On Guns & Mental Health
Terry H. Schwadron
Aug. 25, 2019
Clearly, Americans have both a gun problem and mental health problem. The question is whether putting those two together as a proposed solution will address either.
As Donald Trump, Senate Republicans and the National Rifle Assn. increased the pressure to adopt “red flag” legislation to put the focus of public anger over mass shootings on mentally ill patients rather than on guns, there are serious questions about whether this will prove to be yet another watered-down way for government to appear to be doing something without actually addressing the problems.
Let’s assert that people who are under treatment for serious behavioral problems should not be allowed to own weapons, particularly semi-automated weapons capable of firing dozens of bullets in a minute.
What the red-flag laws would do is to authorize government officials — with some kind of court review — to confiscate weapons from those considered a mental health threat to society.
Politicians just put that kind of statement out there, a hanging curve ball over the plate, as if it is immediately understandable what it means in any practical sense.
What kinds of mental health problems? What kind of medication? Given health privacy laws, how would we even know? How would we know beforeany malicious act? How prevalent are individuals with such problems? Isn’t there just as much mental illness in other countries that do not have mass shootings?
Axiosreported that “A very small proportion of people with a mental illness are at increased risk of violent behavior if they are not treated,” as David Shern and Wayne Lindstrom, former CEOs of Mental Health America, wrote in Health Affairs in 2013. These are the people with the most severe mental illnesses — often those characterized by paranoia and delusions, the authors added. These people also may have a substance abuse problem or a “history of victimization.”
Indeed, Axios quoted experts as saying that the average person suffering from a mental illness is no more prone to violence than anyone without a mental illness, and mental-health advocates say exaggerating a link between mass shootings and mental illness can be stigmatizing and harmful.
Health experts say that two-thirds of all gun deaths are suicides, presumably including a number of mentally ill individuals. Some researchers question whether limiting access to guns for the mentally ill would further discourage them from seeking treatment.
Perhaps Trump forgets that he signed an Republican-backed legal change that blocked a practice of using incidents of domestic violencefrom gun ownership, re-allowing violators to own guns. Isn’t domestic violence something of a mental health issue?
Okay, but maybe we can focus on this issue even if there is a tiny population at risk. After all, many of those charged or killed as mass shooters have had substantial involvement with mental health agencies or treatments, If we can intervene to stop just one mentally ill person with an assault-style weapon from killing a theater audience or mall shoppers, should we do so?
The assumption in this legislative approach is that individuals needing mental health are getting it.
Over years, mental health institutions have been emptied and patients sent into the community. Some general health insurance programs do cover basic mental health visits, even with caps, but others do not. In any event, the Trump administration is committed to undercutting and killing off the Affordable Care Act, eliminating the exact health approach that allows for mental health treatment.
A patient must interact with the system to receive a mental health diagnosis. And one of the system’s biggest problems is that many people with mental illness can’t get the treatment that they need. Only 25% of active shooters included in an analysis released by the FBI last year had ever been diagnosed with a mental illness, even though 62% had appeared to be struggling with some kind of mental health issue in the year before the attack.
“While mental illness typically does not cause violence, acts of violence do typically cause mental illness,” Mental Health America wrote in a policy statement.
In the end, Americans will continue buying guns, and assault-style guns, ammunition, magazines and the rest. Some Americans will get mental health treatment, with a tiny number telling their counselors enough to provide a warning. Of those, some government official will act on a singular case somewhere in the country which, naturally, will result in a court appeal to hold on to the weapon that individual already owns.
We are not going to fix the gun problem, the potential for mass violence or the mental health problem with this legislative approach.