|This series has focused on one specific aspect of American gun violence: gun suicide. Gun suicides account for the majority (61%) of all fatal shootings in America today. But gun suicides rarely receive attention in the American media or the halls of congress. Public mass shooting events - such as school shooting and theater shootings – do get a lot of media attention, though such mass shooting events are relatively rare and account for only a minor fraction of the over one hundred thousand Americans shot every year.
Because of long-standing associations of suicide with psychiatric disorders, and because some of the public mass shooting events have been done by people diagnosed with a psychiatric disorder, mental illness has taken a prominent place in public discussions of gun violence in America. Some Americans have blamed all of gun violence on the mentally ill. Perhaps not surprisingly, the NRA – America's premier lobbying group for the gun industry - suggests the only way to reduce gun violence in America is to a) sell more guns and bullets, and b) address issues of mental health and illness.
Gun violence in America is a complex problem and multi-factorial in nature. Blaming all of gun violence on the mentally ill is both wrong logically, and a derogatory insult to the millions of Americans who suffer from mental illness. And while psychology (the study of mental processes) and psychiatry (the study of mental disorders and their treatment) have both helped us to understand and ameliorate a variety of social problems, neither psychology nor psychiatry alone can solve the problem of gun violence in America.
Here is why:
1) Blaming gun violence on the mentally ill mischaracterizes and stigmatizes mental illness. The vast majority of psychiatric illness (depression, schizophrenia, anxiety disorders, etc) tend to make people shy and retiring, not explosively aggressive. It is a gross mischaracterization to suggest that everyone with a psychiatric illness is a ticking time bomb ready to explode into violence. Such ideas further stigmatize mental illness.
2) Blaming gun violence on the mentally ill has a chilling effect on those needing or seeking help. Suggesting publicly that everyone who goes to a psychiatrist's office is a ticking time bomb of violence and should have their names entered into a national database for federal scrutiny and/or suffer a further erosion of their civil rights is a good way to make people avoid the psychiatrists' offices.
3) Suicides and school shootings are not diagnostic of psychiatric illness. By itself, using a gun to kill oneself, or to shoot first-graders in a public school is not diagnostic of any psychiatric illness. Certainly, using a gun to kill oneself or to shoot first-graders fits our colloquial definition of “crazy”, and such behaviors may occur in a variety of different psychiatric disorders. But in the absence of any other signs or symptoms, such behaviors of themselves do not qualify a person for any specific psychiatric diagnosis under the formal criteria by which psychiatrists establish a diagnosis. The proper and accurate diagnosis of a psychiatric disorder does not depend on any one particular act, but rather on a multitude of behaviors displayed repeatedly over a period of time.
4) The limited powers of psychiatry. When it comes to suicide or violence, psychiatry has no magic bullets. Psychiatrists determine the likelihood that an individual may be contemplating hurting themselves or others by sitting down with the individual and asking them about their plans – a process that can take hours. When a potentially dangerous person is identified, violence is prevented by simply watching that person and keeping them away from dangerous objects and situations. Keeping a person from dangerous objects and situations may mean involuntary treatment: a loss of freedoms and liberty for someone who may well have no prior record of wrongdoings. The case of James Holmes - the shooter at the Aurora, CO. theater - is illustrative. Mr. Holmes had been seeing a psychiatrist who became convinced that Mr. Holmes was becoming homicidal. The psychiatrist reported her concerns to the authorities (as the psychiatrist is required to do by law), but could do nothing more to intervene. One month later, Mr. Holmes committed his act of mass violence. Even in this case where a psychiatrist was involved prior to the act of violence, and whose clinical judgment was that there was a good chance that violence could occur, the psychiatrist could do nothing by herself to prevent the violence. Psychiatry may be able to identify some of the people who later become violent; doing so accurately in a nation of over 300 million is almost impossible. What then happens to those so identified is a social and legal problem of Herculean proportions.
5) Any fixes to a broken mental health system will require years to effect changes in overall levels of gun violence. Fixing a broken mental health system will require changes in private and government funding, advances in clinical research, and a new attitude balancing medical necessity and profits among clinicians and hospital administrators. All of this could take years and even decades before any differences in violent behaviors among Americans are observed. None of the over 100,000 Americans who will be shot this year want to wait that long.
|The gun industry lays the blame for the extreme amounts of gun violence in America squarely at the hands of the mentally ill. From a recent NRA newsletter:
“Since 1966, the National Rifle Association has urged the federal government to address the problem of mental illness and violence. [….] The NRA will support any reasonable step to fix America’s broken mental health system without intruding on the constitutional rights of Americans.” (Source – NRA Institute for Legislative Action)From an article in The Economist:
“(Wayne LaPierre) talks of improving mental-health treatment, but then uses the harshest possible language to describe the mentally ill, telling NBC: “We have no national database of these lunatics. We have a completely cracked mentally ill system (sic!) that’s got these monsters walking the streets” […] “They’re not serious about fixing the mental-health system. They’ve emptied the institutions and every police officer knows dangerous people out there on the streets right now. They shouldn’t be on the streets: they’ve stopped taking their medicine and yet they’re out there walking around...The powerful elites aren’t talking about limiting their capacity for protection. They’ll have all the security they want... Our only means of security is the second amendment. When the glass breaks in the middle of the night, we have the right to defend ourselves” (Source: The Economist).So, according to the NRA, a major advocacy and lobbying group for the gun industry, the best approach to reduce gun violence in America is to fix the “completely cracked mentally ill system”. At the same time, the gun industry hopes to continue the quick and easy selling of lots of guns and ammo to any and all Americans. However, some hypocrisy is necessary to simultaneously maintain these two positions. This hypocrisy becomes apparent when one looks not at what is being said by gun lobbying groups, but instead when one looks at their actions.
Recently, the NRA supported a bill proposed by Sen. Chuck Grassley (R-IA) and Ted Cruz (R-TX) that will allow people who have been involuntarily committed to a psychiatric hospital to buy guns immediately after the commitment order expires, and any guns that had been seized at the time of hospitalization would have to be returned.. The bill further specifies that gun rights should be restored for people who have been adjudicated mentally incompetent (Source: Talking Points Memo.com).
So while the NRA is blaming the mentally ill for gun violence, the NRA is also advocating that gun retailers should be allowed to sell guns to people who have been determined to be a danger to themselves and/or to others. In addition, while the NRA has been resisting any effort to register or even count gun owners, the NRA has advocated - with some success - for a national database of people with psychiatric illnesses (Source: WaPo).
|Fixing a broken mental health care system
Currently, it is estimated that over 13 million Americans suffer from a serious mental illness. We as a nation should, of course, do everything we can do to provide the very best care and treatment for those who suffer from mental illness. Mental health services should be readily accessible and affordable to everyone who needs them. Psychiatry has always been the forgotten step-child of American health care. Most states are wrestling with large budget deficits, and across the country, public programs for the mentally ill have been cut deeply, effecting potentially millions of patients. The care and treatment for those with emotional illness should be improved because we are the richest nation on the planet, and we have the resources to provide the best possible care for those among us who are ill. This is what a loving God entreats and challenges us to do.
We as a nation should improve the care and treatment of mental illness. Not because that will solve the problem of gun violence, but because it is better for our neighbors and communities
If one were to actually consult with psychiatrists about the problem of gun violence in America, we see that psychiatry has useful solutions to the problem of gun suicides, but these solutions are too often simply ignored. One would learn that scientists have shown repeatedly that there is a 2-10 fold increase in the risk of suicides in home where there is a gun, compared to home where there are no guns. And that this increased risk for suicide remains even after controlling for the occurrence of depression and thoughts of suicide among study participants (here, here, here, here, here, and here). One would learn that psychiatrists recognize two general methods to reduce the incidence of suicide: a) reduce the number of suicide attempts by identifying and treating those people contemplating suicide; and b) reduce the possibility that a suicide attempt is lethal, by removing lethal means from people thinking about suicide. The gun industry suggests we focus solely on the first method, and ignore the second method. Yet, research studies have shown that reducing access to lethal means is a highly effective strategy for preventing suicide deaths.
The Daily Kos Firearms Law and Policy group studies actions for reducing firearm deaths and injuries in a manner that is consistent with the current Supreme Court interpretation of the Second Amendment. If you would like to write about firearms law please send us a Kosmail.
To see our list of original and republished diaries, go to the Firearms Law and Policy diary list. Click on the ♥ or the word "Follow" next to our group name to add our posts to your stream, and use the link next to the heart to send a message to the group if you have a question or would like to join.