Hi and welcome to our week three, response to discussion forum questions. Again, I'm Dr Cassandra Crifasi, and I'm joined by my colleague Rebecca Williams. First, we really just want to say thank you all to your amazing engagement with the discussion forum. It's been such a pleasure reading all of the questions that have been coming through. Unfortunately, we can't answer all of them in this weekly response. But hopefully we can provide you with some resources to help you answer the questions we can't directly address. Also, I just want to say some of your questions were addressed in Twitter chat that we did on Tuesday. And Rebecca's going to be posting those in a document for folks to gain access so you can see how we responded to some of those questions. I also just want to note one thing that I've realized that we have not yet done through the course of the teach-out is to thank and recognize the funders that have made this teach-out possible. So we have a great partnership with the center for teaching and learning who have helped us support the production of this teach-out. As well as the David and Lucile Packard Foundation who also supported our other massive online open course. And just were really grateful for the support from both of these organizations in helping us, bring this content to you. Rebecca, is there anything I missed or should we just jump in? >> No, I think that's great. We can just jump in. So, again, the cast and just quickly the Twitter chat sort of transcript of all the questions and answers that we provided. I will have that posted to course resources and will make sure that you all have that and you can see everything that was included in that if you weren't able to logon to Twitter. But so the other questions for this week, we had a lot of questions that we're getting into a bit of the specifics on a state level. So stay specific questions on fire and purchasing laws. And I do know that we just want to let learners know if you can go back to our call to action in week one. We actually had an exercise where we kind of walk you through how to find the information if/or your state. And then, Cass, if you have any other additional resources, you might want to drag learners too. >> Yeah, so we can provide a link to the Giffords Law Center. So they provide a really great overview of different kinds of policies as well as policies by state and you can click on your particular state. Let's say you're interested in Louisiana, for example, and you can see the kinds of things that are or are not required under state law related to a number of things in addition to background checks and licensing. So you can get that link out to folks and they can head out to their state and try to see what is happening where they live. >> Great, awesome. And then there were several learners this week getting onto the topic of suicide and sort of thinking about and talking through. How does, as we know suicide is about nearly two-thirds of all gun related deaths are attributable to suicides. And thinking about how firearm purchases are licensing can help prevent suicides in a dress suicides directly as a policy. >> Yes, so we have done some work as well as some colleagues and other institutions that have found their requiring gun purchasers handgun purchasers, in particular, to obtain a license is associated with reductions in firearm suicide. And so this could function in a couple of different ways. So, the longer time period to conduct the background check in order for someone to get the license creates a sort of built-in waiting period where you can delay impulsive acquisition of a firearm during a time of crisis. So sort of us a separation between the time they want to buy a gun and when they can actually take ownership of it. And then also the access to additional records such as mental health records at the state level can more thoroughly screen out individuals who are prohibited because of a mental health issue. And so that's how the license can function so just to reduce suicide. But I also want to make note, there are over 40,000 suicides in the US, about half of them are committed with a firearm. And mechanism is such an important part of suicide deaths particularly by firearm. Because firearms are so lethal compared to other mechanisms, 90% of people who survived first suicide attempt don't go on to die from suicide. But because firearms are so lethal, there's really no opportunity to change your mind once the trigger is pulled compared to an overdose, for example. And so this limiting access to this really lethal means during times of crisis is really important in helping us reduce the burden of suicide. >> Awesome, thank you. And then also just one by think another something that's will share with you as well and isn't this is we talk a lot about Maryland as a state that has a licensing law. And something that's also I think important to consider that we talked about in sort of how strong are these laws, there's always ways they can improve. And so for example in Maryland, we know that the licensing only applies to there's the minimum age requirement exempts long guns. So we have some research that just came out this week that we will be sharing with you all in the with a form of an article and some link showing how by extending that minimum age requirement to long guns as well. We do have have potentially could impact rates of suicide in a state. So thinking about the different components of each licensing law. And then, Cass, we also had some questions about which I know there's some newer research related to the connection between fire operator licensing and mass shootings. And some learners asking, how can background check policies help prevent these in terms of mass shooters? Yeah, so that's a really great question. One of the challenges with individuals who perpetrate mass shootings is often they are not prohibited from lawfully buying firearms. And so background check policy even a licensing system might not screen out every individual who wants to acquire firearms to commit mass shooting. I will say one important component of a licensing system is it sort of is a system to make sure that people who don't meet state criteria can't obtain firearms. And often in states with licensing, their standards for gun ownership tend to be a little bit higher and so they may be able to screen out those individuals. But it's also really important to keep in mind the other elements that come into play when there is a mass shooting. So often an individual who is thinking about committing a mass shooting engages in what is referred to as leakage. So they will reveal their plan to someone or at least sort of made start speaking in a way that can elevate someone's concern that they may harm themselves or others. Ad that's where our policy like an extreme whirs protection order can really come into play. Reducing gun violence, whether we're talking about intimate partner violence or mass shootings or other elements. It's not going to be solved by one policy alone, we need complimentary policies. And so we need strong policies to keep the wrong people from acquiring guns in the first place, right, these dangerous individuals. But if someone who legally acquired one, then it's going through a time of crisis or elevated risk. We need a mechanism to temporarily separate them from their firearms as well. And that's where these extreme risk protection order or, quote unquote, red flag laws come in. And we're actually in the process of developing teach-out honor posed, we early on but keep an eye out if you're interested in learning more about these extreme risk protection orders and that could be another teach-out where you can learn about that specific policy. >> Awesome, thank you, that's exciting. And then we also have some questions sort of which we've heard a little bit about this in the past but kind of incremental policy change. Like when a state, for example, they don't currently require background checks on private sales and estate, if they of course at the state level, they can take the step to have a universal background check law on the books for a state. Do you recommend for those states, like is that a good first step or should they jump right to advocating for firearm purchaser licensing laws? And kind of what are sort of the steps that a state can take and what's the most effective for change? >> Yeah, that's a great question. And we give a lot of thought to that here in our center and in our department of health policy and management. Often we hear folks at advocating for incremental change, right? We need to sort of make steps to get to the end goal, and that can be an effective strategy. So in Connecticut, they passed a universal background check policy and then a year later complemented it with a licensing component. In Maryland, background checks for handguns had been required since the mid 90s and then in 2013, they added the licensing components. So there have been these sort of incremental shifts. But at times, there may be a policy window that opens up where incremental change might not get you where you need to be. And you can move straight towards advocating for the strongest version of a policy that you know may have the greatest public safety benefits. Some of our work looking at public opinion polling around purchaser licensing has found in states that have only background checks, their support for licensing isn't really that much different than states that don't require background checks. And so it doesn't mean that if you pass background checks, then it is going to suddenly become easier to advocate for licensing. And so really it's going to vary by some of those state contexts that it's hard to sort of talk about broadly. But we can try to make some connections with folks who are interested in promoting these policies in their state with local advocates or other organizations that are interested. And hopefully that can help folks start to think about what's right for their state, because not every policy is going to be right for every state at a particular time. >> Right, awesome, thank you. Yeah, and I think this kind of also just is directly related to if you have not yet taken a look at the content for week four next week. We're going to be talking with Kathleen Sances who works in a Grassroots Advocacy Organization, Illinois. And she talks really specifically about the sort of that incremental change process in Illinois in terms of licensing and background check. And what that was like for that state and that might be something that's helpful as you think about what the laws are like in your state and what is opportunities for policy development are. And then kind of directly so I think this is pretty much sums up our last question. We had a couple which we address this a little bit in our Twitter chats so you all can look out for this. But sort of this question about how we have states with really strong gun laws such as those that have firearm purchase or licensing which we are advocating for. And of course, we know are effective such as in our State of Maryland and also Illinois, but these states still have cities like Baltimore and Chicago that are plagued by really high rates of gun violence. And so what are the other factors that we really need to consider other than gun laws that are sort of related to the illegal trafficking and diversion of guns? And sort of, yeah, I guess this idea that what else do we really need to think about when we're thinking about these on a state level? >> Yeah, that's a really great question. And, we are always talking about in our center that gun violence is not a single solution problem, right? We're not going to solve anything just with policy. But I will say that when we're thinking about places like Baltimore and Chicago, we need to think about both supply-side issues and demand-side issues. So there are gaps in federal and state law that create loopholes where individuals can gain access to firearms who shouldn't have them, either they get them in an underground market, they get them via straw purchase. They trafficking them in from across state lines, for example, and so we have an issue where in many places it's easier to get a gun than it is a driver's license. And that creates too many opportunities for people to supply guns into these areas. But even if we were to magically address all of our policy gaps, we're still going to have a demand-side issue. Where there are urban areas in particular that have generations of concentrated disadvantage and historical policies that again further concentrated the disadvantage. Like redlining, for example, that has created multigenerational issues related to wealth accumulation and gainful employment and a whole range of issues that are really beyond the scope of this course. But, in order for us to really begin to tackle the problem of gun violence, we need both strong policy that we can actually enforce and the resources to do that enforcement, ATF inspections and those sorts of things. But we also need to invest in these communities and community organizations that are focused on violence prevention. Because until we solve issues of distrust between police and communities, until we address issues related to social norms about using guns as a way to resolve disputes. We're still going to have people who want to carry guns either to cause harm or for protection, and really policy isn't gun policy isn't going to be the solution for that. We need to focus on investing in some of our communities. >> Awesome, thank you for that. [COUGH] Great, well, I think that sums it up for this week's responses. We're going to try and keep it shorter. We did go a little bit longer than anticipated last week. But thank you so much for your questions, and we will look out for you those for week four and we'll be doing our last response video next week. So definitely try and get in your questions, and we will also have a special guest next week so really looking forward to the discussion and responding to your questions. So, thank you. And we will see you next week. >> Thanks, everybody. [MUSIC]