manage suicide/homicide risk. This training deficit accounts for many missed
opportunities to reduce gun violence and deter mass shootings (http://www.sprc.org/bpr/section-II/preventing-suicide-through-improved-training-suicide-risk-assessment-and-care).
In recognition of this potential public health hazard, in 2012 Washington State
passed a law “requiring certain mental health professionals to complete
education in suicide risk assessment, treatment and management.” http://apps.leg.wa.gov/documents/billdocs/2011-12/Pdf/Bills/House%20Passed%20Legislature/2366-S.PL.pdf
For each of the above recommendations, the following best
practice and evidence-based programs are now available:
1. General
public training in suicide prevention
- http://www.sprc.org/bpr, e.g., QPR, CALM,
and others
2. Firearm
dealers, gun safety instructors, gun and hunter club training
- http://www.sprc.org/bpr, CALM
3. Health
professional training
- http://www.sprc.org/bpr, Section II
“Adherence to Standards” programs
For Law Enforcement Professionals:
1.
Using best practice registered programs, train law
enforcement officers in how to:
-
Recognize the warning signs of suicide/homicide and
how to conduct a simple 3-step CPR-equivalent emergency intervention
-
Conduct a suicide risk assessment interview using
the same methodology used by thousands of mental health professionals, and of
particular value to officers responding to domestic violence calls, jumpers and
others
2.
Enhance the mental health/suicide/violence
prevention literacy and skills of law enforcement officers by providing
training about:
-
Their key role in the National Suicide Prevention
Strategy 2012
-
Successful violence prevention interventions, e.g.,
the US Air Force project and means restriction strategies (www.meansmatter.org)
-
The link between mental illness/substance abuse and
violence
-
Evidence-based risk mitigation/intervention
strategies
-
How to prevent suicide inside the law enforcement
community itself
- How to develop community
partnerships with firearm dealers, gun owners, gun safety instructors, hunting
clubs and others to enhance gun safety and restriction of access to firearms though
teaching the “11th Commandment” of responsible firearm
ownership: Keep firearms from distressed persons
To enact these recommendations, the following best practice
and evidence-based programs are available now:
2. http://www.sprc.org/bpr/section-III/calm-counseling-access-lethal-means
and http://www.consensusproject.org/learningsites
Key References:
Barber C, Azrael D, et al.,
Suicides and suicide attempts following homicide: Victim–suspect relationship, weapon type, and presence of
antidepressants. Homicide Studies, August
2008 vol. 12 no. 3 285-297
Feldman, B. N., &
Freedenthal, S. (2006). Social work education in suicide intervention and
prevention: An unmet need? Suicide and
Life-Threatening Behavior, 36,
467-480. doi: 10.1521/suli.2006.36.4.467
Institute of
Medicine. (2002). Reducing suicide: A
national imperative. Washington, DC: The National Academies Press.
Knox. K.L., Litts, D.A, Talcott, G.W.,
Feig, J.C., Caine, E.D., (2003). Risk of suicide and related adverse outcomes
after exposure to a suicide prevention programme in the U.S. Air Force: cohort
study. British Medical Journal. 13, 327 (7428)
Luoma, J. B., Martin,
C. E., & Pearson, J. L. (2002). Contact with mental health and primary
care providers before suicide: A review of the evidence. American Journal of Psychiatry, 159, 909-916. doi: 10.1176/appi.ajp.159.6.909
Slovak, K., &
Brewer, T. W. (2010). Suicide and firearms means restriction: Can training make
a difference? Suicide and
Life-Threatening Behavior, 40, 63-73. doi: 10.1521/suli.2010.40.1.63
This issue with guns is on a lot of minds. I have a couple of conservative cousins whose Facebook posts for the last two weeks have been on guns alone, and our right to have them.
ReplyDeleteI heard in a discussion the other day, from a mental health professional in attendance, that the antidepressant Prozac is known to have suicidal thoughts as a side effect. She said that every one of the recent mass shooting perpetrators had been on it. I don't know whether that's entirely true. But I believe guns are not the issue. People are the issue. And as long as they are suffering from depression or another mental health issue, there will be risks. I wish the money and attention could be directed to the people.
Much to chew on here. I've also thought much about those who are involved in the mass shootings also taking their own lives in the process. Some do not, but it seems most do. As Linda said, I also wonder about the side effects of some antidepressants.
ReplyDeleteThere is much that needs to be done in educating the public about suicide and suicidal tendencies. Gun control is just one issue in this matter, but it is one that must be addressed. Ironically, Vice President Biden said, "There is no silver bullet for gun control issues." (Interesting choice of words, don't you think?) True, but as a civilized society, we must begin to look seriously at these evidence based recommendation.
Thanks for publishing this. There's much to ponder. There are a lot of guns in my house. The spouse hunts and is a trap shooter. The guns are kept in a gun safe. It's not having access to guns that is the problem. It's a mental health issue. And even if alert family members identify a problem, there is frequently no treatment option available. We're a rich country with many resources. We can do better.
ReplyDelete