Community gun violence is a public health crisis in the United States and affects people, families, and entire communities every day. Daily nonfatal gun violence in urban communities significantly contributes to poorer health outcomes such as higher rates of depression, anxiety, posttraumatic stress disorder, and functional disability. As a criminologist and health services researcher, I’ve spent the last decade trying to understand the emotional and social effects of nonfatal shootings, as these incidents occur twice as often as firearm-related deaths.
I spent the early part of my career as a crime analyst within a local police department simply trying to accurately count the number of people who had been shot and survived, as there was (and is still is) no comprehensive national database on nonfatal firearm injuries. Now as a professor and researcher, much of my research is aimed at better understanding the direct and indirect traumas of surviving community gun violence on the direct survivor (i.e., the person shot), co-survivors (i.e., families), and entire communities. This research is largely done through partnerships with local community groups who focus on violence prevention and survivor support to ensure the work is helping the people and communities most impacted.
One of the best avenues to learn more about how gun violence is affecting communities is to talk with the people who are directly impacted and ask them about their lived experience after being shot. Yet, we tend to not hear directly from people who have survived community gun violence very often. Therefore, in collaboration with my community partners, in one study we conducted qualitative interviews with 18 survivors of community gun violence. We talked with survivors in the community organization’s headquarters and a community reentry program between June 2021 and January 2022, where we asked survivors to share their experiences through a series of semi-structured questions related to how their shooting impacted their life, how they emotionally healed, and which facilitators and barriers they encountered to seeking mental health care.
As one might expect, survivors discussed their experiences with the physical pain of being shot, often living with bullets inside their body that served as a daily reminder of their shooting. But what was particularly noteworthy was that a lot of survivors were happy to just have someone ask them about their experience. Many said they had never talked about their shooting experience with anyone and participating in the research interview was therapeutic for them.
“Just getting to come here and talk about this. And being able to sit down and meet somebody who is interested in your story. And how you feel about a certain situation, and give you a chance to speak, and let out your ideas. Even the whole, ‘If you had a chance to structure this [prevent gun violence]…’ All of it was cool, man.”
— Survivor who was injured
Research shows injured survivors of community gun violence experience higher rates of posttraumatic stress disorder, anxiety, and depression post-injury (versus pre-injury), particularly among children and adolescent survivors, as compared to non-injured peers. But there is often a stigma that accompanies seeking mental health care among many survivors of community gun violence. Survivors of community gun violence disproportionately identify as Black and due to historical racism and medical mistrust, Black survivors are less likely to seek treatment. Our conversations with survivors confirmed the normalization of gun violence and ignoring the emotional impact. For instance, many survivors we interviewed said they were “fine” and “just needed to move on” from their shooting, yet when they described how their shooting impacted their life, they described every symptom on a PTSD or depression screening tool.
“It’s been more difficult. It’s gonna be that way, because the things you used to do, you can’t do anymore. And that kinda hurts. So you go through your life hurting behind your tragedy.”
— Survivor who was injured
In addition to physical and emotional support, many survivors need support to help them meet basic needs—housing, food, and/or financial support for utility bills. Even less immediately severe firearm injuries can also cause a cascade of events that impact a survivor’s ability to work and pay their bills. Survivors described the importance of having secured basic necessities—a safe place to live and food to eat—before they could think about emotionally healing from their shooting.
Many survivors also mentioned the need to move residences following their shooting, largely due to fear of the offender coming back to “finish the job,” as some knew their assailant. A particularly poignant example of this came from a young man who was paralyzed in his shooting. His apartment complex offered to convert this unit with a wheelchair ramp but he declined because he didn’t want his attacker, who lived in the same complex, to know which unit he and his family lived in.
“Oh, well, my problem was [the apartment complex] was gonna fix everything to accommodate me so I can get in, but I didn’t wanna do that because I didn’t want the people [who shot me] to be able to see this house is accessible for a wheelchair. That would have made our apartment the only apartment accommodated.”
— Survivor who was injured
In addition to the insight these interviews offer, I have gathered data through my work as the research partner for the Nonfatal Shooting Advocacy and Support Program, a novel program based in the Indianapolis Metropolitan Police Department that connects survivors with needed social and emotional services. Preliminary data suggests survivors of community gun violence often need more simple items following their shooting, such as a shower chair or a reclining chair, to help make their recovery more comfortable. Yet purchasing such items can be a struggle due to financial constraints. One older gentleman assisted by advocates in the Indianapolis Metropolitan Police Department, for example, was shot through the walls of his house while he was sleeping. His greatest need after the shooting was a new mattress so he didn’t have to continue sleeping on the bullet-ridden one he had. Few resources for such items exist for survivors of community gun violence, yet even something as simple as a new mattress could have immeasurable benefits for this and other individuals who have been impacted.
There is also an added ripple effect of community gun violence that impacts the family members and peers of those who are shot (i.e., secondary survivors or co-survivors). Family members may instantly become medical caregivers for their loved ones or may have to move residences. They too suffer the consequences of surviving gun violence. For example, one study I led found that family members of firearm injury survivors, particularly children, have even more mental health diagnoses in the year following the shooting incident compared to the direct victim. Yet, we are just beginning to understand the true ripple effect community gun violence has on families immediately following a shooting and longer term research is needed in this space.
How Communities Can Help Support Gun Violence Survivors
There is clearly a great need to support all survivors of community gun violence in their physical and emotional recovery, as well as provide social supports in the post-shooting period. This period, however, is still largely undefined and likely different for each survivor and co-survivor. Resources do exist for survivors and co-survivors, but access can be limited and also may depend on where the survivor lives, their socio-economic status, and/or how they are treated for their injury.
Hospital-based violence intervention programs (HVIPs) seek to provide wraparound services (e.g., case management, counseling, housing assistance, etc.) to survivors after their hospital stay. There is some data to support HVIPs’ role in reducing the risk of re-injury among participants and improving mental health outcomes. More research is needed to ensure programs are working as intended as they expand to more hospital systems and cities.
Local police departments also provide victim services to individuals affected by violent crime. These services, however, have historically served homicide families and not shooting survivors more broadly. Given that police do, however, investigate every shooting incident reported, they are in a unique position to connect survivors with services outside of a hospital setting. These services include those offered by the Nonfatal Shooting Advocacy and Support Program, such as emotional support, connection to community mental health providers, resources for housing support, utility support, food pantries, and help reengage survivors with the local HVIP. The advocates also help survivors fill out the Victim’s Compensation application and provide contact information of the lead investigating detective.
A key piece of HVIPs and the Nonfatal advocacy program is the use of credible messengers to build rapport with survivors and help enroll them in services. Credible messengers are viewed as trusted sources for survivors to connect with because they have often had similar lived experiences. For instance, the NFS Program’s personnel are gun violence survivors themselves, including parents and siblings of children hurt and killed. Similarly, community-based organizations and interventions utilize credible messengers, violence interrupters, other survivors, and mentors to better connect with survivors, as they can often identify with the journey and circumstances the survivors are experiencing.
Resources for survivors are available through local organizations that provide food pantries, housing assistance, mental health services, and more, but there is no systematic way to connect survivors with such resources at present. Informal social networks and a friend-of-a-friend often connects survivors with community groups who can provide the needed emotional, social, and violence prevention services. Such community groups often operate with limited resources to serve each person in need. Coordinated resources could help to improve the healing journey for survivors and co-survivors.
“But I didn’t get connected through nobody but a friend of a friend. You know what I’m saying? They connected me to them.”
— Survivor who was injured
Survivors of community gun violence often heal from their injury alone and/or informally through family and friends and regularly have concurrent and competing priorities (e.g., determining where to live vs. focusing on healing) following their shooting. Although my and others’ research has incorporated the unique perspectives of survivors and co-survivors, more programs should account for these experiences to ensure that resources and services provided are not only available to them, but meet the needs of those who have been impacted. Programs such as Life After the Gunshot and The Second Trauma include survivors’ voices into the conversation through unique methods such as digital storytelling. Their experiences can also help to better inform primary, secondary, and tertiary prevention programs. Researchers, grant funders, and policymakers could further support partnerships with community groups in order to achieve this, so that survivors of community gun violence can receive the best resources possible in their healing journey.
ABOUT THE AUTHOR
Lauren A. Magee is an assistant professor in the O’Neill School of Public and Environmental Affairs at Indiana University Indianapolis and Affiliate Scholar with the Regional Gun Violence Research Consortium at the Rockefeller Institute. She is a criminologist and health services researcher, with an interdisciplinary research agenda focused on preventing firearm injuries, reducing health disparities within communities, and identifying opportunities for intervention among people impacted by firearm violence.