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  1. ISSUE ANALYSIS – BACKGROUND   

    QUESTION

    How To Reduce Gun Violence

 

Subject Law and governance Pages 8 Style APA

Answer

Reporting approximately forty thousand gun deaths each year, gun violence in America is on the rise. The menace associated with gun and gun-related violence has resulted in controversies towards the Second Amendment that gives an individual the right to bear a gun for safety purposes. Irrespective, D.C. v. Heller case influenced the Supreme Court to rule in support of subjecting regulations on the rights to keep arms (Swanson et al., 2015). With this in mind, the government has a solemn responsibility to control gun violence by implementing stricter gun control laws. There are many viewpoints that can be talked about, and there can be other ways to tackle the menaces of gun violence.

In a series of research studies, sociologist have attempted to raise opinions on why Americans are witnessing recurring gun violence despite emerging efforts to stop its impacts. One reliable source is from a sociologist, Andrew Parachristos and acquaintances who explored gun violence from the spectrum of social networks. Their research purposed to understand the pattern of gunshot victimization from social networks, specific to the “six degree of separation”, or the “friend-to –friend chains (Milliken,2019). Through an epidemiological analysis, Papachristos research found out that acts of gun violence unfold within social networks. Most reviewed studies affirmed that high percentage of gun-related injuries occurs within a single social network. Further, gunshot injuries happen among people of the same race, with the African American men being the most susceptible race. From their findings, Papachristos et al. revealed a new point view in which policy makers should adopt when addressing gun violence. First, Papachristos and his colleagues redefined gun violence from at least two facades. One was based on its inequality impacts on the population and two was the level of violence within the population. As of today, young black men are the most vulnerable group to impacts of gun violence, marking African American population a hotspot when addressing gun violence impacts.

Papachristos and colleague’s study heightened the power of social networks as strategy to reduce gun violence in areas considered to have high crime rates (Milliken,2019). They recommended implementation of social –system-wide solution that would address the inequalities of gun violence and differences among populations (Margetta, 2011). Short and long-term psychological effects are common among gun –violence victims, especially exposed children and mothers. According to Bulter et al. (2018), in high crime areas, children are vulnerable to exposures to high levels of violence within their communities. In these high crime areas, there is a need to address the social, emotional physical and mental wellbeing of children, youths and families best achieved through proper identification of the victims. Hence, social networks strategies become more sustainable and inclusive approaches of addressing gun-related violence than addressing it from a mental health perspective.

Another viewpoint is reforming mental health care systems and improving point-of-purchase background checks to keep guns from mentally disturbed people will address the problem (Swanson et al., 2016). Also, Swanson et al. (2015) noted that the aftermath of gun violence accounts for nearly 90 deaths every day in America. An opposing position raised by the National Rifle Association suggests that mass shooting is a matter of untreated mental illness rather than unregulated gun laws. In response, the association proposed the establishment of a database of mental illness individuals (Swanson et al., 2015). In this paper, vocabulary terms used are social environment, Physical environment, and structural and societal factors that contribute to observed disparities in health (National Research Council, & Committee on Population, 2013).

Amidst a glare of heightened media coverage over mass shooting events and a dazed public, tackling gun violence has become almost inevitable for policymakers. The majority of Americans have supported addressing gun violence control by tackling mental health in America. Swanson et al. (2015) opine that the logic behind including an individual`s psychiatric health history in background checks is that it offers a mutual ground between gun rights and gun control protagonists When basing gun violence on the spectrum of suicide, mental illness becomes a significant vector of concern. According to CDC reports, suicide accounts for nearly 61percent of the total gun death rolls in America (Swanson et al, 2015). Suicide is a fatal national concern, and a considerable number of suicidal victims are identified with mental illnesses. Risk fractions for suicide-related mental disorders range between 47percent to 74 percent (Swanson et al., 2015). Correspondingly is literature affirming that gun ownership strongly influences increased risk of suicide cases in the United States. Further, studies prove that restrictive gun control significantly influences reduced suicidal rates. For instance, the District of Columbia reported a rapid decline in suicide rates following the implementation of restrictive handgun licensing (Swanson et al., 2015). Therefore, improving point-of-purchase background checks by including an individual`s psychiatric health history will largely address the problem of gun violence, specifically suicide. 

 Contrary, mental health stakeholders strongly reject the opinion as merely reflective of mental health stigmatization and stereotype. In defense, mental health experts argue that the majority of individuals with mental illness are never violent towards others. Basing on scientific evidence, social-environmental factors such as substance abuse are more likely to trigger violent behavior compared to mental illness. Regardless, this does not entirely conclude that mentally ill persons are not prone to violent behavior. Swanson et al. (2016) argue that the prevalence of violence in a mentally ill patient is strongly dependent on the type or stage of their mental illness. Psychiatric disorders such as schizophrenia and bipolar are considered stronger triggers for violent behavior compared to other mental and personality disorders. Risk proportions for violence range between 2 to 10% for those with psychoses, approximately 20% for personality disorder, and between 20 to 25% for substance use disorder (Swanson et al., 2015). Additionally, violence is often a result of risk exposures such as early life trauma experience or early involvement in substance abuse. This means that mentally ill individuals are at equal risks of crime and violence as any other member of society. 

Madden Lauren introduces a hypothesis supported by clinical psychologists in relation to the phenomenon of mass shooting. The hypothesis claims that “it is anger, not mental illness causing violence” (Madden, 2018, para 2). The psychologists behind this theory is Laura Hayes who claims that violent behavior are present in individuals who lack skills to manage their anger. She points out gaps in the mental health system related to diagnosis, prevention and management of anger disorders. Hayes claims that the mental health community is yet to develop a framework, specific to assisting populations in high crime areas comprehend violence in their communities. To support her argument, Hayes asserts that intermittent explosive disorder (IED), an anger disorder, is believed to arise from repeated exposure to patterns of IED behavior from parents or family members. Even with the acknowledgement of its existence, its diagnostic category in relation to murder and mass shooting remain unknown. Also, Hayes argues that multiple studies supporting violent crimes committed by individual with mental illnesses are insignificant in numbers.

 In support is Paolo del Vecchio of the federal Substance Abuse and Mental Health Service Administration who claims that mental illness contributes to less than 5 percent of the violent crimes that exist (Madden, 2018). Regardless, public opinion thinks different about the mentally ill. Rather than focusing on the IED-diagnosed persons, the public is quick to judge those with serious mental disorders specifically schizophrenia. Thus, Hayes feels that the media is to be blamed for mental illness stigmatization while the mental health system is responsible for the misinformation behind the problem of anger management and its relationship with violent crimes.

From a legal perspective, mental health background check system initially targeted individuals identifies as mentally incompetent by the courts or those involuntary admitted to hospitals for mental related issues (Kangas & Calvert, 2014). Regardless, developing stories show that federal government is considering to extend the background checks to people who voluntary seek mental health services. While this action may seem as a preventive measure to reduce gun violence, ethical concerns have raised doubts over its sustainability. The ethical concern is that the initiative threatens the medical health reporting standards. The privacy of patient’s health information is protected under the department of Health and Human Services (HIPAA). Medical practitioners under HIPAA are obliged to protect their client against breach of personal information. In line with that, it is important to ensure mental health reporting to background check observe patient privacy rights as well as mental practitioners obligations.

Mental health practitioners agree that to some extent, background checks present ethical concerns that may impact on their practice and therapeutic relationship. Kangas and Calvert, (2014) argues that inclusion of patient mental health status is associated with increased risk of stigma and loss of certain privileges such as the right to purchase firearms. In the presence of a possible discriminatory result, individuals are most likely to resolve to reduce health seeking behavior among mentally ill patient. Also patients are likely to limit disclosure of their personal information which will impact on treatment and overall health outcomes. As if mental illness is not widely stigmatized in social settings, adding firearm restrictions would make life unbearable for the mentally ill individuals. Among psychologist, any initiative that threatens their ability to reach and treat the mentally ill is not ideal for their services.

According to Kangas and Calvert (2014), the policy of strict confidentiality is purposed to optimize diagnosis, treatment and reaching out while protecting patients’ privacy rights.  Further, ethical principles of nonmaleficence and beneficence strive to protect patients against any possible harm. Hence, as far as the mental health institution is concerned, the mental health background checks possess potential harm for the mental health system. The mental health databases affirm that placing stricter rules on mentally ill individuals is one way of establishing and supporting the notion that mental illness is violent, dangerous and should be feared. If by any chance mental health background checks are implemented, they should be based upon empirical criteria, not from public opinions.

Enacting laws based on the public opinion that the “mentally ill are violent” unjustifiably makes the mentally ill vulnerable to deprivation of their rights.  Swanson et al.’s (2015) epidemiological evidence on public perception towards mental illnesses prove that news media coverage is responsible for the negative stereotype towards mentally ill persons. On multiple occasions, news stories show mass shootings by mentally ill persons influencing negative public perception towards this group. Swanson et al. (2016) argue that public attitudes and perceptions play a significant role in influencing public policy. Hence, if the public believes that mentally ill individuals are dangerous, they are most likely to support laws that restrict the rights of people with mental illnesses, regardless of whether they are just or effective. 

 Gun violence is an issue that needs immediate attention to keep our Nation, America safe. The question of whether including the individual`s psychiatric health history in the background check for firearms raise ethical concerns worth revisiting. On one hand, is a strategy to reduce the risk of first violence crimes by restricting access to guns to mentally ill persons. On the opposing side is an approach to address gun violence by tackling untreated mental illness rather than unregulated gun laws. While both opinions are strongly supported by epidemiologic evidence, I would confidently root for addressing untreated mental illness as a strategy to reduce gun violence. First and foremost is that the existing federal database on mental health records is far from perfect. There are thousands of Americans suffering from undiagnosed mental illnesses that go unrecorded. Similarly, the criteria for gun-disqualifying mental health records may be biased to some extent. From the public opinion, about 48% consider the mental health system to be highly accountable for gun violence in the United States as compared to the 40 % who blame easy access to firearms (Swanson et al., 2015). 

 Policymakers need to view the failing of mental health institutions and gun violence issues as two extremely different public health concerns. Similarly, while addressing them, they need to support evidence-based policies, rather than supporting tainted opinions from the public often fueled by sensationalized media coverage.

 The way forward is to promote public safety without compromising the rights and privacy of people with mental illnesses. The mental health system needs to not only address untreated mental illnesses but also improve the public image of mental health to reduce social stigma and stereotypes. As Everytown (2015) suggests, to reduce gun homicides and assaults within cities, leaders and legislators must invest in community-driven, evidence-based interventions.  A proposal for an evidence-based intervention would be that proposed by the National Rifle Association on establishment of a database of mental illness individuals by networking gun violence. The advantage of networking gun violence is that it allows access to personal information of the victims including mental health issues. In that case, the system will be able to offer individualized support that will serve the needs of the victims and that of his family and community. For the intervention to work, Papachristos and colleagues recommend flexibility and collaboration among the various groups such as police, social support groups, and the community.  With an accountable database of mental illness persons, the government can effectively establish programs that reach out to all mental illness individuals across America, boosting the mental health system.

 

References

 Butler, O., Yang, X. F., Laube, C., Kühn, S., & Immordino‐Yang, M. H. (2018). Community violence exposure correlates with smaller gray matter volume and lower IQ in urban adolescents. Human brain mapping39(5), 2088-2097.

Everytown. (2015). Violence Intervention Programs | Everytown. Everytown. Retrieved 18 March 2021, from https://everytown.org/solutions/violence-intervention-programs/.

Kangas, J. L., & Calvert, J. D. (2014). Ethical issues in mental health background checks for firearm ownership. Professional psychology: research and practice45(1), 76.

Margetta, R. (2011). In conversation with sociologist Andrew Papachristos: Analyzing how gun violence affects high-risk populations. Retrieved 30 June 2016, from https://news.yale.edu/2016/06/30/conversation-sociologist-andrew-papachristos-analyzing-how-gun-violence-affects-high-risk

Milliken, C. (2019). Using maps and networks to reduce gun violence. Retrieved 19 March 2019, from https://news.northwestern.edu/stories/2019/03/using-maps-and-networks-to-reduce-gun-violence/

National Research Council, & Committee on Population. (2013). US health in international perspective: Shorter lives, poorer health.

Swanson, J. W., Easter, M. M., Robertson, A. G., Swartz, M. S., Alanis-Hirsch, K., Moseley, D., … & Petrila, J. (2016). Gun violence, mental illness, and laws that prohibit gun possession: evidence from two Florida counties. Health Affairs35(6), 1067-1075.

Swanson, J. W., McGinty, E. E., Fazel, S., & Mays, V. M. (2015). Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy. Annals of epidemiology25(5), 366-376.

 

 

 

 

 

 

 

 

 

 

 

 

 

Appendix

Appendix A:

Communication Plan for an Inpatient Unit to Evaluate the Impact of Transformational Leadership Style Compared to Other Leader Styles such as Bureaucratic and Laissez-Faire Leadership in Nurse Engagement, Retention, and Team Member Satisfaction Over the Course of One Year

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