The initial reaction to the most recent mass shooting, this one at a high school Florida, followed all the predictable fanfare that these things tend to follow. People upset, arguments occur, nothing really happens other than a festering anger that has been building in parents and children alike to address a clear danger in public spaces. But then, a slightly different feel came about. It seems the other students at Marjory Stoneman Douglas High School in Parkland, Florida have been given a bit of a voice and have answered admirably.

Their healing on display for everyone, surviving such an event makes therapy a necessity. Sometime after the Virginia Tech shooting occurred in 2007, I recall an administrative push to reach out to literally EVERY student and offer free counseling services. Such a thing could be a positive move for the felled Florida high school, and chances are they are already working hard at providing such things. 

In addition to the clear need to facilitate healing practices among those directly and indirectly affected by this tragedy, there is an underlying need to provide adequate resources to people BEFORE shootings like this occur. The perpetrator of this, the worst high school shooting in the States, had issues with Attention Deficit / Hyperactivity Disorder and Autism, according to a report by the Washington Post. Glaring warning signs presented themselves, so glaring that even the FBI became involved. 

To match, the school's counseling resources were very limited, not meeting the prescribed school counselor to student ratio of 250:1. So when the young troubled man came in with the anger and rage that teenage-hood can sometimes bestow on a broken heart, it was already too late. It is reasons like this that the majority of Americans now believe that inadequate mental health resources contribute more to mass shootings than gun control. With a suicide to homicide ratio of 3:2, I tend to agree. There are not enough therapists in the world to deal with this...

https://slate.com/news-and-politics/2018/02/abc-and-washington-post-poll-finds-americans-blame-mental-health-more-than-gun-control-for-shootings.html
  

 Here we go again. Another day, another mass shooting. This type of thing has occurred with such regularity that the American populace is slowly becoming numbed to it. Yesterday, a gun man, working alone, took out 26 innocent church-goers before being killed himself. Here is an article from the Washington Post about the incident:

https://www.washingtonpost.com/news/post-nation/wp/2017/11/06/investigators-hunt-for-motive-in-texas-church-shooting-as-the-grieving-spans-generations/

Perhaps there will be a little bit of conversation about gun rights, surely this will take up a day or two of our 24 hour news cycle.

Will we take actionable steps towards changing things though? Probably not. It does not seem to be in our blood at this point. Mostly because we haven’t the faintest idea of what to do about it. It would require a comprehensive strategy of identifying non-violence groups in neighborhoods and mapping their assets. Then facilitating the development of a local, community based strategies that include a list of actionable steps towards this common goal. It requires significant evidence to be collected in order to pin point where the requisite resources should be applied.

This “all hands one deck” type of strategy that leverages existing mental, behavioral, and public health resources is rarely discussed. Instead, we meekly suggested SOMETHING should be done, and that that SOMETHING should require a law that limits the sales of guns and provides larger background checks, etc. The problem is, most of these individuals claiming responsibility for these heinous acts would still slip through the cracks, even with new laws in place. Additionally, the black market for gun sales is, and always will be, a very real issue.

So let’s take a moment to reflect on what actually needs to be done, because we are due for another “shocking” mass shooting in three weeks or so. Harnessing the power of our mental, behavioral, and public health resources is crucial, but we will probably not hear about this from the major news outlets, we will have to make this happen on our own. 

There is almost an agreement. There is an acknowledgment on both side of the gun control argument that bump stocks, the technology that can convert a legal assault rifle to an illegal automatic assault rifle, should be banned. The only question is, how?
 
The NRA feels that the authority lies with the Bureau of Alcohol, Tobacco, and Firearms (ATF). However, a legal expert for the ATF, Rick Vasquez, has already deemed the issue legal from their standpoint. You see, a bump stock does not make a gun “fully automatic” in the eyes of the technical expert. Therefore, it cannot be considered an illegal gun.
 
Others believe that Congress should be more explicit with their automatic weapons ban and include technologies that can convert semi-automatic weapons to fully automatic weapons just like the bump stock. This would be a more inclusive piece of legislation that recognizes how conversions can increase the lethality of a mass shooting.
 
Either way, it seems that we can all agree that bump stocks are a tool that make something legal, into something illegal and more lethal. And on that note, it seems that because a bump stock is not a gun, its manufacturers can be sued for loses attributed to its sale (third party injury is usually protected when it comes to gun manufacturers, by the 2005 Protection of Lawful Commerce in Arms Act).
 
Of course, this may limit the lethality of mass shootings, but it still does not get to the ROOT cause. What actually caused this man to walk into a hotel, perch up on the 32nd floor, and indiscriminately shoot concert-goers? Proactive solutions will always be more effective than reactive solutions, but those solutions are difficult when the man appears to have no motive other than some perverse thrill he wanted to give himself upon his Earthly Exit.
 

As we come to the end of May, it is important to remember one more time that this month has been Mental Health Awareness Month (http://www.mentalhealthamerica.net/may/). It is a time to recognize the struggles that many face simply getting on with their day-to-day lives, and reflect on our own mental health challenges. An abundance of research now exists about the role of our behaviors in diagnosing and correlating mental illness. These behaviors can sometimes be linked to the environment. Therefore, mindfully changing the environment can help change a behavior.
 
When diagnosing a mental illness (https://www.psychiatry.org/patients-families/warning-signs-of-mental-illness), doctors tend to look at how a person is feeling, a person’s cognitive functioning, and their behaviors. The affect of an individual can indicate a person’s emotions on a deep level. However, if it is not self-reported, it is communicated in terms of behaviors: “My friend/family member is acting cold and withdrawn.” Likewise, a person’s cognitive functioning requires a description of doing: “He couldn’t even remember his own phone number.” These behaviors coalesce into a rounded form of information that can lead to a formal psychiatric diagnosis.
 
Behaviors, when performed over and over, become habits. Habits such as sleeping too much are linked to depression (http://www.webmd.com/sleep-disorders/guide/physical-side-effects-oversleeping#1/). Habits such as sleeping too less are linked to psychosis (http://serendip.brynmawr.edu/exchange/serendipupdate/effects-sleep-deprivation-brain-and-behavior/). And of course, habits such as substance abuse become their own diagnosis (https://www.centeronaddiction.org/).
 
These habits are all made possible by the schedule a person keeps because of their position in life. Someone who has to work a full-time job and then go to school every night might have a tougher time getting the sleep they need. Someone who works from home may be getting too much sleep. These habits are made possible partially by a person’s employment. Of course, we all have the position in life to change our own behavior. Author Charles Duhigg writes about how to change a behavior given the science of habit loops in his book “How Habits Work” (http://charlesduhigg.com/how-habits-work/).
 
So if you are feeling depressed, consider scheduling some time for a little exercise. If you are having weird thoughts about your neighbor, try getting a good night’s sleep. And if you’re having trouble with an addiction, be it coffee or heroin, try replacing the behavior with something more healthy but still reward-rich. And of course, have a good life the entire way!

The Baltimore-based initiative to provide a safe place for community members to go to in times of conflict just got rotated a few degrees. Last week it was discovered that the program would have its state funding cut entirely from $1M down to zero. In a panic, advocates of the program rallied to the call of their fallen cause:

                               Read about the rally to restore the Safe Streets initiative here.
 
Then on Monday, Maryland Governor Larry Hogan announced that the initiative would indeed be fully funded, and then some. Just over $2M is to be appropriated to the program, taking the number of locations and neighborhoods it represents from 4 to 9. But there is a catch, the program will have to work with the Opiod Task Force to find ways to cut down the heroin use in the state, and its so far unclear whether the new locations will be in the most dangerous Baltimore neighborhoods or will be shipped off elsewhere.

                               Read about the new grants in relation to Baltimore here.

The new program directive to help eradicate heroin is certainly a noble one, however, it could also mean stretching a fledgling project too thin, while limiting resources to its progenitor: Baltimore. Time will tell at this point. One thing is for sure, the program’s efficacy makes it a worthwhile investment.

                               Read the evaluation of the Safe Streets Initiative from Hopkins here.
 

​"Assault Weapon" is an interesting term. Made to categorically remove semi-automatic rifles like the AR-15 from the rest of the lexicon, it stems from a belief that we should rank weapons according to their destructive power and then legislate accordingly. Shotguns sure do “Assault”, so do semi-automatic handguns. Not entirely arbitrarily but mostly so, we section these dangerous weapons off in an effort to curb the homicide rate in the US.
 
We’ve done it before. Between 1994 and 2004, the Public Safety and Recreational Firearms Use Protection Act made the manufacture (but not individual possession) of assault weapons illegal. The result? According to data compiled from US Crimes and Suicide Data, a 38.9% decrease in the homicide rate and a 6.7% decrease in the suicide rate relative to the start of the ban in 1994. 
 
But we should look at the broader picture. What happened in the decades following and preceding the ban? In the decade before the ban, 1984 to 1994, there was an 13.9% increase in the homicide rate and a 5.6% decrease in the suicide rate. In the decade following the ban, 2004 to 2014, the homicide rate decreased by 18.2% and the suicide rate increased by 16.2%. Well that’s interesting.

On the one hand, we seem to be riding a wave of decreasing violence with or without the ban. On the other, an Assault Weapons ban appears to have had a substantial impact on the homicide rate. Add to that, almost as a depressing icing on a morbid cake, our suicide rate has risen an alarming amount (mostly, an increase in Veterans' suicide rate).

Here's a table for summation:

What are the take-aways, in terms of increase constituent safety holistically?

1. Mental Health resources need to be increased, especially among veterans.
2. An Assault Weapons Ban (of the manufacture, but not possession of) could be helpful in continuing to decrease the national homicide rate.
   
3. As violence continues to fall, we must constantly be learning from the effects of different legislation, so as to corner and eliminate the problem as best we can. 

There are times where our largest achievements go unnoticed and the largest achievers go unrecognized. 
 
Kenny Barnes is well known by many, and has been a leading advocate against gun violence since the brutal murder of his son, Kenny, Jr., by a 17 year old youth in 2001.  Although he has been recognized by media, awards, proclamations, and by those on the forefront of the campaign against gun violence, he has somehow been excluded from the national dialogue, and not included with those voices that are offering recommendations and seeking solutions.
 
Furthermore, Mr. Barnes believes firmly that gun violence, and its accompanying youth violence, is a public health/mental health crisis and not a legal issue; that 2nd amendment arguments and debates cloud the real issues of the causes of gun violence; and that legislation, though a part of a comprehensive strategic approach to reducing gun violence, is not, in and of itself, the panacea.
 
In fact, among Mr. Barnes' many accomplishments was the introduction to Congress in 2009 by Congressman Bobby Rush of a public health model for reducing gun and youth violence, entitled The Community in Action Neighborhood Defense and Opportunity Bill, The CANDO Bill –HR1303. This Bill is the only one of its kind ever introduced in Congress to address the reduction of gun violence from a comprehensive, public health perspective.
 
In addition to having proclamations introduced on both the Senate and House floors by Senator Carl Levin and Congressman Bobby Rush, respectively, ceremonial proclamations and resolutions have been introduced in Washington, D.C., along with 2 days named in his honor in Prince Georges County, Montgomery County, and Boston, Mass.
 
Mr. Barnes has been at the forefront of organizing the D.C. community in blocking attempted efforts by others, including members of Congress and the Senate, to change the gun laws as they exist in the District of Columbia.
 
His reasoning, unlike many others, is not based on 2nd amendment issues, but on autonomy.  His rallying cry was that only D.C. residents should decide what regulations regarding gun laws should be imposed in the District of Columbia.  His efforts with respect to his involvement include:
 
▪  Serving as a friend-of-the court, “amicus curiae,” for the landmark decision by the U.S.  Supreme Court, District of Columbia v. Heller.
▪  Senate Majority Leader Bill Frist was dissuaded in his attempt to introduce legislation that would have drastically changed the D.C. gun laws.  After a compassionate meeting with Senator Frist’s chief of staff, led by D.C. Delegate Eleanor Holmes Norton, Mr. Barnes, and Ms. Marita Michael, Senator Frist withdrew his support for the Bill.
▪  Mr. Barnes organized the effort and helped lead the charge against the Ensign Amendment, introduced by Senator John Ensign, which led to its demise.
▪  Mr. Barnes organized and facilitated the campaign and subsequent press conference to denounce S. 3265/H.R. 5162, “The Second Amendment Enforcement Act," together with the D.C. Mayor, the entire City Council, various local and national organizations, and victims of gun violence, all organized by Mr. Barnes, aligned to express opposition to this legislation which was introduced by Senators John McCain and Jon Tester. Based on his efforts, Mr. Barnes was instrumental in having these Senators withdraw their support for the Bill.
 
In April, 2013, Mr. Barnes was selected by the Rotary Club Foundation and the National Rotary Club as one of 10 Rotarians chosen throughout the United States to be presented to the White House as a Champion of Change during Rotary Day at the White House.
 
Mr. Barnes was the recipient of the 2009 National Service Award presented to him by the Attorney General of the United States, Eric Holder during National Victims of Crime Week. This honor is the highest award to an individual based upon their work on behalf of victims of crime.
 
Finally, perhaps his greatest achievement to go unrecognized is that Mr. Barnes may be the only person in the country to have met or discussed with the following organizations, institutions, and individuals in a true quest to set aside differences and work together collaboratively in an effort to reduce the incidents of gun violence:
 
▪  Wayne LaPierre & the National Rifle Association - NRA
▪  The Brady Campaign
▪  The NAACP
▪  The Campaign to Prevent Gun Violence
▪   Dr. Abby Spangler, Founder, Protest Easy Guns
▪  The Vera Institute of Justice
▪  Johns Hopkins University School of Public Health
▪  Howard University
▪  Debbie Weiss and the UCLA School of Public Health
▪  Dr. Carl Bell, Director of Public Health & Community Psychiatry, the University of Chicago
▪  Dr. Deborah Prothrow-Stith, Associate Dean & Professor of Public Health Practice, Harvard 
 University
▪  Lt. Gov. Michael Steele of Maryland

(Article written by Barbara Hanson of HHM Consultants, Inc. - www.hhmconsultantsinc.com)

Cities across America are facing a gun violence epidemic and Baltimore City has been amongst the hardest hit. Last year, a spike in homicides put the area at a record high rate of 55 per 100,000 people. Right before the memorial day break, the count for murders during 2016 passed the century mark. This gives a projected annual rate of 39 per 100,000. A slight improvement, but still not good enough.


                                                          Read the article from the Baltimore Sun.


The spirit of the city is quite a bit calmer, and more people are talking about social change. However, the urban renewal projects set in place to try to create an environment that naturally deters violence still have much work to do, as these things to not happen overnight. 

I came across an article recently that described the relationship of gang membership with suicide attempts. While everyone seems to know about how gang violence increases the amount of homicides on the streets, perhaps more surprising is the its relationship to self-inflicted injury.

                                                            Read the full article here.

It describes a study from the journal of Criminal Justice and Behavior that found that gang members are TWICE as likely to attempt suicide as the normal population. The risks and highly stressful environment of street violence has an enormous affect on those who participate, and the results are extremely tragic. 

As we continue in the fight against gun violence, we find that the symptoms we see are so often a terrible summation of past traumas that congeal into a formidable effect of unpredictability and aggression. Intervening in these situations as mediators and therapists gives us the best chance of properly dealing with these issues.   

When we talk about gun violence, something always gets left out. We fear mass shootings and terrorist attacks, but more often than not, a violent act committed with a gun is committed against oneself rather than others. According to the CDC (http://www.cdc.gov/nchs/fastats/suicide.htm) there are 6.7 suicides by guns per 100,000 people, compared to only 3.5 homicides. The overall rate of suicides and homicides (with or without a firearm) is 13 and 5.1 respectively per 100,000 people.
 
Given that there are twice as many suicides as homicides, why do we focus so much on mass shootings? They certainly affect us emotionally. They drive into us fear that it could happen to us, but when you look around you, you are more likely to have a friend or family kill themselves then die by the hand of another.
 
This is why we argue for a public and mental health perspective on gun violence. Identifying key triggers to suicide can help to save lives. Allocating resources to high risk areas and demographics (males age 18-34 are especially at risk) can go a long way to reduce gun violence that is expressed against oneself. This is an important step, and one of many, involved in properly addressing gun violence.