When O’Neill Assistant Professor Lauren Magee meets with survivors of nonfatal shootings and their family members, she’s focused on their health and well-being.

“We don’t fully understand the ripple effects of the consequences of nonfatal shootings,” she explains.

Magee says that’s because there’s a lack of data and research on the topic—nearly 30 years of missing research, in fact, thanks to a 1996 amendment that stopped most federal research on gun violence and injuries.

She’s working to change that. In 2021, she was named an Indiana Clinical and Translational Sciences Institute (CTSI) KL2 Early Career Investigator awardee. She partnered with several colleagues from the IU School of Medicine to study nonfatal gun violence. They’ve found that survivors and their family members—particularly young family members—suffer both direct and indirect trauma after shootings.

But getting help isn’t always easy. Magee says survivors and their families may not know about or may not be able to access necessary services that would help them heal physically, mentally, and emotionally.

“If we understand the mental health needs of survivors and family members, leaders can work to address the lingering trauma caused by nonfatal shootings,” Magee says. “We talk about health equity and wanting to build healthy communities, but that is not possible if gun violence is part of everyday life for any community.”

That’s what drives Magee’s research.

“My overarching goal is to help prevent gun injuries,” she explains. “Until we advance our society to the point where gun violence isn’t a part of everyday life, I hope to bring awareness to the prevalence of nonfatal shooting injuries, examine and share survivors’ stories, try to improve services for people impacted by gun violence, and provide research and resources for policy makers and survivors.”

She’s been busy keeping to that mission. In 2022 alone, she and her colleagues at the IU School of Medicine published three studies focused on the impact of nonfatal shootings.

Mental health outcomes for survivors and families

The team’s most recent study, released in June 2022, focused on the mental health of nonfatal shooting survivors and their family members.

Key findings:

• A nearly 3% increase in mental health needs for youth family members of nonfatal shooting survivors in the 12 months after the shooting, compared to the previous 12 months.
• The most prevalent diagnoses for these young people were for disruptive behavior disorder, stress and anxiety disorders, and depression and mood disorders.
• Adult gunshot survivors and their younger family members had higher mental health needs after the shooting.

Solutions:

“There is a need for improved trauma-informed services and connection to mental health care for both youth shooting survivors and their youth family members,” Magee says. “These services could come from victim assistance programs within police departments, the health care system, or through other community-based programs or connections.”

Seeking mental health care for gunshot survivors

In May of 2022, the team researched mental health outcomes for nonfatal shooting survivors and how they use the health care system. That study found there are missed opportunities within the health care system to connect shooting survivors with the mental health services they need.

Key findings:

• Overall clinical care utilization and mental health needs for survivors increased in the two years after the shooting, compared to the previous two years.
• Despite higher clinical care utilization, only one-third of survivors received a mental health diagnosis.
• Having a mental health diagnosis before the shooting increased the likelihood that the survivor would receive a mental health diagnosis after the injury, particularly among Black victims.
• Patients with a trusted provider may have been more willing to seek needed mental health services following a traumatic event.

Solutions:

“We need to look at what happens after discharge from the hospital for these survivors, their families, and the broader community,” Magee stresses.

Magee advocates for screening survivors for post-traumatic stress disorder and depression at the time they’re injured but also during follow-up screenings after they’re discharged from the hospital.

“Many survivors may choose not to access mental health or other medical services due to too many other competing interests, such as meeting immediate or basic needs,” she says. “Thinking about their mental health often isn’t even on their radar.”

Nonfatal shootings during the COVID-19 pandemic

To examine nonfatal shootings during the pandemic, Magee and her colleagues at IU School of Medicine brought on O’Neill graduate student researcher, Bailee Lucas. In one study published in February 2022, the team found a significant difference in the rate of shootings and who was injured compared to before the pandemic.

Key findings:

• The rate of nonfatal shootings increased nearly 10% during the pandemic.
• There were substantial increases in the number of female survivors and survivors who were older than 35.
• Nonfatal shootings were most prevalent within neighborhoods that had higher rates of gun injuries, structural disadvantage, and structural racism before the pandemic.

Solutions:

“We need to rethink and expand current gun violence prevention efforts,” Magee explains. “These programs should adapt to address the changes in who is being injured in shootings as well as the larger societal trauma of gun violence.”

Magee says policy changes such as efforts to reduce illegal gun trafficking are important and will make a difference, but the broader issue of gun violence—and its impact on individuals, families, and communities—requires multiple interventions.

“There is no one solution to addressing the impact of gun violence,” Magee says. “It will take interventions on the individual and community levels, things like trauma-informed services that focus on social determinants of health—such as housing, food, access to health care, and mental health care—for people impacted by gun violence but also for entire communities with high rates of gun violence.”