Sticking to My Guns: Managing Firearm Ownership in Older Adults Through Sociocultural Context

Abstract

Psychiatrists are increasingly aware of the broad need for cultural competency, even within cultures in which they may be more familiar. Important examples of this have increasingly come to light in the context of firearm ownership, conversations surrounding gun legislation, and the role of individual autonomy balanced against social responsibility. Included within this understanding are themes of the American identity, including exceptionalism, individualism, democratic autonomy, and hard work, all serving a pivotal role in the development of political anti-establishmentarianism. Within this framework, characteristics of gun culture must be examined within the context of the individual domains which make it up, including the social, political, and individual factors which lead to an individual's personal valence toward firearms and rates of ownership and use of firearms within the United States.Older adults make up an increasing segment of the population, and geriatric psychiatrists play an ever-important role in the provision of mental health services within the United States. A question perpetually present within geriatrics is whether specific characteristics or factors of individuals within the same age group represent a generational cohort effect as consequence of social, economic, or cultural factors or an age-related developmental effect as consequence of universal age-related factors. Such questions include, but are not limited to, whether gun ownership may be best be contributed to by survival during eras of conflict or socioeconomic decline vs. loss of physical abilities of protection or external social support. Within this context, rates of gun ownership among older adults will be examined across time and across specific age groups, with specific examination of potential contributors.Evidence-based research guides development of a framework for lethal means counseling in older adults, which considers all of the aforementioned influences within a cultural context. Specific clinical guidance will be offered which seeks to establish a foundation for safety assessment and treatment planning. Specific discussion of lethal means counseling as it applies to patients with neurocognitive disorders will also be conducted.