Substance abuse history, mental health and firearm violence: from evidence to action

 描述（由申请人提供）：在美国，火器伤害是导致死亡的主要原因之一。1政府的立法反应集中在对枪支购买的背景调查上，精神健康状况导致越来越多的人失去购买枪支的资格。然而，现有证据表明，精神病患者遭受暴力的绝对风险很低，这是由先前的药物使用史和犯罪史而不是精神病史预测的。国家变化：（1）非自愿承诺和其他类型的精神健康裁决的法律的标准;（2）与精神健康有关的枪支资格取消;以及（3）向背景调查数据库报告枪支资格取消的精神健康记录也为负责制定和评估取消资格的临床医生和立法者造成了歧义。需要关于背景调查取消资格的有效公共卫生办法的信息。我们提出了一个基于代理人的枪支市场模型，该模型将估计在取消枪支资格的各种情况下可以防止的死亡绝对数量，重点关注三个主要领域：a）精神疾病; B）药物滥用;和c）犯罪。我们将实施基于风险的枪支政策联盟建议的取消资格方案，以便为利益攸关方提供最佳的公共卫生方法，利用背景调查立法来防止枪支暴力。

 DESCRIPTION (provided by applicant): Firearm injury is one of the leading causes of death in the United States.1 Governmental legislative response has focused on background checks for firearm purchasing, and mental health conditions account for an increasing percentage of disqualifications from firearm purchase. Available evidence indicates, however, that the absolute risk of violence by individuals who are mentally ill is low and is predicted by a prior history of substance use and criminality rather than mental illness. State variations in: (1) legal criteria fr involuntary commitment and other types of mental health adjudication; (2) mental health-related disqualifications from firearms; and (3) reporting firearm-disqualifying mental health records to the background check database also create ambiguities for clinicians and law makers tasked with shaping and evaluating disqualification. Information on an effective public health approach to background check disqualification is needed. We propose an agent-based model of firearm markets that would estimate the absolute number of deaths that would be prevented under various scenarios for firearm disqualification focusing on three main areas: a) mental illness; b) substance abuse; and c) criminality. We will implement disqualification scenarios recommended by the Consortium for Risk-Based Firearms Policy, in order to provide stakeholders with the optimal public health approach to using background check legislation to prevent firearm violence.