Citation

The Lancet Psychiatry. Lancet Psychiatry 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Elsevier Publishing)

DOI

10.1016/S2215-0366(20)30266-2

PMID

32526157 PMCID

Abstract

In early April, 2008, as the USA was in the midst of its worst economic crisis since the great depression, then presidential candidate Barack Obama described people in rural, small US towns as responding to tough economic times by "clinging to their guns and bibles". Although considered a political gaffe, the evidence-- with guns, if not with bibles--supports his view; US gun sales increased in the wake of job losses and economic disaster and have continued to rise as rural communities still struggle, having never fully recovered from the "great recession". As bad as the 2008 US economic recession was, the economic fallout from the COVID-19 crisis has already dwarfed it several fold, with over 40 million new unemployment claims filed since March. True to form, US gun sales have skyrocketed, with over 2 million reported sales since the COVID-19 outbreak began across the country.

As in other countries, the US mental health community is preparing for a wave of mental illness and poor health outcomes owing to COVID-19 that could persist for years after the virus is under control. Although the precise form the problem will take is difficult to predict, we can be sure that this year, like the year before, and the year before that, the USA will lead high-income countries in per capita gun deaths, including homicides and suicides. We can also be confident that more guns will lead to even higher rates of gun deaths. When mixed together with a cratering economy and the highest levels of social inequality in decades, there is little doubt that guns will play a primary role in pushing higher the US's already high preventable death rate, and should therefore be high up on the list of priorities for the US mental health community.

Advocating for fewer guns is necessary, but far from sufficient; the US mental health community will have to be much bolder and braver if it wants to lay a groundwork for real change with gun violence in the coming years. Any serious advocacy and research effort must address the role that racism plays in the US's attitudes towards guns and gun-related deaths. As we have discussed previously in the pages of this journal, the only time gun violence is even discussed among US policy makers is after mass shootings. But despite their tragedy, these only represent a small fraction of gun-related deaths each year in the USA.

Language: en