Survivors of gun injuries often face a long, painful recovery. When the gun victims are children or teens, family members also struggle.

In the year following a firearm injury, child and adolescent survivors endured significant increases in pain, psychiatric and substance use disorders compared to their peers, according to research published Monday in the journal Health Affairs. The mental health of family members also was affected.

“We can’t treat injuries like this in isolation without thinking about all the factors that are occurring in the aftermath,” said Dr. Patrick Carter, an emergency medicine physician and co-director of the University of Michigan Institute for Firearm Injury Prevention. Carter was not involved in the study.