Examining the Impact of Secondary Exposure to Gun Violence on Mental Health Outcomes, Suicidal Ideation and Psychotic Experiences in Four Urban Settings

Background and Purpose: Gun violence contributes to more than 32,000 deaths and 67,000 injuries annually. Given the high probability that U.S. residents will be exposed to gun violence and the mental health impact of losing a loved one to gun violence, it is important to understand the impact of secondary exposure to gun violence, on the mental health and psychological consequences (e.g. suicide ideation and psychotic experiences) of secondary victims. This study examined 1) differences in exposure to gun violence across multiple demographic characteristics and 2) the effect of secondary exposure to gun violence on mental health outcomes, suicidal ideation and psychotic experiences when controlling for significant demographic characteristics.

Methods: Data were drawn from the Survey of Police-Public Encounters (SPPE), an online Qualtrics survey of adult community residents from Baltimore, New York, Philadelphia, and Washington, D.C.  Participants were at least 18 years old residing within target cities resulting in a sample of 1615 respondents. Data analyses were conducted using SPSS. Chi square analyses were used to test for associations between demographic variables and secondary exposure to gun violence. Demographic variables that were significantly associated with secondary exposure to gun violence in bivariate analyses were then modeled together in a logistic regression to determine their independent contributions. Linear regression was used to test for associations between secondary exposure to gun violence and psychological distress. Logistic regression was used to test for associations between secondary exposure to gun violence and suicidal ideation and psychotic experiences.

Results:  23.8% of respondents positively endorsed having known someone who died due to gun violence. This varied across demographic groups, with secondary exposure to gun violence disproportionately experienced by individuals who were Black or Latino, younger, and of lower income and educational attainment. When modeling demographic characteristics together, the odds of secondary exposure to gun violence significantly varied by race/ethnicity. Blacks (O.R.=3.63, C.I. 2.75-4.81, p<.001) and Latinos (O.R.= 2.22, C.I. 1.52-3.25, p<.001) experienced significantly higher odds of secondary exposure to gun violence compared to Whites. Linear regression models indicated that secondary exposure to gun violence was significantly associated with greater severity of psychological distress (β=1.01, p<.001) and depression (β=1.25, p<.001). Logistic regression models indicated that the odds of endorsing suicidal ideation (O.R.= 1.95, C.I. 1.31 – 2.91, p < .01) or psychotic experiences (O.R.=  2.64 C.I. 1.99 – 3.51 p < .001) was significantly higher for participants exposed to gun violence.

Implications: Findings suggest that there are varied mental health reactions to gun violence. A particular novel finding was the significant relationship between secondary exposure to gun violence and psychotic experiences. Implications for research include further examination of secondary exposure to gun violence and its relationship to psychotic experiences in clinical populations. In addition, given the disproportionate number of Black and Latinos exposed to gun violence a more extensive examination of depression, distress, suicidal ideation and their relationship to exposure to gun violence is warranted.