Soliman Layla, Baines-Waiz Omari, Rozel John S, Blankenship Kelly, Rachal James
Atrium Health/Wake Forest School of Medicine, Wake Forest University-Charlotte Region, Charlotte, NC, USA.
Atrium Health Carolinas Medical Center Sandra and Leon Levine Psychiatry Residency, Charlotte, NC, USA.
Curr Psychiatry Rep. 2024 Dec;26(12):859-865. doi: 10.1007/s11920-024-01569-2. Epub 2024 Dec 11.
This review aims to provide an updated overview of trends in firearm- related deaths, the mental health impact on communities, and clinical and legislative interventions. We examine existing interventions and highlight lesser-known yet impactful strategies, such as incorporating appropriate training in medical education on firearm safety. Additionally, we explore the broader impacts of firearm violence on community mental health and address the disputed topic of whether mental illness is a driving factor behind mass shootings.
The rate of firearm suicides has continued to grow in the United States, even as firearm homicides have slightly declined. While the media often attributes mass shootings to the perpetrator having a mental illness, research indicates such symptoms only account for a small subset of shooters. Recent studies highlight the benefits of incorporating firearm safety into professional medical education, which can reduce barriers for healthcare providers when discussing safe storage practices with patients. While suicide risk is frequently assessed among individuals with mental illnesses due to their heightened risk, other factors should be considered by all clinicians, not just those in mental health. Similarly, certain mental health symptoms may play a role in a small fraction of gun violence, but other risk factors account for most violence risk. Despite the implementation of firearm restriction laws and increased access to mental health resources, gaps remain that must be addressed to reduce not only the rate of suicide by firearm, but also the mental burden the aftermath has on the community.
本综述旨在提供与枪支相关死亡趋势、对社区心理健康的影响以及临床和立法干预措施的最新概述。我们研究了现有的干预措施，并强调了一些鲜为人知但有影响力的策略，例如在医学教育中纳入关于枪支安全的适当培训。此外，我们探讨了枪支暴力对社区心理健康的更广泛影响，并讨论了精神疾病是否是大规模枪击事件背后驱动因素这一有争议的话题。
在美国，尽管枪支杀人案略有下降，但枪支自杀率仍在持续上升。虽然媒体经常将大规模枪击事件归咎于行凶者患有精神疾病，但研究表明，此类症状仅占枪击者的一小部分。最近的研究强调了将枪支安全纳入专业医学教育的好处，这可以减少医疗保健提供者在与患者讨论安全储存做法时的障碍。虽然由于精神疾病患者自杀风险较高，经常对其进行评估，但所有临床医生都应考虑其他因素，而不仅仅是心理健康领域的医生。同样，某些心理健康症状可能在一小部分枪支暴力事件中起作用，但其他风险因素才是大多数暴力风险的原因。尽管实施了枪支限制法律并增加了心理健康资源的可及性，但仍存在差距，必须加以解决，以不仅降低枪支自杀率，还减轻其后果给社区带来的精神负担。
