Equipping Social Workers to Prevent Firearm-related Harm: Examining the Role of Discretion and Structural Racism

Abstract

This four-paper dissertation examines the critical role of social workers in addressing the burden of firearm-related harm, particularly when serving clients at highest risk for disparities due to structural racism. Grounded in the theory of situated bureaucrats, it offers a nuanced understanding of social workers’ decision-making processes related to reducing firearm access for clients in crisis, along with the challenges they face in navigating complex social, medical, and legal systems. Chapter One frames firearm-related harm as an urgent social justice issue, delineates the role of social workers in addressing this challenge, and underscores equity considerations in interventions social workers may use to reduce firearm access for clients in crisis. The first paper, Chapter Two, employs qualitative narrative inquiry to identify equity considerations for implementing Extreme Risk Protection Orders by drawing insights from the historical context of Domestic Violence Protection Orders. The second paper, Chapter Three, analyzes qualitative data from ten focus groups with twenty-nine social workers to understand the ethical dilemmas they face when weighing the benefits and potential harms of referring clients to medical and legal system services based on their social identities (e.g., race and ethnicity, immigration status). In Chapter Four, the third paper draws on survey data from 1,306 social workers to investigate potential racial biases in their decision-making regarding care plan options for clients of different races, with social worker race as a moderator. The fourth paper, Chapter Five, revisits qualitative data from ten focus groups to construct an action plan model depicting the complex factors that guide social workers when choosing how to reduce firearm access for clients in crisis. Finally, Chapter Six synthesizes findings from all four papers to offer practice, policy, and training recommendations, discuss social justice implications, suggest directions for future research, and outline efforts to disseminate research findings. This dissertation underscores the pivotal role of social workers in alleviating the burden of firearm-related harm, especially in communities facing disparities, while critically examining potential biases in their discretionary practices and providing actionable policy and practice recommendations.