Gun violence survivors may hesitate to seek mental health care despite trauma, new study found

If you or someone you know is struggling or in crisis, call or text the mental health crisis and suicide prevention number 988 or chat at 988lifeline.org.

Despite the psychological toll of being shot by a firearm and surviving, victims may not seek mental health services from licensed professionals due to stigma, fear, and a lack of trusted resources, a new study found. 

Gun violence, a pervasive problem all across the U.S., disproportionately affects young Black men and people in economically disadvantaged communities. 

Experts say that research and data in this field often focuses on fatal attacks. There isn’t an official national definition of a nonfatal shooting incident, nor a data repository. According to the Brady Center to Prevent Gun Violence, more than 75,000 people in the United States survive a firearm injury every year –– nearly double the number of people who die from gun violence.

Victims of nonfatal shootings are at risk of developing post-traumatic stress disorder (PTSD), depression, and substance use disorder. The new study out of Indiana University’s O’Neill School of Public and Environmental Affairs suggests that people with these mental health needs often do not seek professional help.

“What we found is that survivors noted that they felt like they needed to be fine and that they needed to quickly move on from their shooting, despite having described symptoms of PTSD and depression and anxiety, and [that] there was no need for mental health services,” Lauren Magee, the lead author of the study, said. 

Researchers interviewed 18 participants who survived a firearm injury. The majority of them said family members, friends, and informal networks are their main source of emotional support. 

“They felt like the providers that they did talk to, if they did engage with services, didn't understand their lives, or the communities in which they live in and therefore weren't able to actually provide them any useful resources or a way to heal,” added Magee. 

In an excerpt from one of the study participants' interviews, he talked about his mental health provider: “She’ll sit there and talk and listen to me about stuff. It’s just, I feel the only thing about her is that we’re from 2 different worlds,” one participant said of his experience with his therapist.

Other participants show said they may be worried about getting in trouble or getting someone else in trouble with the law if they open up and share with a mental health professional. 

Gun violence survivors often have a unique set of challenges. For example, they have a deep fear of retaliation. The seemingly mundane act of just being out and about in the community can feel insurmountable to them. This interferes with some of the established treatment methods for PTSD and other forms of trauma-induced mental health issues. 

One of the common methods of treating someone who is afraid of going out in public due to PTSD is through what’s known as exposure therapy and cognitive restructuring. This aims to help them manage their fear by gradually exposing them to the trauma they experienced, and part of it can be through visiting the location where the traumatic event took place. This helps restore their sense of safety. 

“That's not necessarily possible with a survivor of firearm violence,” she said. “Survivors told me that they won't ride the bus, they lay in the back of a car, and they won't leave their houses for the fear of their offender, the person who shot them, seeing them out in public.” 

The study identified two key factors that could help survivors seek mental health care: a safe space and a credible messenger. 

One-third of the study participants said that the research interview was the first time they had discussed their shooting. They felt comfortable doing so because of the privacy and anonymity. 

Magee said it is crucial to connect survivors of firearm injury with community resources and to make sure that these community organizations have the resources to sustain this work. 

The impact of gun violence also extends beyond those who were struck by the bullets. The study highlighted the impact of nonfatal shootings on family members and friends  and the important role they play for victims of firearm injury.

“There's a larger ripple effect of firearm violence into the communities and that it's not just the direct survivor, but it's the families that are also impacted,” Magee added. 

The dearth of local and national data on survivors of gun violence and their families hampers our understanding of the true toll of gun violence and how to address it. But more research on gun violence from a public health lens, like Magee’s, is emerging. 

“It's really important to include the voices of the survivors, and the people [who] have walked this journey, into what these solutions look like going forward and how we can better connect survivors with these resources,” Magee said.

Below is a list of community resources that are available: 

• Prescription for Hope
• 317 Progression: https://www.indynfsresources.com/
• Purpose for my pain: https://www.purpose4mypain.org/
• The Phoenix Nicolas Center: https://phoenixnicholascenter.com/

If you or someone you know is struggling or in crisis, help is available. Call or text the mental health crisis and suicide prevention number 988 or chat at 988lifeline.org.

Contact health reporter Alex Li at ali@wfyi.org.