Understanding Guns And Mental Health Through A Clinical Lens
“There are far too many unnecessary gun deaths and something needs to be done about it.” This is a statement that just about everyone in a healthy state of mind would agree with, whether you consider yourself pro-gun, anti-gun, or gun-neutral. That being said, what is being done about it? From my perspective, there is a pattern that all too often occurs: A shooting happens and lives are lost unnecessarily – The Gun side blames the Mental Health side – The Mental Health side blames the Gun side – Nothing happens – Repeat.
Some believe that tighter restrictions are the answer and some believe that more emphasis needs to be put on mental health. Who is right? Are the people involved in these conversations and making these decisions knowledgeable enough to do so? Most importantly, are the Gun and Mental Health sides working together?
I am a Licensed Professional Clinical Counselor (LPCC) based out of Alliance, OH. In 2018, I fell victim to a home invasion that resulted in acute stress symptoms. Fortunately, I was not at home while the invasion took place, but I wanted to be prepared should something like that happen again. This led to me acquiring my first gun. Wanting to be a responsible gun owner, I invested in practice time at the range, took training courses, watched tutorials, read articles, talked to other gun owners, and acquired responsible storage. Essentially, I stumbled upon a new hobby and immersed myself into the culture.
As someone who now walks openly in both cultures, those cultures being Gun and Mental Health, I have learned that these cultures/terms are not mutually exclusive. The only way that we are going to be able to make a dent in unnecessary gun deaths is if we work together. How do we do that? Let’s dive in!
Death by Firearm
Before we get to finding a solution, it’s important to have a better understanding of the problem. While it may surprise you, the correlation between gun violence and mental health is actually rather weak.1 Between 2017 and 2020, 60% of gun deaths were due to suicide, 38% homicide, and 0.3% mass shootings2. To put this into context, 59 people were killed in 2017’s Route 91 shooting in Las Vegas, NV; the deadliest mass shooting in US history, while 74 people die each day from gun suicide.
If suicide accounts for more than half of annual nationwide gun deaths, why is it that mass shootings get more attention? The sad reality is that mass shootings get more buy-in and ruffle more emotional feathers. With these stats known, it’s obvious that if we are going to effectively reduce unnecessary gun deaths, suicide is where we need to start focusing.
A Gallup study revealed that 32% of US adults own a gun and 44% report living in a household with a gun. I have not found any studies that include minors in these stats, but it is safe to assume that this would increase this number to well over 50%. That means that at least 1 in 2 patients who enter a counseling office either own a gun or live with someone who does. A big question to ask is if these guns are being responsibly stored – Are they out of access to guests, depressed family members, and/or teens? More importantly, are mental health professionals competent enough in this area to have these conversations with their patients?
Why won’t gun owners seek help?
Now that we have established that suicide is the biggest factor in gun deaths, the next obvious step is to get help to gun owners who are struggling. But this poses another problem – Several gun owners are afraid to seek care due to fear of rights restriction. People own guns for many reasons; protection, hunting, recreational shooting, collecting, etc. Consider those, like myself, who have acquired firearms for protection or go target shooting as a form of self-care. What about families who hunt together and pass guns down from generation to generation? The thought of losing these rights can be a lot and would very likely do more harm than good.
Currently, 21 states have adopted “Red Flag Laws,” also known as “Extreme Risk Protection Orders (ERPO’s),” “Gun Violence Protection Orders” in California, and “The New York SAFE Act” in New York. While specifics will vary by state, these laws essentially allow law enforcement or family/friends of gun owners to petition that they have their guns removed for a certain amount of time. In 2023, Colorado extended their petitioners to include mental health professionals, physicians, teachers, school counselors, and others. While the logic behind this seems innocent, if this trend continues, mental health professionals who are uneducated in gun culture can inadvertently cause a lot of damage to this community.
What can we, as Mental Health professionals, do?
Something we hear a lot in the mental health profession is, “Meet the patient where they are.” The field also stresses the importance of being culturally competent and continuing our growth in this area. In the simplest of terms, if we, as mental health professionals, are going to make a dent in reducing unnecessary gun deaths, we need to accept and treat the gun community as a culture. Putting our biases aside and understanding the beliefs and attitudes from their perspective will increase our cultural competency and make it easier to have competent conversations in this area.
Being culturally competent with this demographic will help build rapport and trust with patients. Keeping in mind that several people in the gun community are afraid of losing their rights, building trust is paramount. If you are able to learn that your patient has guns, why they have them, and how they are stored, you can better help them them establish a plan should they enter a time of crisis; one that won’t threaten their rights. Because of the stigma that exists between the gun and mental health communities, few resources exist that offer education on this topic; however, there is work being done to close this gap.
Continuing Education
Walk the Talk America (WTTA) is a non-profit organization that is bridging the gap between the gun and mental health communities. A big part of the organization’s mission is to encourage struggling gun owners to seek mental health care without fear of rights restriction while increasing cultural competency related to firearms in mental health professionals. One way that we accomplish this is through the organization’s three-part cultural competency course for clinicians. This course is arguably the most beneficial resource for mental health professionals with a desire to learn more about gun culture.
The first two courses, which can be found on WTTA’s website, are free and qualify mental health professionals for a total of 6.5 continuing education credits (depending on state board regulations). The first course covers suicide stats, cultural factors pertaining to gun owners, safety practices, gun laws, safe storage practices, and ethics. The second course is a deep dive into the world of first responders. You’ll hear first-hand stories from three former first responders, as well as gain a better understanding of the stigma related to mental health care in this community.
In summary, it is possible for mental health professionals to make a dent in gun deaths, but it involves continued education in the area of cultural competence. We are trained to deal with crises and reduce suicidal ideation in our patients. With suicide being the leading cause of gun deaths, we are halfway there to be able to have these conversations. The other half of the conversation is being able to talk competently about firearms and tailoring plans that are patient-specific. WTTA’s free cultural competency courses are great resources to increase cultural competency among this demographic.
The Introductory Course: https://walkthetalkamerica.org/classes-introductory-course/
The Intermediate Course: https://walkthetalkamerica.org/classes-intermediate-course/
Wrong Speak is a free-expression platform that allows varying viewpoints. All views expressed in this article are the author's own.
Pirelli, G. & Demarco, S. (2023). Firearms and clinical practice: A handbook for medical and mental health professionals. Oxford University Press. DOI: 10.1093/med-psych/9780190923211.001.0001
Wiskerchen, J. (2023, January). Creating a ripple: The intersection of guns and mental health. Concealed Carry Magazine, 20(1), 142-145.
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if mental health professionals want to curb gun violence and suicides, they should stop giving out mind altering drugs that are known to cause homicidal or suicidal thoughts.
I have a quibble with the jump from, perhaps, 45-50% of all persons living in a home where a gun is owned to at least 1 in 2 that seek mental health counseling being from that same pool. It may be true, or it may be true that gun owners are proportionally overrepresented or underrepresented in the counseling seekers pool. Without further citation of studies, it is a leap without a net.