Leaving Lake Wobegon: firearm-related education and training for medical and mental health professionals is an essential competence

Abstract

PurposeFirearm-involved violence and suicide in the USA, often collectively referred to as “gun violence,” has been labeled a public health problem and an epidemic, and even an endemic by some. Many lawmakers, community groups, mainstream media outlets and professional organizations regularly address gun-related issues and frequently associate firearm violence with mental health. As a result, these groups often set forth positions, engage in discussions and promote policies that are at least partially based on the widely held but incorrect assumption that medical and mental health professionals are either inherently equipped or professionally trained to intervene with their patients and reduce gun deaths. The paper aims to discuss this issue.Design/methodology/approachFurthermore, notable proportions of medical and mental health professionals self-report a level of comfort engaging in firearm-specific interventions that is often disproportionate to their actual education and training in the area. This type of overconfidence bias has been referred to as the Lake Wobegon Effect, illusory superiority, the above average effect, the better-than average effect or the false uniqueness bias. While medical and mental health professionals need to serve on the front line of firearm-involved violence and suicide prevention initiatives, the vast majority have not actually received systematic, formal training on firearm-specific issues.FindingsTherefore, many lack the professional and cultural competence to meet current and potential future in regard to addressing gun violence. In this paper, the authors discuss empirical studies that illustrate this reality and a novel model (i.e. the Know, Ask, Do framework) that medical and mental health professionals can use when firearm-related issues arise. In addition, the authors set forth considerations for clinicians to develop and maintain their professional and cultural competence related to firearms and firearm-related subcultures.Originality/valueThis paper provides empirical and conceptual support for medical and mental health programs to develop formal education and training related to guns, gun safety and gun culture. A framework is provided that can also assist medical and mental health professionals to develop and maintain their own professional and cultural competence.