A ‌Lifetime ‌of ‌Exposure: Seniors and the Mental Health Toll of Violence

Article By:

Dr. Rahn K. Bailey, President-elect, American Psychiatric Association; Chair of Psychiatry, LSU Health New Orleans & Esiri Gbenedio, MS, American University of Antigua College of Medicine

This Isn’t Only About Crime. It’s About Health. 

Talk about gun violence in New Orleans usually lands on crime stats, arrests, and what the police should or shouldn’t do. From where we sit in medicine, that frame is too small. Gun violence is a public health issue, and just as much a mental health issue, one that spreads through neighborhoods and households far beyond the people who were directly involved. In recent years, New Orleans has consistently had one of the highest rates of gun violence in the nation.

For many residents, violence isn’t a single shocking event; it is a recurring experience that wears people down over time. Anxiety, depression, and post-traumatic stress can become part of daily life. Chronic stress affects routines, relationships, and overall health. Seniors are often overlooked, even though their burdens are heavy

and real.

Seniors Are Feeling It, Even When It’s Not Loud. 

Older adults in New Orleans have lived through more than most people ever have. Many have a long history of trauma and loss tied to community violence, plus major disasters and disruptions, such as Hurricane Katrina, Hurricane Ida, and the COVID-19 pandemic, among them. On top of that, plenty of seniors are also supporting children and grandchildren who are now dealing with similar pressures.

These effects don’t always show up as dramatic headlines. They can look quieter, but they matter. People become hesitant to leave home. Social circles shrink. Sleep gets interrupted. Medical conditions that were once manageable become harder to control. Over time, that combination can chip away at independence and reduce quality of life. 

How Violence Adds Up Over Years. 

New Orleans has faced long-running problems, poverty, limited health care, and neighborhood disinvestment, which leave certain communities more vulnerable. Repeated citywide stressors keep resetting people’s sense of safety, leading to cumulative trauma that piles up over time. When violence becomes part of the environment, its effects don’t end after the event; they continue in the lives of people who experience it.

Why Mental Health Has to Be Included. 

In health care, prevention is the goal whenever possible. That same mindset belongs here. It means we should be talking with patients about stress, trauma, and safety as a normal part of care. It means screening for exposure to violence and, when appropriate, asking about firearm access. And it means connecting individuals and families to mental health supports early, not only after things have reached a crisis. 

Taking this prevention approach seriously means treating violence exposure like any other health risk: notice it early, take it seriously, and address it before it grows into something even harder to treat. 

What Helps in Real Life? 

There isn’t one fix. Still, we do know what tends to move the needle. Access to community-based mental health care is a big part of it. Caregivers and seniors need programs that lessen isolation and make connections easier. Safe firearm storage matters, too. Early support for youth and families can lower long-term risk, especially when help arrives before patterns get entrenched. 

Of course, these efforts only succeed when the bigger community context is addressed. None of this works well without sustained investment in historically underserved neighborhoods, because those root conditions are tied to the problem. And trust matters. Without stronger trust between health systems and the communities they serve, even well-funded plans struggle to take hold. 

Moving Forward, Together. 

As physicians, our job isn’t only to treat illness after it appears. We also must notice the patterns that are harming our patients and their families. Gun violence is one of those patterns. In New Orleans, addressing gun violence means seeing its full reach, not only what comes through emergency rooms, but what settles into homes, families, and blocks over time. As we move forward, let's commit to prioritizing seniors in these discussions and to making prevention and mental health care a central focus. Each of us, physicians, community members, policymakers, has a role: speak up, engage with local programs, and push for lasting investment in vulnerable neighborhoods. Act now to support prevention and care that truly serve our whole community. 

Resources for Seniors in New Orleans. 

If you or someone you love is feeling overwhelmed, anxious, or affected by violence in your area, support is available. You can call or text 988 for the Suicide Crisis Lifeline for free, confidential help at any time. The Louisiana Behavioral Health Crisis Line (1-866-310-7977) can also provide immediate support and referrals. Local organizations, including the Metropolitan Human Services District, NAMI New Orleans, and the New Orleans Council on Aging, offer mental health services, education, and community resources. If there is an emergency and someone’s safety is at risk, call 911. 

You Are Not Alone. 

Feeling fear, stress, or grief in response to violence is not a personal failure. It’s a human response to repeated threats and loss. Reaching out for help is a step toward protecting your health and your well-being.

Rahn Kennedy Bailey, MD

Rahn Kennedy Bailey, MD, LSU Health Sciences Center Kathleen & John Bricker Chair of

Psychiatry and Assistant Dean of Community Engagement since 2021.

Additionally, as of 2024, he serves as the Academic Medical and Psychiatric Director for the New Orleans Correctional Justice Center Mental Health Services Unit. He has served as Chairman of Psychiatry at Meharry Medical College, 2008-2014, Wake Forest Medical School, 2015-2018, and National Medical Association, 2002-2006.

Dr. Bailey’s early research focused on Psychotic Disorders/SPMI, grew to include Depressive Illness/Bipolar Mood D/O, expanded to forensic topics, Competency, Confidentiality, and Risk Management. Currently, his focus is Health Disparities, Healthcare Reform, and Violence. He has 86 peer reviewed publications in over 20 refereed journals and published three books; Health Disparities, 2013, Gun Violence, 2018, and Intimate Partner Violence, 2020. Dr. Bailey is an advocate for change. He served as the Chairman of the Board of Trustees, NMA/Cobb Research Foundation 2018-2022. He chaired the National Alumni Council Board of Trustees of the National Medical Fellowships, 2015-17 and completed a six-year term on Rutgers State University Board of Trustees, 2014-2020. He served as the American Academy of Psychiatry and the Law, AAPL, Board of Trustees, 1999-2005, 113th President of NMA, 2013, NMA Board of Trustees 2006-2014.

In 2006, he was selected by his peers as NMA Physician of the Year during the Hurricane Katrina crisis. He was selected Outstanding Faculty Member at UT Houston, 2000, AMA Co-Chairman of the Commission to End Health Disparities, 2012-13. In 2022, Dr. Bailey received the National Medical Association Ernest Y. Williams, M.D. Clinical Scholars of Distinction Award. He was elected the 2023-25 Chair of the APA Caucus on Global Mental Health and Psychiatry and received the Solomon Carter Fuller Award at the APA Spring conference 2024.

His work has been seminal in assisting communities in caring for the health of patients, developing strategies to improve their health paradigms, and working to enhance the lives of young professionals via mentorship and professional development and authorship.