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35% of children injured with a firearm receive a new mental health diagnosis in the year following their injury. 

Data published recently in the Anals of Surgery found that child survivors of firearm injury have high rates of new mental health diagnoses, even when compared with children who have injuries in motor vehicle accidents. 

“In 2020, firearms injuries became the leading cause of death among children and adolescents in the United States followed by motor vehicle collisions (MVC). Outside of firearm-related suicides, most firearm victims survive however we know very little about the long-term effects of firearm injuries especially mental health,” Dr. Peter Ehrlich, lead author of the study and director of pediatric trauma care at the University of Michigan’s C.S. Mott Children’s Hospital told Theravive. 

“Trauma exposure, such as that experienced with a firearm injury, is a well-established risk factor for child mental health (MH) conditions. Past work indicates that violent injuries are often associated with greater risk of mental health symptoms and recurrent injury compared with non-violent injuries. These are my patients and  we need to help them so they can have long productive lives,” he said. 

In undertaking the study, Ehrlich and colleagues examined data from nearly 1500 children who experience firearm injury aged between 3 and 17. They also examined data from nearly 3700 children injured in crashes. 

80% of both populations studied were boys, and the average age was 15. Of the children injured by a firearm, 65% were black. 

The data suggests that the majority of the new mental health diagnoses given to children were related to substance misuse of alcohol or drugs. Stress conditions like post-traumatic stress disorder were also common. 

Children who had survived a firearm injury were twice as likely to be diagnosed with substance misuse or a stress related condition compared with those who had survived a car crash. 

“Children following a firearm injury are at high risk of developing serious mental health problems that could have long term effects. Firearm injuries are only going to increase in the next 10 years making this a high priority for trauma centers,” Ehrlich said. 

The researchers also examined whether a new diagnosis was a child’s first ever mental health diagnosis or whether it was in addition to an already diagnosed mental health condition.   

18.4% of the children injured by a firearm who had not previously received a mental health diagnosis received a new diagnosis in the year following their injury. This compares with 13.5% of children in the crash group. 

Of children who already had a mental health diagnosis prior to their injury, 16.4% of those in the firearm group received an additional mental health diagnosis, compared with 12.5% of those who were in a crash. 

The authors say that those who survived firearm injury had higher rates of injury severity, were more likely to need intensive care and were more likely to be hospitalized compared with crash survivors.

They argue this has implications for the complexity of follow up care, as well as the costs of care. 

Those who were admitted to hospital were more likely to receive a new mental health diagnosis. 

Ehrlich says he is hopeful the study will highlight the many disorders that could occurs in young survivors of firearm injury, so that they can receive appropriate care and diagnosis. 

“We need to develop, test, and implement early screening for mental health problems following a firearm injury in a child. We need to ensure access to care for these children. We need to support the families. We need to develop educational materials,” he said.