Psychiatrist

Spring 2023

Jonathan Stone (he/him) OUWB School of Medicine, Class of 2024 Wisconsin Alzheimer's Institute (WAI)

Volume 39, Number 1

A Personal Journey: Confronting the Interplay of Guns and Mental Health in Rural America

As a medical student, I've borne witness to the complexities of mental health and the harrowing impact of gun violence. However, my understanding of this issue is deeply rooted in my own upbringing and experiences in rural Wisconsin—a place where guns were a ubiquitous presence, and mental health care was distressingly scarce. Growing up, guns were an integral part of my life. I received my first gun at the age of 12, and by the time I was 16, I had bought and sold over ten firearms using a private sale website, and fired thousands of rounds of ammunition.

I recall a Military Gun Show, where a friend and I at the age of 14 were offered a private sale for an old Russian World War II sniper rifle for just $80, with an ammo can of 440 rounds for around $50. Access to guns was effortless, but the same couldn't be said for mental health services. My undiagnosed mental health concerns cast a shadow over my life, yet therapists and psychiatrists were few and far between.

The culture of guns in rural Wisconsin extended beyond hobby and sport—it was a way of life. Hunting trips with family and friends, target shooting on the weekends, and gun safety lessons were all part of my upbringing. It was a world where firearms were normalized, yet discussions about mental well-being were virtually absent.

Fast forward to my time working as an EMT for a fire department in rural Wisconsin. Here, I faced the harsh realities of a struggling community—administering naloxone to individuals seeking solace in drugs as family farms crumbled under economic pressures. My colleagues, the heroes who served their community selflessly, kept the traumas of challenging EMS calls to themselves. Yet, in the break room, they'd proudly discuss their newly built AR-15 rifles. It was a poignant reflection of the culture in the Midwest, where guns were a source of pride and identity, while mental health struggles remained hidden behind closed doors.

Spring 2023

Volume 39, Number 1

A Personal Journey: Confronting the Interplay of Guns and Mental Health in Rural America- Continued

My experiences in medicine brought the tragic consequences of gun violence into sharp focus. During my surgery rotation, while on-call in the Surgical Intensive Care Unit (SICU), I received a page to respond to a trauma. In the chaos of the emergency room, I found a patient with a gunshot wound to her chest. The story unraveled as an officer explained that the woman's husband had shot her, their daughter, and then turned the gun on himself. He lay in the trauma bay next to her, a haunting sight.

While the patient survived the ordeal, the emotional wounds cut deep. After her procedure, she faced a new reality: a world without her daughter, taken from her by the hands of her former lover. A fellow medical student, who later rounded on her during Internal Medicine, described her palpable grief.

This tragic event etched itself into my consciousness, highlighting the need for proactive measures to address mental health and prevent gun violence. While access to guns was never a barrier in my community, access to mental health care was. We must confront this disparity, particularly in rural areas where the prevalence of firearms is high.

As I reflect on my journey, I'm acutely aware of the need for potential strategies and initiatives to address mental health and gun violence. Whether it's increasing access to therapists and psychiatrists in rural areas, providing mental health training for first responders, fostering open conversations about mental well-being, establishing schoolbased programs for early intervention and emotional support, or increasing gun restrictions, each step makes a difference.

Community-based initiatives that prioritize mentorship, education, and vocational training can also provide positive alternatives and pathways to success for at-risk youth. By partnering with local leaders, law enforcement, mental health professionals, and community organizations, we can develop programs that address underlying determinants of violence, such as poverty, systemic inequalities, and lack of access to resources.

Spring 2023

Volume 39, Number 1

A Personal Journey: Confronting the Interplay of Guns and Mental Health in Rural America-

Continued

I believe that addressing gun violence requires tackling the underlying societal and systemic issues that contribute to it. In rural areas, where the culture of guns is deeply ingrained, solutions must be nuanced and sensitive to the values of the community. This includes advocating for responsible gun ownership and safe storage practices, as well as providing education on the intersection of mental health and firearm safety.

Moreover, I envision a future where mental health advocacy and education campaigns help break the stigma associated with seeking mental health support. Creating a culture of openness and understanding around mental health can empower individuals to reach out for help when they need it and encourage community members to look out for one another.

As a future psychiatrist, I am committed to using my experiences and medical training to contribute to efforts aimed at mental health care and gun violence prevention. It's a mission that begins in the corridors of hospitals, extends to the fields of rural farms, and reaches the halls of policymakers. It's a mission that calls for collaboration, compassion, and a relentless pursuit of change.

Together, we can break the cycle of violence and create a safer, more compassionate world —one where individuals are empowered to seek help without stigma, where families can heal from trauma, and where communities are equipped with the resources to thrive. It's a vision that I carry with me as I embark on the next chapter of my medical career, and one that I hope will inspire others to join me in making a difference.

As I stand at the crossroads of my journey, I am filled with a sense of purpose and resolve. I am motivated by the stories of those I have met, the resilience of communities that have faced adversity, and the unwavering belief that we have the power to shape a brighter future. For me, the path forward is clear—it is a path of advocacy, healing, and hope.

In closing, I want to extend a special encouragement to my fellow medical students, residents, and early-career psychiatrists. Your voices, experiences, and insights matter. Let us continue to learn, advocate, and strive for a better world—one where mental health is prioritized, and communities are empowered to flourish.

Spring 2023 www.communitypsychiatry.org