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When the Shooting Stops: The Impact of Gun Violence on Survivors in America [1]

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Date: 2023-01

Executive Summary

“We can only learn to live with it and through it—[it] never goes away.” —A gun violence survivor

The trauma of gun violence doesn’t end when the shooting stops. Across the country, people from all walks of life have been impacted by this public health epidemic: in a national poll, 58 percent of adults reported that they or someone they care for have experienced gun violence in their lifetime. More people die from gun violence by early February in the United States than during an entire calendar year in other high-income countries. In addition, millions more in the United States are shot and wounded, threatened with a gun, or witness an act of gun violence in their lifetime. For this reason, Everytown for Gun Safety marks National Gun Violence Survivors Week annually in February.

Experiencing gun violence has lasting emotional, physical, legal, and financial impacts on survivors as well as their communities. The breadth and diversity of the survivor experience is directly related to the wide-ranging nature of America’s gun violence crisis. Gun violence can take many forms, including gun suicides and suicide attempts, gun homicides and assaults, domestic violence involving a gun, school shootings, shootings by police, and unintentional shootings, among other incidents. Identifying as a survivor of gun violence encompasses many different experiences: witnessing an act of gun violence, receiving threats with or being wounded by a gun, or having someone you know or care for wounded or killed with a gun.

Yet America’s culture of silence around gun violence means that too often we do not talk about or fully understand the lifelong impact on survivors. One of the consequences of this silence is that many survivors of gun violence do not receive the support and services they need to live with their trauma and heal. There is also the mistaken assumption that surviving gun violence is something survivors “get over,” while the impacts are actually lifelong, profound, and complex.

To help shatter that silence and elevate the voices of survivors in the national gun violence prevention conversation, Everytown for Gun Safety Support Fund (“Everytown”) conducted a wide-ranging survey of more than 650 survivors from October to mid-November 2021. We collected data about the type of gun violence that survivors have experienced as well as the stories of survivors in their own words, while allowing respondents to remain anonymous. Together, the data illustrate the magnitude of America’s gun violence epidemic and its lasting impacts on individuals and communities. Among the key findings are as follows:

Nine out of 10 gun violence survivors report experiencing trauma from the incident.

More than half of those who had experienced gun violence within the last 12 months were most likely to rate the impact of trauma as a 5 out of 5, meaning that trauma frequently affects their well-being and/or their functioning.

Half of survivors reported that they experienced gun violence in a home: their own, a neighbor’s, a friend’s, or a family member’s.

Nurses, doctors, and medical or hospital staff were the most likely to say they experienced the impact of gun violence through their work, followed by people who work at schools, including educators and staff.

Two-thirds of survivors who were shot and wounded expressed the need for mental health services, therapy, and support. They also expressed the need for legal assistance as the victim of a crime ( 49 percent ); financial assistance to deal with medical expenses such as physical therapy, rehabilitation services, and surgical equipment (40 percent); home health care (25 percent); and help covering funeral related expenses (7 percent).

); financial assistance to deal with medical expenses such as physical therapy, rehabilitation services, and surgical equipment (40 percent); home health care (25 percent); and help covering funeral related expenses (7 percent). Nearly one in three survivors said that they needed legal assistance as a victim or for the death of a family member.

One in three survivors said they needed financial support to help cover funeral costs or medical costs, or to make up for income lost because of death or injury.

This report is divided into five sections discussing bereavement and grief from gun death, healing after gun injuries, living in fear of gun violence, the impact of persistent gun violence, and recommendations for how to better support survivors and prevent violence.

We strive to center the experiences of survivors, and through this work we hope to honor them by providing a deeper understanding of who they are, what they have experienced, and how we can better support them.

Introduction

“Dealing with the inconsistencies of healing, both physically and emotionally. The existence of being this gray person in a world where everyone else sees everything as black and white. I’m either completely fine and it’s over and done, or I’m this wounded person who can never be functional—the lack of understanding that I am not really either, but some days may be one or the other….” —A gun violence survivor

America’s gun death rate—which is 13 times higher than that of other high-income countries—makes us a global outlier. Every year, more than 40,000 Americans are killed in acts of gun violence, and approximately 85,000 more are shot and wounded. That is the equivalent of over 110 people shot and killed each day in the United States, with more than 200 others shot and wounded. The crisis disproportionately impacts Black, Latinx, and other communities of color.

The US Gun Death Rate is 13 Times That of Other High-Income Countries. Source: Everytown analysis of the most recent year of gun deaths by country (2015 to 2019), GunPolicy.org (accessed January 7, 2022).

With death and injury tolls this high, America is undeniably a nation of gun violence survivors. But the impact of gun violence extends far beyond those killed or wounded. Witnessing an act of gun violence, being threatened with a gun, or having a loved one wounded or killed with a gun also makes someone a gun violence survivor, among other experiences. A poll found 58 percent of American adults or someone they care for reported experiencing gun violence in their lifetime.

Results from Everytown’s survivor survey, which included responses from over 650 participants, provide an in-depth look at the experiences, needs and perspectives of gun violence survivors and present data to inform support services and gun violence prevention work going forward. Much of the rich material in this report going forward that captures the voice and perspectives of survivors, including many verbatim quotes, are taken from this anonymous survey.

While several very valuable surveys of survivors have been done in the past, this one is the most geographically comprehensive (with respondents from 46 states) and the broadest, looking at gun violence survivors across the full scope of types, ranging from mass shootings and intimate-partner gun violence to suicide, community gun violence, and more.

The scope of America’s gun violence crisis means that there are gun violence survivors from every walk of life with a diverse array of experiences.

“No services were ever offered, law enforcement officials seemed more interested in pressing charges against the perpetrator. Myself and my younger daughter were simply, I believe, considered to be bystanders.” —A gun violence survivor

9 out of 10 9 out of 10 gun violence survivors report experiencing trauma from the incident. Source: Everytown for Gun Safety Support Fund, Survivor Survey, November 2021, https://www.surveymonkey.com/r/CLYN9TR

Yet the trauma of gun violence—which is long-lasting, complex, and unique to each person—is often not well understood or holistically addressed. Nine out of 10 gun violence survivors report experiencing trauma, yet fewer than half of survivors said they had access to the support, assistance, or services they needed to cope with its impact within the first six months or a year or more after the incident.

Trauma can and does interfere with survivors’ physical and mental health and impacts their relationships, work, financial situation, and family life. Survivors who had experienced gun violence within the last year were most likely to say that trauma frequently affects their well-being and/or their functioning.

Those who had experienced gun violence within the last 12 months were most likely to rate the impact of trauma as a 5 out of 5: 54 percent responded that the trauma frequently affects their well-being and/or their functioning.

Furthermore, the violent, unexpected, and sometimes random nature of gun violence means that, for many survivors, there is no such thing as a full recovery or an end to the healing process. The experience is not something to simply “get over” or “move on from.” Furthermore, some survivors are exposed to persistent gun violence in the places where they live, leading to community trauma. For many, it feels like a scar that never heals and a lifelong journey of trauma and grief that ebbs and flows based on one’s lived experiences.

For this reason, gun violence survivors often report needing counseling not only for short-term support in the immediate aftermath of an incident, but for longer-term care to be able to cope with the lasting trauma. Survivors listed counseling as their largest unmet need, while their smallest unmet need was for immediate crisis services. Nearly one out of every four survivors identified the need for additional counseling services.

Everytown compiled this report to share the voices of gun violence survivors as they express what support they needed after the incident and barriers they encountered in accessing it. This report provides a data-driven perspective on the scope of America’s gun violence crisis and draws on primary source survey data that are both quantitative and qualitative in nature to explore survivors’ experiences.

The report is divided into five sections:

Bereavement and Grief from Gun Death, where we put the toll of the crisis into context, focusing on gun homicides and suicides; Healing After Gun Injuries, where we explore the experiences of people who have been shot and wounded; Intimidation and Fear, where survivors speak about the trauma of receiving threats or experiencing intimidation against certain targeted groups from such gun violence incidents as mass and school shootings, hate crimes, and armed protests and the intimidation and fear in domestic violence; Community Trauma, where we discuss the effects of persistent community violence on neighborhoods; and Charting the Way Forward, where we offer solutions on how we can better support survivors and prevent gun violence in the future.

Bereavement and Grief from Gun Death

The sheer quantity of gun deaths in the United States—more than 110 people shot and killed each day—means that individuals and families are continuously being initiated into what some survivors refer to as “a club no one wants to belong to.” While people can recover from grief, the challenges they face can be persistent and life-long.

Our focus here is on gun suicide and homicide because these two forms of gun violence account for the great majority of gun deaths each year; suicides make up six in 10 gun deaths, with homicide, including shootings by police, accounting for nearly four in 10. The United States’ elevated gun homicide rate represents the starkest disparity compared to other high-income countries. While the overall gun death rate of the United States is 13 times that of other high-income countries, the gun homicide rate is 26 times higher than these peer countries.

In the immediate aftermath of gun death, survivors face not only bereavement and grief but often financial barriers, stigmatization, and challenges accessing the services they need.

Additionally, children who have experienced the loss of a parent or caregiver to sudden death face unique challenges that impact their development long into adulthood. Children who have lost a parent are more likely to experience posttraumatic stress disorder (PTSD), depression, impairment of their daily ability to function, and suicidal ideation. The death of a child’s caregiver is also associated with a whole host of ripple effects, including housing instability, separations, mental health problems, shorter schooling time, and higher risks of suicide and violence.

Among survey respondents, six out of 10 said their loved one was killed in a gun homicide. The unexpected, traumatic nature of these deaths—and the feeling that a loved one has been taken or ripped out of their families and communities in an instant—brings with it a profound and lasting sense of grief.

Families and communities of color are disproportionately impacted by gun homicide. Black Americans represent the majority of gun homicide victims and are 10 times more likely than white Americans to die by gun homicide. Young Black men face the greatest risk and are 22 times more likely than young white men to die by gun homicide.

In addition to the tragedy of lives taken, the trauma has lasting effects on the wider community, as is discussed further below on community gun violence. Twenty-three percent of Black American adults and 22 percent of Hispanic American adults report that someone they cared for has been killed with a gun.

One form of homicide in particular, shootings by police, reverberate well beyond those individuals directly involved to impact whole communities. On average, police fatally shoot three people in the United States every day. In this facet of gun violence, the United States is also a global outlier: the rate of fatal shootings by police in the United States is at least 15 times higher than its peer countries, including Australia, England and Wales, Germany, and New Zealand. And for each person shot and killed by police, two more are shot and wounded in a way that requires emergency room care or hospitalization.

The toll of this form of gun violence falls heavily on one community. A key contributor to trauma in Black communities is police violence. Police shoot and kill Black Americans at nearly three times the rate of white Americans and unarmed Black Americans at four times the rate of unarmed white Americans.

“A cop shot me. A militia member shot my friend. I don’t trust cops or feel safe around them.” —A gun violence survivor

Though the direct victims of police violence are disproportionately Black young men, whole communities are traumatized by abuse from police. While they have not personally experienced this violence, repeated experiences of being pulled over, invasively searched, or tasered, coupled with the relentless news of death by police, have made whole communities survivors. The nationwide protests of 2020 showed clearly how trauma from police violence affects communities of Black Americans as a whole.

The shooting of unarmed civilians by police also has a corrosive impact on crime more broadly, eroding residents’ trust in police and willingness to collaborate on issues of public safety. This in turn contributes to continuing violence that then repeats the trauma.

For young people, this trauma has consequences that affect their life course. A 2021 study that looked at outcomes among Los Angeles high school students in communities where police killings took place showed marked decreases in students’ academic performance, development of learning deficiencies related to PTSD and depression, and higher levels of high school dropouts. These impacts were most pronounced for Black and Latinx students living in close proximity to police shootings of Black and Latinx people.

“My husband killed himself, and now my son is statistically three times more likely to do the same. My brother killed himself, and now my sister-in-law lives with the image and loss every day.” —A gun violence survivor

America’s unimaginably high firearm suicide rates, with nearly 24,000 Americans dying by firearm suicide every year, also leave behind survivors who face particular challenges. In fact, many families do not consider themselves survivors of gun violence, because society does not understand the unique role of firearms in our suicide epidemic. It is a prevalent misconception that if a person contemplating suicide is not able to get a firearm, they will use another method equally likely to result in death. While this is sometimes the case, nearly all other methods are less lethal, making it far less likely that an attempt will result in death. For example, 90 percent of suicide attempts using a gun result in death; by comparison, only 4 percent of suicide attempts by other means are fatal. And the vast majority of people who survive a suicide attempt do not go on to die by suicide.

A better understanding of the relationship between easy access to guns and the risk of suicide makes it clear why firearm suicide is an integral part of gun violence.

The grief that survivors of gun suicide face is exacerbated by the way that mental illness and suicide are uniquely stigmatized in our culture, leading many survivors to feel isolated or unable to share their experiences. Survivors of gun suicide were also more likely than other survivors in our survey to say that they did not seek help or services immediately after the death of their loved one.

Healing After Gun Injuries

“Severe depression, fear, isolation. PTSD. Self-doubt. Affects my family and has ruined relationships. I am in constant fear everywhere I go. Financially, it’s been hard. I let my self-doubt and fear get in the way.” —A gun violence survivor

Every year, approximately 85,000 Americans survive a gunshot wound, more than double the number killed with a gun. Over time, the toll of these shootings magnifies: according to a national poll, an estimated 8 million people have been shot and wounded in their lifetimes, or 4 percent of American adults.

Gunshot wound survivors face a lifelong healing process and may experience a broad array of difficulties, including psychological trauma, loss of work, and steep medical costs. Aside from immediate hospital costs associated with the wound, these survivors can encounter lifetime medical care costs, including readmission(s) to the hospital and nursing care. Many survivors report that the psychological effects of the shooting remain long after their wounds have physically healed. A recent systematic review found that after hospitalization for gunshot injuries, survivors had high rates of PTSD, chronic pain, readmission, and poor mental health; they were also less likely to report having been able to return to work or levels of social functioning that they had before the gun injury.

“His entire life has changed. He deals with depression and pain often. I know that my friend is still here and I am so thankful for that, but at the same time, it is like he has been taken.” —A gun violence survivor

Survivors who were shot and wounded expressed the following needs: Everytown for Gun Safety Support Fund, Gun Violence Survivor Survey, November 2021.

Overlapping experiences with gun violence meant that some survivors in our survey had to arrange funerals or manage the estates of deceased loved ones as they were also trying to heal.

The impact of firearm wounds for young people is particularly damaging. In a study of children and young adults who were hospitalized for nonfatal firearm-related injuries, nearly half of patients were discharged from the hospital with some disability. Many gun injury survivors are left to live with bullets or shrapnel inside their bodies, which may cause long-term pain and serve as a constant reminder of the traumatic injury.

“He was shot in the face and is disfigured. It affects his self-esteem and the type of job he can get. It has altered his public and personal behavior and attitude and left physical scars.” —A gun violence survivor

Gunshot wounds can lead to disability, permanent disfigurement, pain, and injury, as well as mounting medical bills. Gun violence continues to financially burden survivors by diminishing wages and productivity. Estimates suggest that productivity loss—the sum of the value of wage and household work lost due to short- or long-term disability in the recovery phase—totals an average of $33,000 for each survivor of an assault by firearm, as well as time spent investigating, prosecuting, and punishing violent perpetrators.

“I have permanent/ongoing health issues—physical and mental. The impact interrupted my financial well-being—I am single and the sole provider of my own financial health. My career (at its height) was severely interrupted (it affected my career and salary growth, and along with that, my ability to contribute to my own retirement fund.) Other members of my family were personally impacted by the incident of gun violence in which I was wounded, too.” —A gun violence survivor

Intimidation and Fear

“I have had two gun violence incidents. The one that still haunts me is the threatening, stalking me with the gun. I think if someone would have protected me, helped me find resources to heal, it would have been beneficial.” —A gun violence survivor

Feeling safe is foundational to a healthy life and to our ability to live, work, play, and thrive. Being threatened with a gun, or living through a mass or school shooting, hate crime, or other incident in which guns are used to terrorize, coerce, or control people, erodes that safety. Those who live through this type of fear and intimidation are survivors of gun violence, even if no shots were fired.

Four out of 10 survivors in our survey reported being threatened or intimidated with a firearm. The threats and intimidation can take many forms, but the primary goal is the same: to instill fear in others and use the specter of violence to exert control over them.

Half of the survivors in the survey reported experiencing gun violence in a home—their own or that of a family member, neighbor, or friend. Domestic violence survivors face a particular challenge in that the closed-door nature of this violence means that survivors can often feel invisible or struggle to access the support and services they need. And while domestic abuse of any kind is devastating, the presence of firearms creates a relentless atmosphere of fear. In addition, it makes abuse more likely to turn deadly.

1 in 2 Gun violence is not distant or far away. One in two survivors experienced gun violence at a home—their own, a neighbor’s, a friend’s, or a family member’s. Everytown for Gun Safety, Survivor Survey, November 2021, https://www.surveymonkey.com/r/CLYN9TR 70 Every month, an average of 70 women are shot and killed by an intimate partner. Everytown analysis of CDC, National Violent Death Reporting System (NVDRS), 2019.

Yet domestic violence with a gun is astonishingly prevalent: every month, an average of 70 women in the United States are shot and killed by an intimate partner, and many more are shot and wounded. Nearly one million American women alive today have been shot or shot at by an intimate partner. Again, the United States stands apart. Women in the United States are 28 times more likely to die by firearm homicide than women in other high-income countries. Put another way, 92 percent of all women murdered by gun in high-income countries were from the United States.

One study of domestic violence and coercive control found that women who had been threatened with a gun—or feared that their partner would use one against them—had more severe psychological symptoms than women who had endured other types of abuse, such as psychological or physical abuse. According to the author, “The fear of a firearm threat—just the fear of the threat, not even the actual threat—is significantly associated with PTSD. It’s stronger even than the link between physical or sexual abuse and PTSD.”

Another example of widespread intimidation and fear involves school shootings. The return to in-person learning in 2021 following COVID-19 lockdowns has coincided with a surge in incidences of gunfire on school grounds. In 2021, there were at least 199 incidents of gunfire on school grounds, resulting in 47 deaths and 122 injuries nationally, according to a database maintained by Everytown. The fall semester of 2021 was the worst by far: between August 1 and December 31, 2021, there were at least 126 instances of gunfire on school grounds, the most instances and casualties since Everytown began tracking them in 2013.

“[I have a] fear of being on a school campus.” —A gun violence survivor

75% Although, <1% of gun violence at schools in the US are mass shootings, 75% of youth ages 15 to 21 cite mass shootings as a primary source of stress. American Psychological Association, “Stress in America: Generation Z,” (2018), https://bit.ly/2EATluc.

The prevalence, and threat, of school shootings has created a generation of young Americans who are growing up with the constant fear of being shot and killed in a place they should feel safe. For students who have experienced other incidents of gun violence in their communities, the trauma and symptoms are compounded. This is taking a significant emotional and psychological toll. In a 2018 national poll, 75 percent of youth ages 15 to 21 cited mass shootings as a primary source of stress, and more than one in five of them who are in school reported that the possibility of a shooting at the school is a source of stress on a day-to-day basis.

While school shootings are relatively rare—accounting for less than 1 percent of the more than 40,000 annual US gun deaths—they instill a deep sense of fear in communities, propelling school systems to take immediate action. Measures designed to mitigate risks of school shootings, however, including active shooter drills involving students or lockdowns, can be traumatic in and of themselves. While there is almost no research affirming the value of involving students in school shooter drills for preventing shootings or for protecting the school community when they do occur, research by Georgia Tech and Everytown has found that shooter drills that involve students can be traumatizing for the entire school community. Active shooter drills in schools are associated with a 39 percent increase in depression, a 23 percent increase in physiological health problems, and a 22 percent increase in concerns over deaths—for children as young as five up through high schoolers, their parents, and school staff.

“I was living in a hostile and racist town. I did not think that there were services for me there.” —A gun violence survivor

10k+ In an average year, more than 10,300 hate crimes in the U.S. involve a firearm–more than 28 every day. Everytown analysis of BJS, “Hate Crime Victimization, 2004-2015,” (2017), https://bit.ly/2KrFyoe.

Hate-motivated gun violence is another aspect of fear and intimidation surrounding firearms in the United States. In addition to the fear caused by the prevalence of gun violence in public and home spaces, survivors in the survey also reported fearing that they would be targeted because of an identity they hold. In an average year, over 10,300 hate crimes are committed with a gun—more than 28 each day.

The vast majority of hate crimes are directed against communities of color, religious minorities, and LGBTQ people. In 2020, about 63 percent of reported hate crimes were motivated by racism, more than half of which were motivated by bias against Black people, while 15 percent were motivated by religious bias, most often anti-Semitism, and 17 percent were motivated by anti-LGBTQ bias. In addition to the direct effect of hurting and injuring a person because of who they are, these acts of violence also create an atmosphere of fear and intimidation for whole demographic groups.

Hate Crimes by Bias Motivation, 2020 Source: FBI, “Crime Data Explorer: Hate Crime in the United States.”

The recent increase in hate crimes—13 percent in 2020 compared to 2019 —not only impacts individual survivors but also reverberates through entire communities. For individuals struggling against bias, news of a violent hate crime targeting members of a shared identity group can feel like a personal attack, creating an atmosphere of fear and terror. At the same time, the identity-targeting nature of hate crimes can make it harder for survivors to receive the support they need. As one survivor told us in the survey, they doubted their ability to get appropriate services or support locally because of the bias in their community.

Another area where intimidation, rather than actual shots fired, has a negative impact on survivors is related to gun carrying at demonstrations. The alarming rise in armed demonstrations in recent years, which pose immediate public safety issues, has further exacerbated an atmosphere of fear and terror for gun violence survivors. While armed events represent a small proportion of the total number of public demonstrations in the country, they are significantly more likely to involve violence or destructive behavior: roughly one out of every six demonstrations where firearms were present included reports of violent or destructive activity.

While proponents of carrying guns at demonstrations say that they are simply exercising their right to openly carry a firearm in public, the effect and primary motivation of doing this activity are to frighten and intimidate their opponents. This fear is often far more acute for survivors of gun violence and can have a particularly chilling effect on their ability to exercise their First Amendment rights. Several of the survivors surveyed said they feel uncomfortable or anxious around firearms following a trauma they had experienced from gun violence.

“I have a lot of anxiety about guns. Hearing/reading about gun violence makes me very upset. I once had a panic attack at a drum performance because the drumming sounded like gunshots to me. Very often when I’m out in public, I have intrusive thoughts about someone appearing with a gun and shooting me/others.” —A gun violence survivor

Our survey made it plain that it isn’t only people who are shot and wounded who live with the lifelong trauma of gun violence. Instead, everyone who witnesses acts of gun violence, who has cared for someone wounded or killed with a gun, or who feels threatened with serious harm—whether it is physical, mental, or emotional, and regardless of whether it is a one-time event or threat and intimidation over a period of time—is a survivor.

Community Trauma

The preceding section discusses the various ways in which sporadic or even random acts of gun violence and intimidation can impact those not physically harmed. But what happens where gun violence and intimidation is sustained and concentrated in a community? Community trauma is not only the sum of the hurt and suffering of individuals. It is also a collective trauma experienced in communities with elevated levels of violence. In these situations, the label of survivor is an all-too-common experience. Black communities across the United States suffer this trauma, as homicide, police violence and hate crimes contribute to trauma at multiple levels—individual, family, and community. The term “community trauma” seeks to name an effect that many in Black communities know to be ever-present and deeply problematic.

The manifestations of this type of trauma extend far beyond those who directly witness violence and even beyond those who have experienced intimidation with or fear because of a gun. It is compounded by interactions with other forms of violence. That can include exposure to structural violence such as underinvestment in social services, the education system, and decent housing. And it can include historical violence such as the legacy of slavery or predatory banking practices.

Living with a constant backdrop of gun violence leaves indelible marks on the memory that can alter the health, choices, and lifelong trajectory of children, young people, adults, and the collective community in serious and lasting ways. Pervasive community gun violence has a particularly devastating impact on children. Children and adolescents exposed to violence, crime, and abuse are more likely to abuse drugs and alcohol, suffer from depression, anxiety, and PTSD; fail or have difficulties in school; and engage in criminal activity. Stress related to community gun violence affects student performance and wellbeing in schools, from lower standardized test scores to more disciplinary problems.

​​The trauma that results from community gun violence also has an impact on community trust. As entire neighborhoods face high levels of trauma, cohesion can break down, and the bonds of cooperation can weaken. This results in such changes as neighbors being less likely to intervene when trouble crops up and less chances for informal solidarity and involvement of adults that contribute to safer communities. This community trauma can dampen residents’ capacity and willingness to work together to address the causes of trauma and build safer communities.

Charting the Way Forward

“If the university I was studying at had social workers or counselors, I would have asked them for help.” —A gun violence survivor

1 in 2 Fewer than one in two survivors said that the support, assistance, or services that they needed to cope with the impact of gun violence was available to them within the first six months or a year or more after the trauma. Everytown for Gun Safety Support Fund, Gun Violence Survivor Survey, November 2021.

Gun violence shapes the lives of the thousands who experience it and the millions who witness it, know someone who was shot, or live in fear of the next shooting. While there are no simple solutions to an epidemic this complex, there are clear steps we can take both to break the cycle of violence and provide survivors with the support they need to be able to heal.

The Everytown Survivor Network is a nationwide community that connects survivors to each other, amplifies the power of survivor voices, offers trauma-informed programs, provides information on direct services, and supports survivors who choose to become advocates.

Following are some of the other resources survivors expressed a need for, with information about how to access them.

Counseling

Nearly one in four survivors surveyed identified the need for additional counseling services. Gun violence survivors often report needing counseling not just for short-term support but for longer-term care to be able to cope with the trauma from the experience. This reflects the reality of the response to gun violence in America: after an initial burst of support following a shooting, many survivors struggle to access care.

Various mental health resources and techniques can be instrumental in healing communities that experience gun violence. However, because mental health services are predominantly provided through private medical insurance or Medicaid in the United States, survivors reported a plethora of financial and bureaucratic barriers to receiving long-term counseling. Additionally, some survivors shared that they feared retaliation or judgment if they were to seek out counseling due to the stigmatization of mental health.

Resources are Available If you or someone you care about are in need of counseling or mental health support you may contact the Substance Abuse and Mental Health Services Administration Distress Helpline at 1-800-985-5990. You can also text the Public Distress Helpline by texting “TalkWithUs” to 66746. More information on resources for victims and survivors of gun violence is available here. If you or someone you know is in crisis, please call or text 988, or visit 988lifeline.org/chat to chat with a counselor from the 988 Suicide and Crisis Lifeline, previously known as the National Suicide Prevention Lifeline. The 988 Suicide and Crisis Lifeline provides 24/7, free, and confidential support to people in suicidal crisis or emotional distress anywhere in the US.

Support Groups

“[I would have benefitted from] support from other survivors earlier on. I didn’t identify as a survivor of gun violence for years and would have benefitted from acknowledgment, support, and likely from therapy.” —A gun violence survivor

Survey respondents also said they experienced an unmet need for support groups, either clinical or peer-to-peer in nature. These groups can help survivors feel less isolated and help them heal knowing that others have gone through similar experiences.

Support groups allow survivors to process their experiences with a group of individuals who have been through something similar, and often with the assistance of a clinician trained in conducting support groups for individuals with trauma.

The Everytown Survivor Network can help connect survivors with each other for support.

“We stay in touch many years later despite living in different cities, and I feel as though he saved my life.” —A gun violence survivor

Family Support and Helping Children Heal

“[I would have benefitted from] talking to someone who wouldn’t have minded listening to me cry and question . . . help for my other children who were greatly affected as well and for my mom who needed just as much as I.” —A gun violence survivor

Survivors of gun violence are often part of families that are affected by gun violence too. Support often may be offered to the direct survivor or victim but not to family members, even though they also need those services. Parents many times do not know how to talk to their children about what occurred or how to navigate the myriad systems that are part of many post–gun violence incidents, such as the courts or social services agencies.

The death of a parent or caregiver can have a profound impact on children. In 2020, deaths among adults who may have had children at home—from gun violence, opioid addictions, and COVID-19—were at record highs and present an urgent need for support.

Programs and policies that address childhood adversity, strengthen economic support to families, identify children experiencing bereavement and mental health problems, and shore up family relationships can help. Some information on the warning signs and risk factors and how to talk about mental health are available here.

In October 2021, the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children’s Hospital Association jointly declared a national emergency in child and adolescent mental health and made recommendations related to youth mental health, which the US Surgeon General echoed and endorsed in December 2021.

Financial Support

“I had to borrow money to have my son cremated.” —A gun violence survivor

The previous discussion has outlined the devastating emotional cost of our country’s gun violence crisis. Another irrefutable cost is the high economic cost of gun violence. Many survivors of gun violence report needing help financially, both with covering the direct costs of gun violence, such as medical bills, legal fees, and funeral expenses, as well as compensating for income lost while they physically and emotionally heal. In total, families directly affected by gun violence in the United States bear $4.7 million in out-of-pocket costs for medical bills and mental health support each day, and $140.3 million in lost income from work absences due to injury or death. Each gun suicide results in more than $1 million in lost income and nearly $5 million in lost quality of life.

Gun violence can also have severe economic consequences for entire communities. High rates of gun violence in geographic areas lower property values, slow new business creation, and reduce available jobs, thereby creating the very economic and social conditions that are associated with higher violence. One study estimated that surges in gun homicides slowed home value appreciation by 4 percent relative to communities that did not experience a surge in violence. When survivors are supported, entire communities benefit.

Federal, State, and Local Actions to Support Survivors

“He has to live with the fact that he’s paralyzed and may never walk again. He turned his life around and helps his community and the youth in the gun violence pandemic in our city.” —A gun violence survivor

Despite the severity of the gun violence epidemic and its associated emotional and financial tolls, the United States lacks a comprehensive system to provide financial, emotional, medical, and legal assistance to survivors. While processing the grief caused by gun violence, survivors are often forced to shoulder its financial burdens alone.

In March 2021, US Sen. Bob Casey (D-PA) and Rep. Dwight Evans (D-PA) reintroduced federal legislation to help gun violence survivors find the resources and benefits available to support the wide range of needs of those affected by the unrelenting toll of this violence. The Resources for Victims of Gun Violence Act establishes an Advisory Council to assess the medical, educational, financial, legal, workplace, housing, and other needs of gun violence survivors and to disseminate that information through all relevant channels. Everytown strongly supports this bill, which is still pending.

Under the Victims of Crime Act (VOCA), there is a Crime Victims Fund distributed to states, resourced from court fines and fees. However, too many gun violence survivors are unaware of this funding source or struggle to access these funds both due to criteria that are overly rigid and to bureaucratic red tape. As the survey shows, many gun violence survivors are not provided adequate support to navigate the aftermath of the incident financially, emotionally, medically, and legally.

At the state level, victim compensation funds available to survivors of gun violence are a valuable resource. But too many survivors are not aware of this resource, and obstacles and restrictions make the funds difficult to access. Everytown’s report Hurdles to Healing details recommendations directed to policymakers to reduce bureaucratic hurdles that survivors encounter. Many of these recommendations could be addressed through state-level legislation. States can also dedicate American Rescue Plan Act dollars to support much-needed services for gun violence survivors, with financing available at the state and local levels.

Local work to support survivors can take the form of increasing availability of local services, helping to build awareness of survivor resources at all levels of government and from community-based organizations, and making sure that survivor perspectives and voices are included wherever decisions are being made on behalf of those who are living through the trauma of violence.

An overwhelming message of our survey was that fewer than half of survivors had access to the various forms of assistance they needed in the year after the incident. This points to an urgent role for local agencies to support the services and strategies that will foster health and wellbeing as well as healing in their communities. This includes adequate physical and mental health services, strategies to rebuild trust and social relationships in communities, and robust support for community-based violence intervention programs to disrupt cycles of violence.

Innovative ways to increase awareness of existing survivor resources could include outreach beyond the traditional venues—law enforcement and criminal justice advocates—to include community events, medical facilities, libraries, salons, and other easily accessed public places.

A final set of actions involves including survivor voices in all forums and agencies where gun violence and its aftermath are being discussed. This could mean including survivors as staff in violence prevention offices, in advisory committees to advise mayors and local government on gaps in services, as speakers at town halls and other public events on gun violence, and many other opportunities to learn from those who have firsthand experience of the needs and perspectives of survivors.

Finally, the ability to design these actions relies on solid research on the long-term health outcomes of firearm injuries and the full impact of these incidents on the lives of survivors. And this research is sorely lacking. A recent review found only 10 studies in the last two dozen years focused on these long-term consequences. Future research needs to encompass not just the medical impacts of these injuries but also all of the other ramifications of firearm injuries on the lives of immediate survivors and those who love and care for them.

Conclusion

“I have remained active in the community where gun violence has always challenged the quality of life of its citizens.” —A gun violence survivor

We will continue to be a nation of survivors unless we take action at the local, state, and federal levels to prevent gun violence. By passing laws to strengthen the background check system, disarm domestic abusers, fund community violence intervention programs, and give families and law enforcement the tools they need to act on warning signs to protect people in crisis and prevent mass shootings, we can prevent gun violence from shattering lives and communities.

Gun violence forever changes the lives of people who experience it, witness it, and are threatened by it—and survivors live with its trauma every day. But they also find the strength to fight to save the lives of others, bringing their empathy, courage, and resilience to the gun violence prevention movement and challenging all of us to do the same. It is vital that we support gun violence survivors with the resources they need to heal, and continue to elevate their voices in our nation’s gun safety policy conversation.

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[1] Url: https://everytownresearch.org/report/the-impact-of-gun-violence-on-survivors-in-america/

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