This blog is part of a month-long series from NAPH members addressing the relationship between gun violence and health care. Look for more posts this month covering issues from California to New York.

Pediatricians and parents know that children are “unsafe at any speed.” Kids are endlessly curious and quickly become very adept at getting anything they are not physically prevented from reaching. They explore their world without understanding danger and, in one unsupervised instant, can drown or shoot someone or get run over. School-aged children learn from everything they see, hear and experience, modeled by us and in the media. They want to act like their avatars and often do not understand that pain is real or that death is permanent. I am still haunted by the memory of aiming a loaded rifle at my babysitter.

Studies have shown how powerful and dangerous violent videogames, movies and TV shows can be in causing aggressive and risky behaviors in children. Teenagers fight over lovers, money, even sneakers. They are impulsive, decide to do things in an instant, and often feel the need is much greater than it is in reality. A gun in their hands is often fatal. Ninety percent of suicide attempts with guns are lethal, while attempts by other means cause death less than 5 percent of the time.

Parents rely on pediatricians, like my wife and me, to discuss all manner of worrisome issues with them and to help them cope. The American Academy of Pediatrics (AAP) provides extensive guidelines to help busy physicians screen and identify children at risk for diseases and behaviors that could harm themselves and others.

I see it as our responsibility as physicians to help parents nurture, educate, and protect their children so that they can thrive, excel in school, and grow up to be happy, socially engaged, productive, and successful members of society. To do this, I routinely discuss issues of considerable sensitivity, such as forms of discipline used in the home; exposure to violence; sexual activity; and, yes, the presence of lead, poisons, guns, and other dangerous items in their homes. Parents seem to deeply appreciate my help. And studies show that conversations like these are often eye opening, and that counseling is effective in decreasing the risks of these situations.

As pediatricians, every day we see children whose behaviors are antisocial and even dangerous. Young people with mental illness are often not given a diagnosis, at least not early on, and the danger they pose to themselves and others is often underestimated or misinterpreted. Withdrawn, antisocial individuals can be as dangerous as angry, disruptive ones, and isolated teens may seem harmless until a professional opens the can of deadly ideas they may harbor.

Here in the United States, we have too few mental health professionals and a poor insurance coverage system. Parents, doctors and law-enforcement personnel struggle to find diagnostic and therapeutic services for troubled children and adolescents. Occasionally, these children and our system’s deficiencies combine for nightmarish tragedies that might have been avoided had we given more attention to both.

President Obama has started the process by proposing a number of important first steps. My wife and I are extremely supportive of this effort. Pediatric leaders worked closely with the vice president in the development of this “Plan to Protect our Children and our Communities by Reducing Gun Violence.” Our daily experience as physicians underscores how critical these initiatives could be in reducing civilian gun violence and keeping guns out of the hands of immature and unsafe individuals. We urge our national leaders to act speedily and wisely, and urge the rest of us to start building a national culture focused on safety, responsibility and the prevention of violence in all our communities.

Sean Palfrey, MD, FAAP
Professor of Pediatrics and Public Health
Boston University and Boston Medical Center