In April, Dr. Anthony Fauci, President Biden’s chief medical advisor, affirmed that gun violence is a national public health emergency. Agreed. Gun violence deaths in 2020 were the highest they’ve been in 2 decades. Ask adults in the UK about shootings on UK soil and recollections of the Dunblane massacre in 1996 might be most common. Any adult in the US who can not name 5 mass shootings in the past 5 years is either sleepwalking or intentionally cut off.
A friend, a doctor in the UK, plays devil’s advocate:
“Maybe it’s too fatalistic to suggest you look on armed shooters as just another risk, like mountain lions or rattlesnakes? The number of guns in the US is so high now that an amnesty, or ban, or other attempt to remove them from circulation, remove temptation and ability, is doomed to failure… Perhaps better to celebrate the vast number of helpful, friendly, peace loving people in your country who, no matter their upbringing, do not take assault rifles to school or work.”
The good doctor would be wise to note that we still strive for harm reduction in relation to animal attacks in the wild. We educate people on risk factors and what to do, and provide medical services to improve chances of survival. Megan Ranney (MD, MPH) offers a 4 step public health approach to reduce deaths from gun violence as well as the grief, PTSD and lost wages that go with each death. However, as Ranney notes, “Considering the number of guns in private hands in America, we’re kidding ourselves if we think that laws alone will fix this problem.” In addition to changes in policy/law that impact behavior, what else would help?
My friend’s point about shifting our focus to those not acting out may have merit, especially in the context of the cumulative effects of multiple serious public health threats — including also the pandemic and racism.
Has your mental health been impacted indirectly? If you are a data person, research has found links between “what people consider to be unjustified police killings and worse mental health in the larger African American community, with the negative impact lasting for three months.” If you are willing to reflect more personally, let me say that you are not alone if the mass shootings in Atlanta, Boulder or Indianapolis made you turn inward for protection, affirming that we carry trauma in our bodies. You are not alone if you become distracted, fixated on the crawl of time while your children are walking home from school. If you’re white, you are not alone if videos of police brutality have shocked your conscience. You are not alone if you are a parent feeling weight, like Dr. Esau McCaulley, from the awareness that through George Floyd’s murder, your children reached “the moment when the monster reveals itself and the shape of the fight becomes clear.” You are not alone if you feel helpless, passively watching COVID- 19 spread across the world. You are not alone if you are disillusioned by the role of governmental public health due to painful history. One doesn’t have to be a direct “victim” of these harms for them to have a negative impact on their mental health. But we don’t talk much about that.
So a snapshot of the trauma may look like this:
Perhaps this woman is facing an accumulation of stressors, including oppression. Perhaps this woman is ambivalent about rejoining crowds post COVID or is weary from gaslighting and/or indifference by leaders. Perhaps she continues to function alongside a decrease in motivation or connection. According to Corey Keyes, in 2003 fewer than 25% of adults age 25- 74 meet the criteria for flourishing. About 10% were languishing, which means they are neither mentally ill nor mentally healthy, as they lack positive emotion for life yet still function. Analysis of longitudinal data (1995 and 2005) shows that people with symptoms of poor mental health now aren’t the people most likely to experience major depression and anxiety in the next decade. It’s those who are languishing today. The analysis found that “nearly 6 in 10 adults (i.e., 49% with moderate plus 10% with languishing mental health) were free of mental illness … but had as high or even a higher risk of developing a mental disorder as individuals who had 1 of those mental disorders in the past.” It seems likely that the percentage of adults who are languishing has increased since 2005.
Promoting positive mental health in a society reeling from a pandemic, racism and gun violence can occur alongside action to address upstream causes of mental health disorders. For sure we need to improve access to, and destigmatize, mental health care. The Wellbeing Lab offers a survey and strategies for improving well-being. And everyone, not just public health professionals, can find space to talk about the truth of what we are experiencing, ideally in a community setting.
One example is Bryan Doerries’ Theater of War. Since 2008 they have been bringing Greek tragedies to communities — military families, prison guards, the unhoused, towns impacted by tragedy — so they can communalize their trauma. (During the pandemic they moved onto Zoom — free upcoming events here.) Community discussion taps a groups’ enhanced capacity to relate to and process emotions. As Doerries says, through the plays and discussion afterwards
“…[we] see that we are not the only people to have felt this isolated or this ashamed or this betrayed — not just because it’s being enacted onstage, but because people around us in this semicircular structure are all validating and acknowledging the truth of what we’re watching.”
Ancient texts connecting us to our own experience — sounds like what we might get from services at a church or synagogue. Dialogue that sparks reflection and desire to share with others — sounds like an affinity group at a school or a podcast like On Being that taps imagination and courage in conversations about life. Different cultures have their own version — please post what you know in the comments below.
Dr. Fauci spoke a truth about gun violence in America. But as important is our willingness to speak the truth about the impact of the public health threats surrounding us — to validate the experience, shoulder the pain, and build resiliency together.
