Structural competency and the future of firearm research. (May 2021)

• Record Type: Journal Article
• Authors: Metzl, Jonathan M.; McKay, Tara; Piemonte, Jennifer L.
• Is Part Of: Social science & medicine. Volume 277(2021)
• Publication Date: 2021-05
• Subjects: Coronavirus -- Pandemic -- Mass shootings -- Gun violence -- Racism -- Structural competency -- Mental illness -- Firearms -- Antiracism; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2021.113879
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: In this critical literature review we develop a five-part agenda for pandemic-era research into mass shootings and multiple-victim homicides that promotes understanding the psychologies of individual shooters within larger structures and systems. We show how the momentous events set in motion by the COVID-19 virus, and the structural drivers of inequity and racism that its spread exposed, challenge mental health research on gun trauma to better account for broader terrains of race and place, as well as the tensions, politics, and assumptions that surround guns in the U.S. more broadly. Doing so will broaden mental-health interventions into epidemics of U.S. gun trauma, and challenge mental health research better recognize structural biases inherent in its own purview. We frame the agenda through the rubric of structural competency, an emerging framework that systematically trains health care professionals and others to recognize ways that institutions, neighborhood conditions, market forces, public policies, and health care delivery systems shape symptoms and diseases. Developing a structural framework around research into U.S. gun violence addresses the risks, traumas, meanings, and consequences that firearms represent for all communities—and highlights the importance of a renewed focus on mental health and safety for communities of color. Recognizing how gun violence reflects and encapsulates structures helps mental health experts address common sense gun policies within broader contexts—by fighting against structural racism or racially inflected gun policies for instance, or against economic policies that undermine access to mental health care more broadly. Highlights: Propose a five-point agenda for research into multiple-victim gun homicides. Agenda is framed through the rubric of "structural competency". Promotes understanding the psychologies of individual shooters within contexts of larger systems. Mental health research needs to better address structural determinants of American gun violence. Gun research needs to better recognize racializing biases inherent in its own frameworks.