Gunshot survivors experience chronic pain, post-traumatic stress disorder and other physical and mental health challenges at rates higher than survivors of other traumatic injuries, according to a new study by researchers at Boston’s Brigham and Women’s Hospital.
Researchers surveyed patients 6-to-12 months after discharge from three level I trauma centers in Boston who had survived traumatic injuries like shootings, car crashes and falls. Among survivors of firearm injuries, 68 percent reported daily pain, 59 percent had not returned to work, 53 percent screened positive for PTSD and 39 percent experienced difficulties with daily activities like walking, driving, showering and going to the bathroom. These rates exceeded those of survivors of car crashes and falls.
“What those numbers are telling us is that most of the firearm injury survivors are really struggling to come back and have the life they used to have before the injury,” said lead study author Dr. Juan Herrera-Escobar of Brigham and Women’s Hospital and Harvard Medical School.
The number of people that survive gunshot injuries in the U.S. is notoriously difficult to calculate, due to a lack of information from the U.S. Centers for Disease Control and Prevention. But by any measure, tens of thousands of Americans survive a gunshot wound every year.
According to Herrera-Escobar, no trauma registry in the country collects data beyond 30 days after a patient is discharged from the hospital. The lack of that data, he says, makes it challenging to analyze how a survivor’s health is impacted in the months and years following their initial hospitalization.
“In some ways the trauma systems are failing to provide optimal care after the patients are discharged from the hospital,” Herrera-Escobar said. “We need to get better at guaranteeing the continuing of care throughout the injury up to when the patient is back to their baseline status.”
Sasa Harriott is a registered nurse and founder of Harriott Home Health Services (HHHS), a Hartford, Connecticut-based health agency that provides an array of in-home medical, behavioral and occupational health services. Harriott started HHHS because she saw people within her community struggling to recover from their injuries and access long-term rehabilitation services like therapy and consistent medical assistance.
“They go home but then they’re going back to the hospital a lot because their wounds deteriorate quickly,” Harriott said. “So someone may have just have been shot in the leg and that wound to the leg, because they don’t get care, results in major bone infections and then at that point they need to become amputees.”
Many survivors, she said, go home believing they can manage their injuries but then become overwhelmed.
“They have a support system in place that after a while gets burned out quickly,” Harriott said. “Family members get burned out, caregiver-role strains starts to sink in but then by then, they’re no longer connected to the initial agencies that were in place.”
Herrera-Escobar recalled a patient suffering from PTSD who was struggling to find adequate psychiatric services because of language barriers.
“Translation in the clinic wasn’t very helpful for him, as he was not comfortable with sharing all the things he was going through with an extra person in the room,” Herrera-Escobar said. “So I think that highlights that there are some structural barriers in the system that we can work on to guarantee that these patients have better access to the service they need in the long-term.”
He says the study highlights that gunshot survivors are a vulnerable population that have special needs when it comes to their recovery and their rehabilitation once they are discharged from the hospital.
“As trauma systems continue to improve and we keep getting better at saving lives every year,” Herrera-Escobar said, “our attention should start shifting to the impact that firearm injuries have on those who survive.”
Guns & America is a public media reporting project on the role of guns in American life.