After Newtown: From Emotion to Action

It is clear that so many of us have been deeply impacted by the horrific school shooting in Newtown. My social media channels have been flooded by this event in a way I can’t remember happening before. Countless expressions of deep, deep sadness. Now, as the days pass many have started asking how to turn this deep emotion into positive change. How can we better protect our children?

These are not new questions. After all, this is not a new problem. In the United States, one child or teen dies every three hours due to gun violence and we have had an alarming number of mass murders over the past few years. But, I became hopeful that perhaps this is finally the moment for change after hearing President Obama say,

“In the coming weeks, I’ll use whatever power this office holds to engage my fellow citizens, from law enforcement, to mental health professionals, to parents and educators, in an effort aimed at preventing more tragedies like this, because what choice do we have? We can’t accept events like this as routine.”

But, change will not come from the White House alone. This must be primarily a grassroots effort, with people like you and me demanding that we do better. In trying to figure out what I can do to help, I’ve done a lot of reading and thinking.

I strongly believe that we need to think about violence prevention from a public health perspective. We need to set aside emotion and look at what is known about the causes of injuries and death from gun violence on a population level. I have learned that this is harder than it otherwise would be due to limitations that politics has placed on research in this area. In the Journal of the American Medical Association, Drs. Kellermann and Rivara state,

“The nation might be in a better position to act if medical and public health researchers had continued to study these issues (firearm injuries) as diligently as some of us did between 1985 and 1997. But in 1996, pro-gun members of Congress mounted an all-out effort to eliminate the National Center for Injury Prevention and Control at the Centers for Disease Control and Prevention (CDC). [. . . ] The effect was sharply reduced support for firearm injury research.”

So, there’s the first common sense action we can take. We can demand a return to funding well-done research on firearm injuries and violence prevention, much like we have done with issues like drowning, seat belts, and air bags.

In addition, a number of areas of potential intervention have been brought to the fore since Newtown. Let’s look at each of these.

Gun Control

There are a number of things we know to be true about firearm-related injuries in children. This fall’s report from the American Academy of Pediatrics’ Council on Injury, Violence, and Poison Prevention states,

“The absence of guns from children’s homes and communities is the most reliable and effective measure to prevent firearm-related injuries in children and adolescents. Adolescent suicide risk is strongly associated with firearm availability. Safe gun storage (guns unloaded and locked, ammunition locked separately) reduces children’s risk of injury. Physician counseling of parents about firearm safety appears to be effective, but firearm safety education programs directed at children are ineffective. The American Academy of Pediatrics continues to support a number of specific measures to reduce the destructive effects of guns in the lives of children and adolescents, including the regulation of the manufacture, sale, purchase, ownership, and use of firearms; a ban on semiautomatic assault weapons; and the strongest possible regulations of handguns for civilian use.”

This report suggests a number of common-sense actions we (child health advocates and parents) can take to reduce our children’s risk of incurring firearm related injuries. We can continue to ask families about guns in the home and safe storage of guns at well child visits. We can advocate for bans on semi-automatic assault weapons and large capacity ammunition magazines.

Mental Health

There has been much talk regarding the need for improved access to mental health services for those facing serious mental health diagnoses. I wholeheartedly agree. Too many times I have seen families face long waiting lists and inadequate services until they are in crisis, at which time more attention is paid to them. This is too little, too late. We need to provide support and attention to parents and teachers who notice early warning signs of serious mental illness in their children and students.

However, I have also been reminded that we must be cautious in believing that lack of mental health care is the only answer here. As Dr. Friedman stated in a recent article,

“there is overwhelming epidemiological evidence that the vast majority of people with psychiatric disorders do not commit violent acts. Only about 4 percent of violence in the United States can be attributed to people with mental illness.”

We must also be careful not to fear or punish certain people because they fit a profile. We simply are not yet very good at predicting who may become violent. And, while this may be scary, it must be remembered. People with mental health diagnoses or neurodevelopmental disorders such as autism are far more likely to be victims of bullying or violence than to be its perpetrators.

Violence in the Media

Some may argue that the vast majority of American are exposed to violence in the media and yet do not become violent. This is certainly true. However, we also know this. The average child will have viewed 200,000 acts of violence on television alone by the time they are eighteen years old and,

“Research has associated exposure to media violence with a variety of physical and mental health problems for children and adolescents, including aggressive and violent behavior, bullying, desensitization to violence, fear, depression, nightmares, and sleep disturbances.”

We also know that children are influenced by media. They learn by observing and tend to imitate or repeat what they’ve seen. And, given our inability to predict for whom exposure to violence may lead to violent behavior, we must decrease all children’s exposure. This is an area where I believe we, as parents, can take the lead. Many of the children’s movies being produced (even cartoons) have significant levels of violence. Research movies and television shows before allowing your child to watch. Vote with your wallet. If something seems inappropriate, don’t buy a ticket or rent the film. If you decide something is appropriate, watch with your child and discuss what they are seeing. Give them context.

Given the complexity of this issue, there is so much more to say and do. But, here’s where I am going to start in my own life.

  • I have called my legislators and expressed my support for funds for firearm-injury research and common sense legislation aimed at preventing violence.
  • I will continue to educate myself and advocate for violence prevention.
  • I will do my best in clinic every day to support families that are concerned about their child’s mental health and connect them to resources.
  • I will ask families about guns in their homes and discuss safe storage.
  • I will spend time with my son and, as much as I can, decrease his exposure to violence.

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