Wednesday, January 16, 2013

Mental Health and Gun Ruminations

All of the discussion about preventing the "mentally ill" from getting guns is way too simplistic. As Hennepin County Sheriff Rich Stanek wrote recently in the Star Tribune op-ed section, more than a quarter of American adults have a diagnosable mental-health problem, and I'd be willing to bet that they're over-represented within the population that already has a home arsenal. (Paranoid personality disorder, anyone?) Does anyone think they can be prevented from having guns?

A quarter of the population. That means we all know someone, or we all are someone. And while very few mental illnesses would have any chance of leading to mass murder, a number of them are strongly related to suicide.

Charlie Quimby had this to say on Twitter:

Mental health check for gun purchase based on ideas 1) mental health is immutable, 2) purchase occurs AFTER illness, 3) own guns are used
And Kristine Vruno Huson made this point:
How do you do a mental health background check? Shouldn't those records be protected by HIPAA? > Idea's ludicrous on many grounds
It's already being pointed out that New York's just-passed law requiring mental health clinicians to report their patients will likely cause people who need help to not seek it, or to be less than honest if they do.

This is the exact opposite of what Sheriff Stanek wrote in his op-ed:
More than anything, we must encourage individuals facing mental-health issues to seek treatment. We must "make it OK" for our family, friends and colleagues to seek treatment.
Passing laws requiring reporting and further stigmatizing mental illness is not the way to go. Stanek also pointed out the egregiously low level of psychiatric beds available (3.9 per 100K in Minnesota, 14.1 per 100K, when 50 per 100K is the recommended number). That is unacceptable.

Treating people first, without reporting them, would go a long way to resolving the problems. Making guns less accessible to everyone, with or without a mental illness, wouldn't hurt either.

If we're concerned about more than mass shooters -- if we're concerned about suicides as well, which are most likely to be successful when a gun is used -- then we can't just be looking for people who fit the mass shooter profile described by Stanek:
With the benefit of hindsight, we can see commonalities among the 2012 mass shooters: They threatened family members, committed domestic violence, expressed unusually strong interest in mass shootings (and studied them on the Internet), were fascinated with weapons, excessively played violent video games, and exhibited a disconnect from reality.
If we really believe that suicide is the result of an illness, depression, then we should treat it like an illness, accept it as such, and treat it.
We do not secretly wish that people would just get over hepatitis; we do not assume that they know best how to cure it; we do not wonder aloud what part of their personality the hepatitis comes from; we do not shrug and say that if someone apparently wants hepatitis – and, implicitly, they have it because they want it – it’s not society’s place to stop them.
Depression is an illness and suicide is its most extreme symptom.

Listening today to a discussion on MPR's Daily Circuit, before and after President Obama's announcement of changes to gun policies, I came away with a few other conclusions about the gun angle on this whole question:
  • It will be possible for Congress to pass more rigorous background checks and possibly the ammunition magazine limitation, but the ban on assault weapon ban will be much harder and packaging it with the other changes may bring the whole set of changes down to defeat. I'm starting to wonder if that ban is really all that important, since very few people -- out of the many gun deaths each year -- are killed with that type of weapon anyway.
  • The background check requirement is more plausible because important interest groups like Walmart and other bricks-and-mortar gun sellers don't like the fact that their competition (internet and gun show sales) has an unfair advantage.
  • Requiring safe storage of weapons (as is done in Switzerland, and was advocated by two different gun owners who called in) doesn't seem to be mentioned on Obama's list. This has the possibility of preventing some family members (such as Adam Lanza) from using a gun, and it even more likely would prevent the theft of guns, which over time should decrease the number of illegal weapons on the street.
  • The hunters who called in all scoffed at the idea that anyone needs more than six bullets in a magazine. The counter (from one of the guests) was that a large magazine is needed for self defense if four or five people break into your house at once. That's the kind of stupidity and paranoia that passes for logic among anti-gun-safety flaks.

1 comment:

Gina said...

I've been ruminating on these subjects, too, at Eyes on Life. I think it's possible to control gun access, and I think the mental health issue is actually separate but needs even more attention than the gun control issue.

We need to decide what kind of a society we are, and realize that it's no longer the 18th century. There are other countries on the planet that provide interesting models for us (UK, Germany) in which they allow specific types of guns for hunting but otherwise ban guns. We'd have a hard time taking all the guns out there off the street at this time -- there are millions -- but going forward there may be some steps to take to eventually curtail gun access.

I also want to see more support for people seeking help for mental issues -- better insurance coverage, no stigmatization, more access to help. I have an acquaintance in another state who cannot get the help she needs because she's on disability. Hello?! The therapist she needs to go to doesn't accept her insurance (it's totally inadequate too) and she can't afford his regular fee. So she's had to settle for therapists who aren't qualified to treat her issue and end up hurting her even more.

We need to wake up and treat mental illness as we do physical illness.