Tag: violence in society

What? You’re calling my kid a simp? | CNN

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Editor’s note: After we first published this story in 2021, we received reader feedback about the term’s derivation and use in pop culture. We updated the story to reflect those additional details.



CNN
 — 

Shannon was used to her socially awkward son being bullied by other boys at the private school he attends.

But when she picked him up from school and he told her he was being called a “simp,” Shannon, who’s only using her first name to protect her son’s identity, didn’t know what to think.

“He’s telling me this and I’m driving and I’m trying to make sense of it,” she said. “I’d never heard the word.”

“He told me, ‘It basically means that I’m just being nice to girls because I like them,’” she said. “I was like, wait, my kid is being picked on for being nice to girls?”

Her son had told her he had recently been put in the “friend zone” by one of the girls, who made it clear she wasn’t interested in dating him. They had continued to be friendly.

“You do all these things as a parent to raise your kid right, to be nice to everyone, especially kids without many friends,” Shannon said. “And you never think that by making your kid the nice one you could be making them a target for bullies.”

Many parents might be unfamiliar with the word “simp,” but chances are your tween or teen has used or at least heard the term.

Simp hashtags are rampant on TikTok. Instagram has more 600,000 posts tagged #simp, and there are Facebook groups devoted to simps and simping. (It can be a verb, too.)

Depending on whom you talk to, there is some debate on the word’s usage and how much (if at all) it has evolved over time. While simp’s origins are connected to the word “simpleton,” its current usage is linked to West Coast American rappers such as Too Short, who first used it in the mid-1980s in a way that denotes the opposite of “pimp” in his song “Pimpology.”

In 1992, Boyz II Men released a song called “Sympin’ Ain’t Easy,” offering a different spelling of the word and evoking frustrated yearning.

Urban Dictionary’s top definition of a simp is “someone who does way too much for a person they like.” Other definitions on the crowdsourced online dictionary include “a guy that is overly desperate for women, especially if she is a bad person, or has expressed her disinterest in him whom which he continues to obsess over.”

“‘Simp’ is slang for a person (typically a man) who is desperate for the attention and affection of someone else (typically a woman),” said Connor Howlett, then a digital strategist in New York City in 2021, in an email to CNN.

“Think the energy of puppy dog eyes but manifested in a romantic, human form,” Howlett said. “It’s used in an insulting manner. Though typically playful, there are definitely undertones of toxic masculinity since it’s related to showing too much emotion.”

Karen McClung first encountered the word in group chats she closely monitors with her daughter and son.

“I saw the word and quickly looked it up,” McClung said. “I asked my kids what they thought it meant and my son said, ‘It’s basically if you had $1,000 and you could do anything with it, you’d use it to get the attention of a girl — then everyone would make fun of you.”

“I blocked the thread,” she said.

McClung said her son wasn’t being called a simp in the thread, but she said she’s “curious to see how it impacts my son because he’s very chivalrous by nature.”

A word that emerged into Generation Z vernacular from social media usage, as simp is thought to have arrived, is bound to get muddled and continue to evolve.

And simp can have different contexts depending on the age group using it, said Laura Capinas, a clinical social worker in Sonoma County, California.

“Depending on if it’s a middle schooler or a high schooler using it, it could be different,” she said, and it’s not just boys talking about simps and simping either.

“Girls in high school sometimes throw out the term to their high school girlfriends,” Capinas said. “Some kids I’ve talked to have said it’s not a derogatory term. It’s sort of like teasing someone, like ‘You’ve left us to go hang out with your friends, you’re simping us.’”

“If you have someone saying it who’s used to being a bully, it will be received as a bully comment,” she said.

She hasn’t heard kids or parents in her practice be overly concerned about the word, but Capinas often hears kids use it in describing their day or their peer groups.

Myra Fortson said she has discussed the word with her daughter and thinks such words often “spread more quickly than their meaning.”

“Kids will also own their language by refusing to go back to its original meaning,” said the mother of three. “They will say things like, ‘Maybe that’s where it comes from, but it doesn’t mean that anymore.’ And they keep using the term the way they want.”

One way to think of a simp, said Sean Davis, a marriage and family therapist in California, is “simply someone who is ahead of their time.”

“Though it hurts in the moment, in the big picture, a boy who is called a ‘simp’ can wear it as a badge of honor,” Davis said.

“Today’s boys are being raised in the middle of the biggest redefinition of male gender roles in recent history,” Davis said. “Should I be kind and sensitive or distant and aloof when trying to win a partner over?”

As with all bullying, teens and tweens should first tell their parents or a trusted adult who may be able to intervene on their behalf, he said. “Otherwise, simply owning it and refusing to be ashamed can help.”

It’s important for parents to remember that there have always been slang terms to navigate for kids and parents alike, Capinas said, and the goal is to “make sure it’s being received in a playful manner and used playfully.”

“I think we are always looking to stop our kids from being hurt,” she said. “We don’t like language that’s slang and has potential for negative connotation.”

One tactic she teaches kids in her therapy sessions, she said, is the “humor tool.”

“It’s comic relief. You practice not putting down the other person, you put down the situation,” she said.

If someone is being called out for always “simping the girls,” Capinas said, “he could turn it around and say, ‘It’s tough being the lone soldier simp nice guy, who wants to join me?’”

“You can turn it and make it into comedy,” she said.

Davis pointed to a similar approach.

“Telling the bully, ‘That’s right,’ while holding your head up high and walking away can help, as bullies usually give up if they don’t succeed in tearing the other person down,” he said. “And you can tell yourself that being bullied is simply the price a revolutionary has to pay for standing up for what’s right.”

Shannon said her son’s therapist advised similar tactics, but the boy said he only comes up with the perfect retort three hours later.

“It’s just been really heartbreaking, especially because I know a lot of these boys bullying him. He’s been at the school since second grade,” Shannon said. “If their moms knew, they’d be horrified. But my son doesn’t want me to tell them because it will just get worse.”

This story was originally published in February 2021 and has been updated.

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How the nursing shortage may lead to gaps in sexual assault care | CNN

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Missoula, Montana
KFF Health News
 — 

Jacqueline Towarnicki got a text as she finished her day shift at a local clinic. She had a new case, a patient covered in bruises who couldn’t remember how the injuries got there.

Towarnicki’s breath caught, a familiar feeling after four years of working night shifts as a sexual assault nurse examiner in this northwestern Montana city.

“You almost want to curse,” Towarnicki, 38, said. “You’re like, ‘Oh, no, it’s happening.’”

These nights on duty are Towarnicki’s second job. She’s on call once a week and a weekend a month. A survivor may need protection against sexually transmitted infections, medicine to avoid getting pregnant, or evidence collected to prosecute their attacker. Or all the above.

When her phone rings, it’s typically in the middle of the night. Towarnicki tiptoes down the stairs of her home to avoid waking her young son, as her half-asleep husband whispers encouragement into the dark.

Her breath is steady by the time she changes into the clothes she laid out close to her back door before going to bed. She grabs her nurse’s badge and drives to First Step Resource Center, a clinic that offers round-the-clock care for people who have been assaulted.

She wants her patients to know they’re out of danger.

“You meet people in some of their most horrifying, darkest, terrifying times,” Towarnicki said. “Being with them and then seeing who they are when they leave, you don’t get that doing any other job in health care.”

A former travel nurse who lived out of a van for years, Towarnicki is OK with the uncertainty that comes with being a sexual assault nurse examiner.

Most examiners work on-call shifts in addition to full-time jobs. They often work alone and at odd hours. They can collect evidence that could be used in court, are trained to recognize and respond to trauma, and provide care to protect their patients’ bodies from lasting effects of sexual assault.

But their numbers are few.

As many as 80% of U.S. hospitals don’t have sexual assault nurse examiners, often because they either can’t find them or can’t afford them. Nurses struggle to find time for shifts, especially when staffing shortages mean covering long hours. Sexual assault survivors may have to leave their town or even their state to see an examiner.

Gaps in sexual assault care can span hundreds of miles in rural areas. A program in Glendive, Montana — a town of nearly 5,000 residents 35 miles from the North Dakota border — stopped taking patients for examinations this spring. It didn’t have enough nurses to respond to cases.

“These are the same nurses working in the ER, where a heart attack patient could come in,” said Teresea Olson, 56, who is the town’s part-time mayor and also picked up on-call shifts. “The staff was exhausted.”

The next closest option is 75 miles away in Miles City, adding at least an hour to the travel time for patients, some of whom already had to travel hours to reach Glendive.

Nationwide, policymakers have been slow to offer training, funding, and support for the work. Some states and health facilities are trying to expand access to sexual assault response programs.

Oklahoma lawmakers are considering a bill to hire a statewide sexual assault coordinator tasked with expanding training and recruiting workers. A Montana law that takes effect July 1 will create a sexual assault response network within the Montana Department of Justice. The new program aims to set standards for that care, provide in-state training, and connect examiners statewide. It will also look at telehealth to fill in gaps, following the example of hospitals in South Dakota and Colorado.

There’s no national tally of where nurses have been trained to respond to sexual assaults, meaning a survivor may not know they have to travel for treatment until they’re sitting in an emergency room or police department.

Sarah Wangerin, a nursing instructor with Montana State University and former examiner, said patients reeling from an attack may instead just go home. For some, leaving town isn’t an option.

This spring, Wangerin called county hospitals and sheriff’s offices to map where sexual assault nurse examiners operate in Montana. She found only 55. More than half of the 45 counties that responded didn’t have any examiners. Just seven counties reported they had nurses trained to respond to cases that involve children.

“We’re failing people,” Wangerin said. “We’re re-traumatizing them by not knowing what to do.”

First Step, in Missoula, is one of the few full-time sexual assault response programs in the state. It’s operated by Providence St. Patrick Hospital but is separate from the main building.

The clinic’s walls are adorned with drawings by kids and mountain landscapes. The staff doesn’t turn on the harsh overhead fluorescent lights, choosing instead to light the space with softer lamps. The lobby includes couches and a rocking chair. There are always heated blankets and snacks on hand.

Kate Harrison turns on her pager at the start of her night shift as a sexual assualt nurse examiner.

First Step stands out for having nurses who stay. Kate Harrison waited roughly a year to join the clinic and is still there three years later, in part because of the staff support.

The specially trained team works together so no one carries too heavy a load. While being on night shift means opening the clinic alone, staffers can debrief tough cases together. They attend group therapy for secondhand trauma.

Harrison is a cardiac hospital nurse during the day, a job that sometimes feels a little too stuck to a clock.

At First Step, she can shift into whatever role her patient needs for as long as they need. Once, that meant sitting for hours on a floor in the lobby of the clinic as a patient cried and talked. Another time, Harrison doubled as a DJ for a nervous patient during an exam, picking music off her cellphone.

“It’s in the middle of the night, she just had this sexual assault happen, and we were just laughing and singing to Shaggy,” Harrison said. “You have this freedom and grace to do that.”

When the solo work is overwhelming or she’s had back-to-back cases and needs a break, she knows a co-worker would be willing to help.

“This work can take you to the undercurrents and the underbelly of society sometimes,” Harrison said. “It takes a team.”

That includes co-workers like Towarnicki, who dropped her work hours at her day job after having her son to keep working as a sexual assault nurse examiner. That meant adding three years to her student loan repayment schedule. Now, pregnant with her second child, the work still feels worth it, she said.

On a recent night, Towarnicki was alone in the clinic, clicking through photos she took of her last patient. The patient opted against filing a police report but asked Towarnicki to log all the evidence just in case.

Towarnicki quietly counted out loud the number of bruises, their sizes and locations, as she took notes. She tells patients who have gaps in their memories that she can’t speculate how each mark got there or give them all the answers they deserve.

But as she sat in the blue light of her computer screen long after her patient left, it was hard to keep from ruminating.

“Totally looks like a hand mark,” Towarnicki said, suddenly loud, as she shook her head.

All the evidence and her patient’s story were sealed and locked away, just feet from a wall of thank-you cards from patients and sticky notes of encouragement among nurses.

On the harder evenings, Towarnicki takes a moment to unwind with a pudding cup from the clinic’s snacks. Most often, she can let go of her patient’s story as she closes the clinic. Part of her healing is “seeing the light returned to people’s eyes, seeing them be able to breathe deeper,” which she said happens 19 out of 20 times.

“There is that one out of 20 where I go home and I am spinning,” Towarnicki said. In those cases, it takes hearing her son’s voice, and time to process, to pull her back. “I feel like if it’s not hard sometimes, maybe you shouldn’t be doing this work.”

It was a little after 11 p.m. as Towarnicki headed home, an early night. She knew her phone could go off again.

Eight more hours on call.

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Bullying doesn’t look like it used to. Experts share how to fix it | CNN

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Editor’s Note: If you or someone you know is struggling with suicidal thoughts or mental health matters, please call the National Suicide Prevention Lifeline at 988 (or 800-273-8255) to connect with a trained counselor or visit the NSPL site.



CNN
 — 

Every generation has tales of bullying, but perhaps today’s adults are not as familiar with what it means now for a kid to be bullied.

Physical bullying — like confrontations involving hitting or shoving — actually showed very little association with a risk for mental distress, according to a new study.

“For adults doing this research, you kind of assume that bullying consists of being stuffed in a locker and beaten up on the playground,” said lead study author John Rovers, professor and John R. Ellis Distinguished Chair in Pharmacy Practice at Drake University in Des Moines, Iowa. “We found out that that really has remarkably little effect.”

Researchers took data from the 2018 Iowa Youth Survey of sixth, eighth and 11th graders to see whether there was an association between bullying and mental health and suicidal ideation, according to the study published Wednesday in the journal PLOS ONE.

The results showed different forms of bullying did have an impact on feelings of sadness or hopelessness or thoughts of suicide — but that they did not impact students equally.

Identity bullying, which includes bullying based on sexual orientation or gender identity as well as sexual jokes, was correlated with significant feelings of distress or suicide attempts, the study said.

Cyberbullying and social bullying — leaving someone out or turning peers against them — followed identity bullying on degree of impact.

The study is limited in that the sample did not include a high level of racial and religious diversity, but it does show “a theme very consistent with recent surveys as well as what I’m seeing in my clinical practice,” said child and adolescent psychiatrist Dr. Neha Chaudhary, chief medical officer at BeMe Health who is in the faculty at Massachusetts General Hospital and Harvard Medical School. Chaudhary was not involved in the research.

The teachers and school administrators surveyed were worried most about physical bullying, however, according to the study.

“This is a good learning for schools and families as they think about anti-bullying initiatives and how to talk to young people about the effects of bullying,” Chaudhary said.

It makes sense that identity would be a particularly painful form of bullying.

“Identity is so incredibly important for kids and teens as they develop, and not being able to be themselves without fear of judgement or bullying from others is not only isolating, it can significantly alter their confidence, peace of mind, and ability to see a future for themselves that’s free of pain,” Chaudhary said in an email. “People just want to be themselves, and be loved for who they are.”

The survey data reviewed by the study team revealed a troubling statistic when it came to the state of adolescent mental health.

“About 70,000 students responded to this survey. Five percent of them had attempted suicide in the last year,” Rovers said. “That’s 3,500 kids.”

And this week’s results of the US Centers for Disease Control and Prevention’s biannual Youth Risk Behavior Survey showed mental distress among teens is getting worse.

In rates that “increased dramatically” over the past decade, most high school girls (57%) felt persistently sad or hopeless in 2021, double the rate for teen boys (29%), according to the CDC. Nearly 1 in 3 teen girls seriously considered attempting suicide.

Most LGBTQ students (52%) have also recently experienced poor mental health, and more than 1 in 5 attempted suicide in the past year, the CDC survey showed.

Solutions that address adolescent mental health may come from families and schools working together — not in focusing on what the kids themselves can change, Rovers said.

“Blaming this on some 9-year-old kid is not right,” he added.

When it comes to bullying, there are three types of players: the bully, the victim and the child that is both being bullied and bullying others, Rovers said.

All three need support, said Dr. Hina Talib, adolescent medicine specialist at the Atria Institute in New York and associate professor of clinical pediatrics at the Albert Einstein College of Medicine in New York City.

“Bullying is such a pattern of behavior that causes harm to the victim of the bully, the children that might just be witnessing the bullying happening and even to the bully themselves,” said Talib, who was not involved in the research.

Rarely is a child exerting power over others just for its own sake, Talib added.

While caregivers may have the first reaction to punish their child when they hear they are bullying others, it is important to probe a little deeper into what is going on with them, she said.

“There are likely reasons there that are causing them to act out in this way,” Talib explained. “Underneath that, I think it’s important to see that their child is hurting also.”

She recommended coming to them with the mindset of “this is not acceptable behavior, and this is why, and I’m here to help you through it,” Talib said.

“The bully can and should be helped as well,” she added. “There’s almost always more to it.”

There are many ideas about what motivates bullying behavior, but one could be that kids are emulating how they see the adults in their lives resolve conflict, Rovers said. These adolescents might learn that violence is a way to protect themselves.

For children that are being bullied, they may not always be direct in telling the adults in their lives what is wrong, Talib said.

Instead of hearing about cruel words or isolating actions, families might first see stress, anxiety, depression, stomachaches and avoiding school, she said.

She recommended being attentive to your child and their individual behaviors and stepping in when you see a change. That could mean asking directly, having their pediatrician speak to them about it privately or even coming to them indirectly.

A helpful way in could be to ask about their friends’ experiences.

Say something like: “There was an interesting research report about bullying, and it made me think about bullying. It made me interested in if your friends were bullied or if you ever witnessed a bullying situation,” Talib said.

If you do find that your child is the victim of bullying, Talib said it’s a good idea to get in contact with the school and the other family to develop an action plan together.

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Children’s mental health tops list of parent worries, survey finds | CNN

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CNN
 — 

Forty percent of US parents are “extremely” or “very” worried that their children will struggle with anxiety or depression at some point, a new survey finds.

The Pew Research Center report said mental health was the greatest concern among parents, followed by bullying, which worries 35% of parents. These concerns trumped fears of kidnapping, dangers of drugs and alcohol, teen pregnancy and getting into trouble with the police.

Concerns varied by race, ethnicity and income level, with roughly 4 in 10 Latino and low-income parents and 3 in 10 Black parents saying they are extremely or very worried that their children could be shot, compared with about 1 in 10 high-income or White parents.

Nearly two-thirds of the respondents said that being a parent has been at least somewhat harder than they expected, about 41% say that being a parent is tiring, and 29% say it is stressful all or most of the time.

The report captured the perceptions of a nationally representative sample of 3,757 US parents whose children were younger than 18 in 2022.

Experts say mental health issues among children and adolescents have skyrocketed in recent years.

“I would say over the last 10 years, since I’ve been practicing as a general pediatrician, I have seen a shift both in the amount of patients and of all ages dealing with anxiety and depression. And their parents being concerned about this is a key issue,” said Dr. Katherine Williamson, a pediatrician and spokesperson for the American Academy of Pediatrics. “Even before the pandemic, we were seeing skyrocketing numbers of kids and adolescents dealing with mental health issues, and that has increased exponentially since the pandemic.”

Suicide became the second leading cause of death among children 10 to 14 during the Covid-19 pandemic, according to the US Centers for Disease Control and Prevention. Mental health-related emergency room visits among adolescents 5 to 11 and 12 to 17 also jumped 24% and 31%, respectively.

Many parents feel helpless when their children have mental health issues because they don’t feel equipped to offer support in this area.

“They are unable to relieve [mental health issues] and address that as they could if they were struggling with their grades or other things that seem more traditional to for kids to struggle with,” said Allen Sabey, a family therapist at the Family Institute at Northwestern University.

Parents trying to “work out and look at and connect with their own feelings will give them important information about what feels off or OK for their kid,” he said.

When it comes to anxiety and depression in children, pediatricians say, parents can watch for signs like decreased interest or pleasure in things they previously enjoyed, poor self-esteem and changes in mood, appetite or sleep.

Experts also say parents should consider the amount and content of social media their child consumes, as research has found that it can have negative effects on their mental health.

But, they say, having more parents recognize the importance of mental health in children is a step in the right direction.

“I have always felt there’s been so much resistance to seeking care for mental health among the population that I serve. And I am actually happy that since the Covid pandemic, at least people now are recognizing this as a very key and important health need,” said Dr. Maggi Smeal, a pediatrician at Stanford Medicine Children’s Health.

Smeal hopes that “all people that are interacting with children can be aware of these issues and feel empowered to identify and advocate for these children, to tell them to go to their primary care provider and have an assessment just like you do if your kid has a cough or a fever or ear infection.”

The number of parents concerned about gun violence reflects the fact that guns are the leading cause of death among children in the US, research has showed. From 2019 to 2020, the rate of firearm-related deaths increased 29.5% – more than twice the increase as in the general population.

“Gun violence is a real risk to our kids today. And that is both being killed by somebody else as well as suicide in the face of the mental health issues that we’re seeing today,” Williamson said.

The survey found that Black, Hispanic and lower-income parents were most likely to be concerned about gun violence, a finding that’s consistent with the communities most affected. Research has shown that from 2018 to 2021, the rate of firearm-related deaths doubled among Black youth and increased 50% among Hispanic youth. Another study found that children living in low-income areas are at higher risk of firearm-related death.

Direct and indirect exposure to gun violence can contribute to mental health problems.

“Even if they hear gunshots in their community, they hear adults talking, there’s all different ways that children are traumatized and victimized by gun violence. And what we see is all the symptoms of anxiety in even the youngest of children. We see children with somatic complaints – stomachaches, headaches. They have post-traumatic stress disorder,” Smeal said.

Most of the parents in the survey said parenting is harder than they expected, and that they feel judgment from various sources.

“The findings of this of this report were, as a pediatrician and a parent, just exactly what you would expect. Parenting is the hardest thing you’ll ever do, and there are very high levels of stress and fatigue, especially in the parents of young children,” Smeal said.

One of the best things parents can do is lean on fellow parents, experts say.

“The main challenge for parents is our siloed independent nature sometimes, and so we want to find people who we trust and kind of work towards being more vulnerable and open with,” Sabey said. “To where it’s like not just you and your kid, but it’s a kind of a group of people caring and working together.”

Pediatricians emphasize that no parent is perfect and that the most important thing you can do is to just be there for your child.

“We know that the best chance for a child to be successful and happy is for them to have at least one person in their life who believes in them and advocates for them. So I think it’s important for parents to know that there’s no such thing as a perfect parent, because we are all human, and humans are imperfect by nature, but that is OK,” Williamson said.

A parent’s job is to “really make sure that they know how important they are and they have a voice in this world,” she said. “Every child will have their own unique struggles, whether it is academically, emotionally, physically. Our job is to help them with the areas [where] they struggle, but even more, help them recognize their strengths.”

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Pediatricians are giving out free gun locks to approach the gun violence epidemic as a public health crisis | CNN

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CNN
 — 

In a triage waiting room of St. Louis Children’s Hospital in Missouri, a clear basket filled with gun locks sits near the walkway, just noticeable enough to those passing by.

The hospital staff calls it the “No Questions Asked” basket, to encourage gun safety without having to confront gun owners about what can be a sensitive and divisive topic. It holds an assortment of cable gun locks free of charge, available to those who need them, alongside pamphlets explaining how to properly and safely store firearms.

The initiative, aimed at reducing the stigma of addressing gun safety, is part of a growing effort by medical professionals who are treating the country’s gun violence epidemic as a public health crisis.

“It takes standing at the bedside of one child who has been shot to realize that we all have to do more and as the leading cause of death for children in this country, pediatricians need to be front and center of the solution, of all the solutions,” said Dr. Annie Andrews, a professor of pediatrics at the Medical University of South Carolina and an expert on gun violence prevention.

Over the course of two years, thousands of gun locks have been taken from the basket, according to Dr. Lindsay Clukies, a pediatric emergency medicine physician at the hospital.

In the coming weeks, baskets filled with free gun locks will be available at more than 17 locations operated by BJC HealthCare, an organization serving metro St. Louis, mid-Missouri and Southern Illinois, Clukies said. It’s a low-cost and effective way to easily distribute firearm safety devices.

“We’ve had employees as well as patients take our locks, also their families and even a grandmother who took one for her grandson. It’s for anyone who needs them,” Clukies told CNN. In recent years, a rising number of pediatricians across the country have been engaging with the topic of gun safety in medical settings by focusing on safety and prevention, already a natural aspect of their work.

During patient visits, it’s increasingly common for pediatricians to ask the patient’s parents if there are guns at home, and if so, how they are stored. Some hospitals then offer free gun locks, often sourced from donations or police departments and paired with safe storage education.

Some pediatricians, who bear witness to the effects of gun violence on children in their workplace every day, told CNN they see it as their obligation as medical professionals to be part of the solution to the epidemic.

In 2022, 1,672 children and teenagers under 17 were killed by gun violence and 4,476 were injured, according to the Gun Violence Archive, a nonprofit organization tracking injuries and deaths by gunfire since 2014.

“We have just as an important voice in this conversation as anyone else because we’re the ones who have invested our entire careers to protecting children and ensuring that children can grow up to be the safest healthiest version of themselves,” said Andrews.

“It is only natural that we see these things that we understand that they’re preventable, and we want to get involved in finding the solutions,” she added.

So far in 2023, high-profile incidents of children accessing firearms have heeded calls for stronger, more consistent laws nationwide, requiring adults to safely secure their guns out of the reach of children and others unauthorized to use them. They have also highlighted a lack of public education on the responsibility of gun owners to store their guns unloaded, locked and away from ammunition, CNN previously reported.

In early January, a 6-year-old boy was taken into police custody after he took a gun purchased by his mother from his home, brought it to school and shot his teacher at Richneck Elementary School in Newport News, Virginia, police said. Just over a week later, a man was arrested in Beech Grove, Indiana, after video was shown on live TV of a toddler, reportedly the man’s son, waving and pulling the trigger of a handgun, CNN previously reported.

Hundreds of children in the US every year gain access to firearms and unintentionally shoot themselves or someone else, according to research by Everytown for Gun Safety, a leading non-profit organization focusing on gun violence prevention. In 2022, there were 301 unintentional shootings by children, resulting in 133 deaths and 180 injuries nationally, Everytown data showed.

Firearm injuries are now the leading cause of death among people younger than 24 in the United States, according to the Centers for Disease Control and Prevention. The American Academy of Pediatrics released an updated policy statement in October 2022, stating firearms are now the leading cause of death in children under the age of 24 in the US.

The Academy’s statement urged a “multipronged approach with layers of protection focused on harm reduction, which has been successful in decreasing motor vehicle-related injuries, is essential to decrease firearm injuries and deaths in children and youth.”

The Academy has free educational modules for pediatricians to guide them on how to have what can be challenging or uncomfortable conversations about firearms with families, according to Dr. Lois Kaye Lee, a pediatrician and the chair of the Academy’s Council on Injury, Violence and Poison Prevention.

“This shouldn’t be considered as something extra; it should be considered as part of the work that we do every day around injury prevention, be it around firearms, child passenger safety and suicide prevention,” Lee said.

Dr. Georges Benjamin, executive director of the American Public Health Association, told CNN the public health approach to addressing gun violence removes the politics from the issue and “puts it into a scientific evidence-based framework.”

“Physicians have a unique opportunity to engage their patients, the parents of kids or the parents themselves as individuals to make their homes safer,” Benjamin said. “We already do this for toxins under our kitchen cabinets, razor blades and outlets in the wall.”

In the emergency department at St. Louis Children’s Hospital, all patients are screened for access to firearms and offered free gun locks, as well as safe storage education, Clukies said. Gun locks can also be mailed to families, free of cost, through the hospital’s website.

“Every patient that comes into our emergency department, whether it’s for a fever or a cold or a broken arm, is asked about access to firearms,” said Clukies, adding 5,000 locks have been given out since the initiatives were started in 2021.

In a collaborative effort between trauma nurses, physicians, social workers, violence intervention experts and family partners, the hospital created a “nonjudgmental” script for doctors to follow as they ask patients about access to firearms, Clukies said.

During the screening process, pediatricians will ask parents or caretakers questions such as: Do you have access to a firearm where your child lives or plays? How is it stored? Is it stored unloaded or loaded?

“When I first started doing this, I would say, ‘Are there any guns in the home? Yes, or no?’ But I have found and learned from other experts that if you just say, ‘If there are any guns in the home, do you mind telling me how they’re secured?’ it takes away the judgment,” said Andrews, a pediatrician whose hospital, the Medical University of South Carolina, also offers free gun locks to patients.

An assortment of cable gun locks offered free of charge by the Medical University of South Carolina.

Families are asked about firearms in the “social history” phase of a patient visit, during which pediatricians will ask who lives in the home, what grade the child is in, what activities they engage in and where the child goes to school, according to Andrews. When parents indicate their firearms are not safely stored, like on the top of a shelf or in a nightstand drawer, Andrews said those are important opportunities for intervention and education about storage devices such as keypad lockboxes, fingerprint biometric safes and other types of lock systems.

It’s also important for pediatricians to understand the parents’ or caretakers’ motivation for owning a firearm to “inform the conversation about where they’re willing to meet you as far as storage goes,” she added.

Andrews and Clukies said they were pleasantly surprised by the willingness of families to discuss firearm safety, most of whom recognize it is an effort to protect their children.

“I expected more pushback than we received, which is attributed to us really focusing on how we properly word these questions,” Clukies said. “I think it’s because we turn it into a neutral conversation, and we focus on safety and prevention.”

Andrews added it is uncommon for medical schools or residencies to discuss gun violence prevention, which she says is due to the “politics around the issue.”

“Thankfully, that has evolved, and more and more pediatricians are realizing that we have to be an integral part of the solution to this problem,” Andrews said.

At the St. Louis Children’s Hospital, pediatricians followed up with patients who received a free gun lock in a research study roughly two months after they launched the initiative in the fall of 2021 to see if their storage practices changed.

The study found two-thirds of families reported using the gun lock provided to them by the hospital and there was a “statistically significant decrease” in those who didn’t store their firearms safely, as well as an increase in those who stored their firearms unloaded, according to Clukies.

But there is still much more work to be done in the medical community to fight the gun violence epidemic and scientific research on the issue is “woefully underfunded,” Andrews contended.

According to the American Public Health Association’s Benjamin, a multidisciplinary approach by policymakers, law enforcement and the medical community is essential to fostering a safer environment for children.

“Injury prevention is a core part of every physician’s job,” Benjamin said. “It’s clearly in our lane.”

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