I need a research paper on the bill I chose, which can be found at this link: https://www.congress.gov/bill/118th-congress/house-bill/46/all-info.

It needs to include Background and Significance, Literature review, Discussions, and conclusions. In one of these paragraphs, I also have info about opponents and opponents of such a bill or topic. It’s for my class NSG-398 Health Policy. The paper should be a minimum of 4-6 pages.

The bill: H.R.46-118th Congress (2023-2024) Mental Health Access and Gun Violence Prevention Act of 2023.

Mental Health Access and Gun Violence Prevention-Sample Solution

Gun violence is a contemporary social issue affecting human lives globally. In the United States, gun violence is a significant problem and a key driver of violent crimes (Emund, 2022). The United States remains an outlier in firearm-related violence compared to other nations, with remarkably high gun-related homicides and suicides (Strong et al., 2018). Increased access to firearms increases the risks of homicides, violence, and related suicides. Ideally, gun violence threatens the right to life. Although anyone can be affected by gun violence, specific racial and ethnic communities, especially marginalized groups, women, and people of color, are disproportionately impacted. Gun violence is concentrated in neighborhoods with limited resources and racially segregated. Systemic racial inequalities, weak gun laws, and little investment in public services and infrastructure in communities with high incidences of gun violence. Gun violence is associated with adverse social, mental, and physical health outcomes. These outcomes spiral down the right to education and healthcare, considering the fear of attending schools or health facilities.(Gun-Violence Prevention Essay Example)

Research by the Pew Research Center based on data from the center for disease control and prevention (CDC) shows that more gun-related injuries among Americans were recorded in 2020 compared to other years. The data mainly focuses on gun violence issues, including murders and gun-related suicides (Gramlich, 2022). Specifically, there was an estimated mortality of 45 222 associated with gun-related injuries in 2020, including murders, suicides, unintentional, law-enforcement, and undetermined deaths (Centre for Disease Control and Prevention [CDC], 2023). The gun-related mortality in 2020 represented an increase of about 43% from 2010. In addition, gun-related murders have significantly increased, with a record of about 19 384 deaths in 2020, which is about a 75% increase from 2010. These statistics indicated 13.6 gun mortality per 100,000 people. According to the CDC, 321 people, including 22 children and teenagers, are shot daily in the United States (CDC, 2023). This number accounts for 117 345 people annually, where 7 957 teenagers and children are shot in the country. Despite the growing cases of gun violence, these recorded statistics do not account for the ever-increasing population. This suggests that gun-related violence remains low, considering previously registered peak levels.(Gun-Violence Prevention Essay Example)

Besides the high mortalities, gun violence is associated with increased public health costs. Gun violence-related injuries have a significant financial burden on the United States healthcare system and reduce the general productivity of the working force (Strong et al., 2018). The National Violent Death Reporting System (NVDRS) recorded an average of about $186.6 million in medical costs for 30000 people who died from gun violence and with an average of $5891 per person in 2010 (as cited in Strong et al., 2018). In addition, about $852.9 was incurred on the same year’s hospitalization cost for 38500 people who survived gun-related injuries. Moreover, the United States lost approximately $3 billion in lost wages, while victims whose symptoms were not severe with no inpatient admission accumulated a cost totaling $200 million on medical expenditure and lost wages. These statistics provide a broader picture of gun violence’s financial impact in the USA.

An annual review by Public Health identified an increase in the mortality rate from gun violence. Nevertheless, the age-adjusted mortality rate from gun violence increased by 7.8% in 2015 (Strong et al., 2018). Reducing trends in death associated with gun violence have not been observed, suggesting a need for further intervention. In light of the chronic nature of firearm violence and the increasing mass fatality, Representative Jackson Lee introduced the bill: H.R.46-118th Congress (2023-2024) Mental Health Access and Gun Violence Prevention Act of 2023 (Congress.gov, 2023) “to authorize the FY2024 appropriations for the departments of Justice, the Social Security Administration, and Health and Human Services.” The two departments are to “increase access to mental health care treatment and services, and (2) promote reporting of mental health information to the National Instant Criminal Background Check System” (Congress.gov, 2023). The National Instant Criminal Background Check System (NICS) questions every administration level, including tribal, local, state, and federal levels, for criminal history. The critical history is recorded at specific times at these administration levels and is required to determine a person’s eligibility to win a firearm.(Gun-Violence Prevention Essay Example)

A review of gun injuries and violence trends in the United States showed that a lack of scientific knowledge is a significant constraint (Alcorn, 2017). In addition, the 2013 report by the Institute of Medicine showed that the inadequacy of gun-related violence knowledge limits the ability of policymakers to recommend evidence-based policies to reduce or prevent firearm-related injuries and deaths and maximize safety (cited in Alcorn, 2017). The present predicament of gun violence comes despite early efforts by the CDC to research gun injuries, and Congress has played a vital role in forbidding the agency from funding research to advocate for gun control, which has seen the CDC’s spending fall by 96% in the last decade (Mayors Against Illegal Guns, 2013). This research reviews the background and status of gun violence in the USA, contextualizes existing research, and critically evaluates the provisions and implications of the Mental Health Access and Gun Violence Prevention Act of 2023.(Gun-Violence Prevention Essay Example)

Literature Review

Various studies have explored the status and impacts of gun violence in the USA. Alcorn (2017) reviewed the developments in research on firearm violence in the United States. The study established a significant increase in gun violence research in the early 1980s and markedly between the mid-1980s and 1999, followed by a plateauing period through 2012 with about 90 articles annually before rising after 2014. These findings show an inconsistent academic pursuit of firearm violence in the United States yet present an opportunity to evaluate further research on gun violence and its effects on the community and identify and evaluate existing and potential interventions.

Jehan et al. (2018) determined the relationship between existing firearm-related injuries and legislation in the United States. The study was founded on the increasing firearm violence and the consequent need for strict legislation. A retrospective analysis of a nationwide patient database showed that the mean rate of firearm-related injuries was lower in states with strict gun laws compared to states with less stringent firearm laws (Jehan et al., 2018). Moreover, the years of life lost and gun-related deaths are higher in states with less strict gun laws. The findings show the significance of gun laws in mitigating gun violence.

Ssentongo et al. (2021) studied the risks of firearm violence during the Covid-19 pandemic in the USA. The study was based on daily police reports consistent with firearm-related injuries and mortalities across 50 states. The study was founded on the increasing gun violence reported during the Covid-19 pandemic across the United States that strained the healthcare system resources, including personnel protective equipment, intensive care beds, and blood products. The study adopted a mixed-methods model to perform a poison regression analysis to estimate the rates of gun violence. Ssentongo et al. (2021) showed 30% higher rates of firearm violence during the study period.

Kolbe (2020) established the extent of firearm violence in schools in the United States and interventions to prevent them. The authors argue that despite only 2% of homicides being associated with schools, gun violence in K-12 has injured over 1403 people and killed about 728 others since 1970. In addition, Kolbe (2020) reviewed gun violence in the school and intervention efforts. The study showed that school firearm violence has increased despite various intervention efforts, including a school-associated violent death surveillance system, the naval postgraduate school (NPS)—K-12 school shooting database, and the education Week (E.W.)—School shooting tracker, among others.(Gun-Violence Prevention Essay Example)

Hemenway & Nelson (2020) sought to inform further conceptions of the degree and impact of gun violence in the USA. Hemenway & Nelson (2020) argued that there had been an increase in public mass shootings, firearm injuries, homicides, and suicides in the United States. The authors identified higher rates of homicides among non-white males in the urban neighborhoods and gun suicides highest among older white males in the rural areas. The burden of gun-related violence falls on the victims with a spiraling impact on their families, friends, and communities. Hemenway & Nelson (2020) identified the indirect costs of gun-related violence as mental health issues, including fear, grief, hopelessness, and post-traumatic stress disorders. Efforts to mitigate gun violence require additional fees and burdens from individuals and communities. Notably, Hemenway & Nelson (2020) suggest that U.S. gun violence is far more extensive than the medical costs and mortality.

Smith et al. (2020) examined the demographic and prevalence variations in exposure to fatal firearm violence and the associations between psychiatric health problems and exposure, including suicidal ideation, psychological distress, psychotic experiences, and depression. Smith et al. (2020) also evaluated the interactions between exposure to gun violence and race concerning these mental health issues. The authors hypothesized that the widespread firearm availability, high prevalence of firearm prevalence and association of race, violence, and mental health outcomes are critical in understanding the mental health outcomes associated with exposure to fatal gun violence on victims from diverse ethnical and racial backgrounds. The study established that the majority of those exposed to gun violence are young, from lower education and income, and are more likely to be Black and Latinos. Furthermore, the study established that victims suffer present depression symptoms, higher psychological distress, psychotic experiences, and suicidal ideation than those not exposed to gun violence. The study found a strong association between depression and exposure to gun violence among Latinos compared to other races. This study suggests the need to provide mental health care to people disproportionately exposed to gun violence. Besides, there is a need for interventions to reduce gun violence to impact mental health at the community level positively.(Gun-Violence Prevention Essay Example)

Leibbrand et al. (2020) hypothesized that there is little knowledge about the extent of gun homicides in a neighborhood that affects adolescents’ behavioral and mental health outcomes. The authors argue that gun-related homicides may have a unique harmful impact on adolescents, and the consequent behavioral and mental health outcomes may show the limited appreciation aspect of the gun violence epidemic in the USA. The study established that firearm violence near an adolescent school or home is associated with adverse psychiatric health outcomes, including anxiety and depression among girls and sometimes boys. Moreover, the study established that the mental health impact of gun violence exposure varied with the distance to schools and homes.

Yelderman et al. (2019) examined the association between the severity of mass shootings and firearm access and the media-reported mental health history of mass shooting perpetrators. The study hypothesized that understanding the interactions between mental health, firearm access, and mass shooting extent might establish a healthier foundation for policy growth to minimize mass shootings. Yelderman et al. (2019) established that unaddressed mental health issues contributed to the severity of mass shootings. Moreover, the safety and responsibility of firearms reduce and prevent gun violence and casualties.(Gun-Violence Prevention Essay Example)

Discussion

Various efforts have been pursued to prevent and minimize gun violence in the USA. One such attempt is the Mental Health Access and Gun Violence Prevention Act of 2023, which is presently in the House of Representatives for action (Congress.gov, 2023). The bill has two provisions; “to increase access to mental health care treatment services and promote reporting of mental health information to the NICS.” These provisions have been primarily identified in the literature reviewed as ways in which gun violence can be mitigated in the United States.(Gun-Violence Prevention Essay Example)

As established in the bill, the departments of justice, social security administration, and health and human services must establish appropriations to promote access to mental health treatment and services. The link between mental health and gun violence is a complex issue that has been widely studied in recent years. For example, mental health conditions such as depression and anxiety have been associated with increased risks of violent and aggressive behavior, including gun violence among youth, particularly boys (Leibbrand et al., 2020). Conversely, exposure to gun-related violence has been shown to contribute to anxiety and depressive symptoms among victims (Leibbrand et al., 2020; Leibbrand et al., 2020). In addition, individuals living in a neighborhood with persistent gun violence, particularly homicides, would want to arm themselves for protection. Therefore, gun violence can also promote access to firearms in a community.

Access to mental health care has been shown to reduce firearm violence, particularly those related to mass shootings. Mass shootings have increased in the USA (Hemenway & Nelson, 2020), leading to adverse mental health outcomes among victims, friends, and families. Hemenway & Nelson (2020) suggests that additional costs and burden from individuals and communities is necessary to mitigate gun violence. Hemenway & Nelson’s (2020) position supports the need for appropriations by the departments of justice, social security administration, and health and human services to increase access to mental health care. Moreover, it has been established that access to firearms and unaddressed mental health issues increase the risks of violence and related suicides, homicides, and the severity of mass shootings (Yelderman et al., 2019; Strong et al., 2018). Therefore, increasing access to mental health care would be crucial in identifying and diagnosing underlying mental health issues among people and establishing mitigation measures, including mental health care and restrictions to firearm access to minimize incidences of gun violence. Moreover, mental health care could increase gun safety culture and responsibility among gun holders, ultimately reducing gun violence and casualties.(Gun-Violence Prevention Essay Example)

Identified and undertreated mental health problems can equally increase the incidence of mental health. Most mental health issues tend to be persistent, particularly depression and anxiety, tend to be persistent and require adequate treatment interventions (American Psychiatric Association [APA], 2019). In this case, when such mental health issues are undertreated, they can affect an individual’s social behaviors and potentially contribute to the incidence of gun violence, such as homicides and suicides. For example, Goldstein et al. (2019) assert that about 90% of gun-related suicides are associated with mental health illness and associated substance abuse. Moreover, early mental health interventions, including medication and psychotherapy, reduce the risks of engaging in violent behavior, including gun violence. Therefore, increasing mental health care and access to mental health treatment and services is a significant intervention in reducing risks and gun violence related to mental health.

The Mental Health Access and Gun Violence Prevention Act of 2023 also implies the need for the departments of justice, social security administration, and health and human services to establish appropriations that promote reporting mental health information to the NICS. Traditionally, when individuals want to purchase a gun, the Federal Firearms Licensee (FFL) contacts NICS by phone or electronically or by phone, relaying a duly filled firearms transactions form to the FFL and consequently to the NICS (The Federal Bureau of Investigations [FBI], 2023). In addition, the NICS performs background checks on a buyer to verify the buyer’s criminal record and other issues determining the legibility of purchasing or owning a gun.

NICS checks are crucial in many ways. First, previous literature has established that most gun-related violence is perpetrated by individuals whose criminal and mental health backgrounds suggest risks of violent behavior. For instance, mass shooting perpetrators have been shown to have unaddressed or poorly treated mental health problems (Yelderman et al., 2019; Strong et al., 2018; Hemenway & Nelson, 2020). These findings corroborate the need for background checks before issuing firearms to civilians. However, unaddressed mental health issues could be difficult to determine during gun issuance, yet clinical records could provide credible information to evaluate an individual’s capacity to own a firearm.(Gun-Violence Prevention Essay Example)

The Mental Health Access and Gun Violence Prevention Act 2023 has profound implications for individuals with mental illness regarding their ability to purchase firearms. Federally prohibited individuals include adjudicated mentally defective persons, addicted or illegal users of controlled substances, and persons committed to mental facilities (FBI, 2020). The act aims to expand the reporting practices, including those within the mental health databases by states and relevant authorities, to the NICS to mitigate gun violence in the United States. Studies have shown that a history of engagement in violent crime strongly predicts future violence among mental health patients (Leiding et al., 2021). Among the risk and protective factors of violence, as established by the CDC, include violence and mental health history (CDC, 2020). This suggests that evaluating background checks that consider violence and mental health history is crucial in predicting future risks of engaging in gun violence and preventing them.

In 2016, the DHHS modified the HIPPA privacy rule to permit certain instances in which disclosure to NICS of the identities of persons whose mental health conditions preclude them from having firearms according to federal law (Department of Health and Human Services [DHHS], June 2017). Significantly, the modification ensured that the HIPPA privacy rule is upheld by the disclosing entities, which are obliged to share some limited and accurate information to NICS, enough to determine an individual’s firearm capacity. Moreover, the modification upholds the therapeutic alliance and ensures no discouragement for voluntary treatment-seeking behavior among people. Information shared includes identifying non-clinical information (DHHS, 2017) yet. Still, the modification applies to only a few HIPPA entities making mental health determinations to disqualify individuals from owning firearms. The move facilitated the reporting of identities of individuals prohibited from possessing firearms to the NICS and improved public safety.(Gun-Violence Prevention Essay Example)

Conclusions

Research shows a high prevalence of gun violence in the USA. Specifically, there are high incidences of gun violence among males and certain ethnic and racial minorities, including Blacks and Latinos. Nonetheless, the victims of gun violence are majorly racial and ethnic minorities and females. Gun violence costs and burdens go beyond injuries, related costs, and mortality. Additionally, gun violence contributes to mental health impacts, including post-traumatic stress disorder, fear, depression, and anxiety following exposure to firearm violence. Considering the association of mental health and gun violence, the Mental Health Access and Gun Violence Prevention Act 2023 is a crucial legislative intervention that would reduce the incidence and prevalence of mental health in the USA. The provisions in the bill have evidence-based support in the literature, with most researchers suggesting that a history of mental health and violent behavior are the strongest determinants of gun violence. Therefore, increasing access to mental health services and reporting to NICS would prevent and minimize gun violence in the USA.(Gun-Violence Prevention Essay Example)

References

Congress.gov. (2023). All Information (Except Text) for H.R.46 – Mental Health Access and Gun Violence Prevention Act of 2023. Available at: https://www.congress.gov/bill/118th-congress/house-bill/46/all-info (Accessed 25 January 2023)

Strong, B., Tracy, B., Sangji, N. F., & Barrera, K. (2018). ​ Gun violence and firearm policy in the U.S.: A brief history and the current status. Bulletin of the American College of Surgeons. https://bulletin.facs.org/2018/07/gun-violence-and-firearm-policy-in-the-u-s-a-brief-history-and-the-current-status/

Hemenway, D., & Nelson, E. (2020). The scope of the problem: gun violence in the USA. Current Trauma Reports, 6(1), 29-35. https://doi.org/10.1007/s40719-020-00182-x

Jehan, F., Pandit, V., O’Keeffe, T., Azim, A., Jain, A., Tai, S. A., … & Joseph, B. (2018). The burden of firearm violence in the United States: stricter laws result in safer states. Journal of Injury and Violence Research, 10(1), 11. https://doi.org/10.5249%2Fjivr.v10i1.951

Ssentongo, P., Fronterre, C., Ssentongo, A. E., Advani, S., Heilbrunn, E. S., Hazelton, J. P., … & Chinchilli, V. M. (2021). Gun violence incidence during the COVID-19 pandemic is higher than before the pandemic in the United States. Scientific Reports, 11(1), 1-8.

Kolbe, L. J. (2020). School gun violence in the United States. Journal of School Health, 90(3), 245-253. https://doi.org/10.1111/josh.12866

Alcorn, T. (2017). Trends in research publications about gun violence in the United States, 1960 to 2014. JAMA Internal Medicine, 177(1), 124-126. https://doi.org/10.1001/jamainternmed.2016.7076

Smith, M. E., Sharpe, T. L., Richardson, J., Pahwa, R., Smith, D., & DeVylder, J. (2020). The impact of exposure to gun violence fatality on mental health outcomes in four urban U.S. settings. Social Science & Medicine, 246, 112587. https://doi.org/10.1016/j.socscimed.2019.112587

Leibbrand, C., Hill, H., Rowhani-Rahbar, A., & Rivara, F. (2020). Invisible wounds: Community exposure to gun homicides and adolescents’ mental health and behavioral outcomes. SSM-Population Health, 12, 100689. https://doi.org/10.1016/j.ssmph.2020.100689

Yelderman, L. A., Joseph, J. J., West, M. P., & Butler, E. (2019). Mass shootings in the United States: Understanding the importance of mental health and firearm considerations. Psychology, Public Policy, and Law, 25(3), 212. https://psycnet.apa.org/doi/10.1037/law0000200

Leibbrand, C., Hill, H., Rowhani-Rahbar, A., & Rivara, F. (2020). Invisible wounds: Community exposure to gun homicides and adolescents’ mental health and behavioral outcomes. SSM-Population Health, 12, 100689. https://doi.org/10.1016%2Fj.ssmph.2020.100689

Shulman, E. P., Beardslee, J., Fine, A., Frick, P. J., Steinberg, L., & Cauffman, E. (2021). Exposure to gun violence: associations with anxiety, depressive symptoms, and aggression among male juvenile offenders. Journal of Clinical Child & Adolescent Psychology, 50(3), 353-366. https://doi.org/10.1080/15374416.2021.1888742

American Psychiatric Association (APA). (2019). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Publishing

Goldstein, E. V., Prater, L. C., & Wickizer, T. M. (2019). Behavioral health care and firearm suicide: do states with greater treatment capacity have lower suicide rates? Health Affairs, 38(10), 1711-1718. https://doi.org/10.1377/hlthaff.2019.00753

The Federal Bureau of Investigations. (2023). Firearms Checks (NICS). Available at: https://www.fbi.gov/how-we-can-help-you/more-fbi-services-and-information/nics (Accessed 25 January 2023)

Leiding, D., Kaiser, F., Steffens, M., Puiu, A. A., & Habel, U. (2021). What determines violent behavior in men? Predicting physical, psychological, and sexual violent offending based on classification and regression tree analysis. Aggressive Behavior, 47(5), 570-582. https://doi.org/10.1002/ab.21981

Mayors Against Illegal Guns. (January 2013). Access denied: how the gun lobby deprives police, policymakers, and the public of the data we need to prevent gun violence. Available at: http://everytownresearch.org/reports/access-denied. (Accessed 25 January 2023).

Department of Health and Human Services (HHS). (June 2017). HIPAA Privacy Rule and the National Instant Criminal Background Check System (NICS). https://www.hhs.gov/hipaa/for-professionals/special-topics/nics/index.html

The Federal Bureau of Investigations. (January 2020). Identify Prohibited Persons. https://www.atf.gov/firearms/identify-prohibited-persons

The Centre for Disease Control and Prevention. (March 2020). Risk and Protective Factors. https://www.cdc.gov/violenceprevention/youthviolence/riskprotectivefactors.html (Accessed 25 January 2023)

Gramlich, J. (February 2022). What the data says about gun deaths in the U.S. https://www.pewresearch.org/fact-tank/2022/02/03/what-the-data-says-about-gun-deaths-in-the-u-s/

Emund, M. (June 2022). Gun Violence Disproportionately and Overwhelmingly Hurts Communities of Color. Available at: https://www.americanprogress.org/article/gun-violence-disproportionately-and-overwhelmingly-hurts-communities-of-color/ (Accessed January 2023)

The Centre for Disease Control and Prevention. (January 2023). Fatal Injury and Violence Data. Available at: https://www.cdc.gov/injury/wisqars/fatal.html (Accessed 24 January 2022)