{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T16:23:41Z","timestamp":1768407821734,"version":"3.49.0"},"reference-count":22,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Eastern Association for the Surgery of Trauma Templeton Injury Prevention Scholarship"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"accepted":{"date-parts":[[2025,2,20]]},"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Despite being high risk for post-traumatic stress disorder, Black men survivors of gun violence, and particularly young men aged 18\u201324, seldom participate in mental health services after injury. The aim of this study was to identify barriers to participation in mental health services for this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Over a 2-year period, 1 hour-long focus group was conducted with three counselors of the local hospital-based violence intervention program and 21 individual, semistructured in-depth interviews were held with Black men who were hospitalized for a firearm-related injury. All interviews were recorded and transcribed. Transcripts were coded using open coding and grounded theory methodology and ultimately grouped into themes using MAXQDA V.2022 software.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Median age of participants was 34 years (IQR=11). Barriers to participation revolved around competing priorities\/stressors, expense, difficulty with trust and openness and the demands of street life. Motivating factors included cultural competence, persistence, availability, reliability and genuineness of the therapy staff. Most participants denied negative social stigma of therapy as a barrier but emphasized that the individual must value therapy to participate. Young, Black men were perceived as struggling with self and peer-imposed views of masculinity that conflicted with therapy participation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Black men who have experienced violent firearm injury face strong social pressures that conflict with participation in mental health services. Programs must be integrated with other social services and be responsive to community conditions to be successful.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of evidence<\/jats:title><jats:p>IV<\/jats:p><\/jats:sec>","DOI":"10.1136\/tsaco-2024-001560","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T10:16:26Z","timestamp":1743156986000},"page":"e001560","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Crossing the chasm: engaging Black men survivors of gun violence in mental health services"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5706-1121","authenticated-orcid":false,"given":"Erin","family":"Major","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celina","family":"Thomas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Healy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amy","family":"VanderStoep","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph B.","family":"Richardson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas M.","family":"Scalea","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9555-5698","authenticated-orcid":false,"given":"Melike N.","family":"Harfouche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,3,28]]},"reference":[{"key":"2025032803150450000_10.1.e001560.1","unstructured":"Fast facts: firearm violence and injury prevention |violence prevention|injury center|cdc. 2023. Available: https:\/\/www.cdc.gov\/violenceprevention\/firearms\/fastfact.html [Accessed 27 Nov 2023]."},{"key":"2025032803150450000_10.1.e001560.2","unstructured":"CDC . Firearm Deaths Grow, Disparities Widen. Centers for Disease Control and Prevention, . 2022 Available: https:\/\/www.cdc.gov\/vitalsigns\/firearm-deaths\/index.html [Accessed 27 Nov 2023]."},{"key":"2025032803150450000_10.1.e001560.3","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.044560"},{"key":"2025032803150450000_10.1.e001560.4","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1016\/j.jss.2016.04.027","article-title":"Risk factors for recurrent violent injury among black men","volume":"204","author":"Richardson","year":"2016","journal-title":"J Surg Res"},{"key":"2025032803150450000_10.1.e001560.5","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1097\/TA.0b013e31825ff713","article-title":"Screening for traumatic stress among survivors of urban trauma","volume":"73","author":"Reese","year":"2012","journal-title":"J Trauma Acute Care Surg"},{"key":"2025032803150450000_10.1.e001560.6","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1016\/j.injury.2017.12.002","article-title":"Emotional responses to unintentional and intentional traumatic injuries among urban black men: A qualitative study","volume":"49","author":"Jiang","year":"2018","journal-title":"Injury"},{"key":"2025032803150450000_10.1.e001560.7","doi-asserted-by":"crossref","first-page":"1299","DOI":"10.1097\/01.ta.0000240460.35245.1a","article-title":"Mental Illness as an Independent Risk Factor for Unintentional Injury and Injury Recidivism","volume":"61","author":"Wan","year":"2006","journal-title":"The Journal of Trauma: Injury, Infection, and Critical Care"},{"key":"2025032803150450000_10.1.e001560.8","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxv013"},{"key":"2025032803150450000_10.1.e001560.9","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1097\/01.ta.0000236576.81860.8c","article-title":"Hospital-Based Violence Intervention Programs Work","volume":"61","author":"Cooper","year":"2006","journal-title":"The Journal of Trauma: Injury, Infection, and Critical Care"},{"key":"2025032803150450000_10.1.e001560.10","doi-asserted-by":"crossref","first-page":"107232","DOI":"10.1016\/j.ypmed.2022.107232","article-title":"Exploring emergent barriers to hospital-based violence intervention programming during the COVID-19 pandemic","volume":"165","author":"Wical","year":"2022","journal-title":"Prev Med"},{"key":"2025032803150450000_10.1.e001560.11","unstructured":"MAXQDA, . 2022 Available: https:\/\/www.maxqda.com\/"},{"key":"2025032803150450000_10.1.e001560.12","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1023\/A:1021355727114","article-title":"Assessing the implementation and effects of a trauma-focused intervention for youths in residential treatment","volume":"74","author":"Rivard","year":"2003","journal-title":"Psychiatr Q"},{"key":"2025032803150450000_10.1.e001560.13","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.janxdis.2014.10.009","article-title":"Implementation and effectiveness of integrated trauma and addiction treatment for incarcerated men","volume":"30","author":"Wolff","year":"2015","journal-title":"J Anxiety Disord"},{"key":"2025032803150450000_10.1.e001560.14","doi-asserted-by":"publisher","DOI":"10.1177\/1524838010374481"},{"key":"2025032803150450000_10.1.e001560.15","unstructured":"The ROAR Center . ROAR Center Peer Healing Circle: A new video shows how Black men are helping each other heal from the trauma of gun violence, Available: https:\/\/roarcenter.org\/news\/roar-center-peer-healing-circle-a-new-video-shows-how-black-men-are-helping-each-other-heal-from-the-trauma-of-gun-violence\/ [Accessed 15 May 2024]."},{"key":"2025032803150450000_10.1.e001560.16","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1007\/s11121-022-01428-7","article-title":"Implementation of an Outpatient Violence Intervention Program to Increase Service Uptake","volume":"24","author":"Harfouche","year":"2023","journal-title":"Prev Sci"},{"key":"2025032803150450000_10.1.e001560.17","doi-asserted-by":"crossref","DOI":"10.1136\/tsaco-2016-000024","article-title":"Hospital-based violence intervention programs targeting adult populations: an Eastern Association for the Surgery of Trauma evidence-based review","volume":"1","author":"Affinati","year":"2016","journal-title":"Trauma Surg Acute Care Open"},{"key":"2025032803150450000_10.1.e001560.18","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1097\/TA.0000000000001261","article-title":"A decade of hospital-based violence intervention: Benefits and shortcomings","volume":"81","author":"Juillard","year":"2016","journal-title":"J Trauma Acute Care Surg"},{"key":"2025032803150450000_10.1.e001560.19","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1001\/jamasurg.2019.4533","article-title":"Long-term Functional, Psychological, Emotional, and Social Outcomes in Survivors of Firearm Injuries","volume":"155","author":"Vella","year":"2020","journal-title":"JAMA Surg"},{"key":"2025032803150450000_10.1.e001560.20","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1097\/TA.0000000000002746","article-title":"Recidivism rates following firearm injury as determined by a collaborative hospital and law enforcement database","volume":"89","author":"Marshall","year":"2020","journal-title":"J Trauma Acute Care Surg"},{"key":"2025032803150450000_10.1.e001560.21","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.1177\/1557988315611227","article-title":"Masculinity, Racism, Social Support, and Colorectal Cancer Screening Uptake Among African American Men: A Systematic Review","volume":"11","author":"Rogers","year":"2017","journal-title":"Am J Mens Health"},{"key":"2025032803150450000_10.1.e001560.22","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1146\/annurev-soc-091620-024714","article-title":"Black Men and Black Masculinity","volume":"47","author":"Young","year":"2021","journal-title":"Annu Rev Sociol"}],"container-title":["Trauma Surgery &amp; Acute Care Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/tsaco-2024-001560","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T10:17:09Z","timestamp":1743157029000},"score":1,"resource":{"primary":{"URL":"https:\/\/tsaco.bmj.com\/lookup\/doi\/10.1136\/tsaco-2024-001560"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":22,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3,28]]},"published-print":{"date-parts":[[2025,3]]}},"alternative-id":["10.1136\/tsaco-2024-001560"],"URL":"https:\/\/doi.org\/10.1136\/tsaco-2024-001560","relation":{},"ISSN":["2397-5776"],"issn-type":[{"value":"2397-5776","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}