|Title:||Mental health outcomes from direct and indirect exposure to firearm violence: A cohort study of nonfatal shooting survivors and family members|
Magee, Lauren, Indiana University Purdue University Indianapolis; Matthew C. Aalsma, PhD, Adolescent Behavioral Health Research Program, Department of Pediatrics, Indiana University School of Medicine; J. Dennis Fortenberry, MD, MS, Department of Adolescent Medicine, Indiana University School of Medicine; Sami Gharbi, MS, Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine; Sarah E. Wiehe, MD, MPH, Children’s Health Services Research, Department of Pediatrics, Indiana University School of Medicine
Background/Significance/Rationale: Firearm violence is a public health crisis in the United States. Beyond the survivor, firearm violence impacts family members and communities. Despite the known health inequities that exist among nonfatal shooting survivors, little research has focused on the mental health needs of family members. The objective of this study is to examine mental health prevalence rates of survivors and family members of nonfatal firearm violence.
Methods: Police and Medicaid claims data were linked at the individual level between January 1, 2007 and December 31, 2016 in Indianapolis, Indiana. The Medicaid case number was used to identify nonfatal shooting family members. Differences in mental health prevalence and clinical care utilization were examined in the 12-months preceding and following an index nonfatal shooting for survivors, family members and compared to the Medicaid population. Results were stratified by age group (youth and adult).
Results/Findings: There was a nearly three percent increase in mental health prevalence rates for youth family members (Pre: 8.51 vs. Post: 11.2, p < 0.05) of nonfatal shooting survivors in the 12-months post injury compared to the preinjury period but no observed increase in adult family members (Pre: 6.49 vs. Post: 6.49, p < 0.05). Stress and anxiety disorders were the most prevalent new mental health diagnoses in the 12-month post injury for both youth (youth: 27.3 vs Medicaid: 16.3) and adult family members (adult: 44.4 vs. Medicaid: 31.5), and rates were significantly higher compared to the general Medicaid population.
Conclusions/Discussion: Addressing mental health needs of youth impacted by firearm violence is critical to reducing future involvement in firearm violence, improving health outcomes, and breaking the cycle of violence.
Translational/Human Health Impact: There is a need to extend trauma informed services to siblings and children of firearm injury survivors through current clinical and community-based programs.