Leaving Lake Wobegon: firearm-related education and training for medical and mental health professionals is an essential competence
| Pages | 78-87 |
| Date | 08 April 2019 |
| DOI | https://doi.org/10.1108/JACPR-11-2018-0391 |
| Published date | 08 April 2019 |
| Author | Gianni Pirelli,Liza Gold |
| Subject Matter | Health & social care |
Leaving Lake Wobegon: firearm-related
education and training for medical and
mental health professionals is an
essential competence
Gianni Pirelli and Liza Gold
Abstract
Purpose –Firearm-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 regularl y 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/approach –Furthermore, 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.
Findings –Therefore,many lack the professionaland cultural competenceto meet current and potentialfuture
in regardto addressing gun violence.In this paper, the authorsdiscuss empiricalstudies that illustratethis 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 setforth considerations for cliniciansto develop and
maintain their professional and culturalcompetence related to firearms and firearm-related subcultures.
Originality/value –This 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.
Keywords Violence, Mental health, Suicide, Firearms, Guns, Gun violence
Paper type Conceptual paper
Professional eth ics codes highlight the importa nce of developing and maintainin g professional
competencies as a core concept and moral obligation for medical and mental health
professionals; this includes the American Psychological Association (APA) (APA 2017); the
American Medical Association (AMA) (American Medical Association, 2017); the American
Psychiatric Association (American Psychiatric Association, 2013); the American Counseling
Association (ACA) (ACA 2014); and National Association of Social Workers (NSW) (National
Association of Social Workers, 2017). In fact, each of these organizations cites professional
and cultural competence as a critical component for ethical practice. Specifically, the American
Psychological As sociation’s and the A merican Psychiat ric Association' s codes emphasize
both the need for psy chologists and ps ychiatrists to pra ctice within the bou ndaries of their
competence and to maintain such; the AMA’s Code of Ethics indicates that their ethical
principles are based upon physicians’dedication to provide competent medical care; and both
Received 15 November 2018
Revised 9 January 2019
Accepted 18 January 2019
This paper forms part of a special
section “Novel firearms-related
research and scholarship”.
Gianni Pirelli is the Leader of the
Group Practice, Pirelli Clinical
and Forensic Psychology, LLC,
Verona, New Jersey, USA.
Liza Gold is Clinical Professor of
Psychiatry at Georgetown,
University School of Medicine,
Washington, District of
Columbia, USA.
PAGE78
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JOURNAL OF AGGRESSION, CONFLICTAND PEACE RESEARCH
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VOL. 11 NO. 2 2019, pp. 78-87, © Emerald Publishing Limited, ISSN 1759-6599 DOI 10.1108/JACPR-11-2018-0391
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