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Mental Health Care for Children Lagging After Firearm Injury, Study Finds

June 23, 2023 by Janet Essman Franz

A study by UVM researchers and colleagues finds mental health care lagging after firearm injury, which increases risk for serious mental health conditions.

Young shooting survivors are not receiving timely mental health services, which increases risk for serious mental health conditions. (Shuttertock image)

A nationwide study by UVM researchers and colleagues found that children who are victims of firearm injuries are not getting mental health care when they need it most. More than three in five children do not receive mental health services within six months after a firearm injury, according to the study published in the journal Pediatrics. It’s a trend that Christian Pulcini, M.D., M. Ed., M.P.H., assistant professor of emergency medicine and pediatrics, co-author on the study, would like to see reversed.

“Pediatric firearm injuries are the leading cause of death and disability in children across the country. We know that firearm injury is a traumatic event that can lead to serious mental health conditions,” Pulcini said.

In the United States, 11,258 youth experienced nonfatal firearm injuries in 2020. Children who survive firearm injuries are at increased risk for adverse mental health outcomes, such as newly diagnosed trauma-related disorders, substance use, and disruptive disorders. In addition to these disorders, the study found that after injury, the percentage of children diagnosed with bipolar disorder, schizophrenia spectrum disorders, and suicidal ideation/self-injury nearly doubled.

 “Kids who survive are forced to live with the trauma of being shot, and there is a window of opportunity to identify and treat mental health conditions early. It is imperative that primary care physicians, pediatricians, and trauma teams who treat the kids while in the hospital remain cognizant of this to provide timely screening and treatment," said Pulcini.

The emergency department has been the main point of entry for youth experiencing mental health crises.

“We have seen a lot of children come through the emergency department who are discharged, and then come back with mental health issues later,” he said. “We want to try and close that gap to support better identification of mental health issues at the time of the injury.

The study also detected racial and sociodemographic disparities in mental health care access after a firearm injury, with Black youth less likely to have any mental health follow-up than white youth. Researchers examined Medicaid data of children aged 5-17 years with a nonfatal firearm injury, living in 11 geographically dispersed states from 2010-2018. They identified 2,613 children with firearm injuries. They found that the first outpatient mental health visit after injury occurred sooner among children with prior mental health service use.

“Children who received mental health services before the injury were more likely to get them after, suggesting they were already connected and receiving treatment. Children who were white were more likely to receive mental health services within six months after the injury.” said Pulcini. “This is an access problem. To improve outcomes, it is important to prioritize early detection of mental health needs, equitable access to mental healthcare and timeliness of care.”

Read the published study.

View media coverage of the study on Fox 5 Washington, D.C. and ABC22/Fox 44.

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