By Brian L. Grant MD
If a sign of mental illness is delusional thinking and being out of touch with reality, Wayne LaPierre may qualify. His ongoing rants suggesting that there exists some sort of mental health database that if consulted, would screen out murderers, is absurd.
Mr. LaPierre, please show us what you refer to. Also, please demonstrate how many — if any— of those thousands of killers who used firearms were in this non-existent database?
I hope you are not suggesting that an individual who seeks counseling or psychotherapy from a psychiatrist or psychologist, or antidepressants from their primary care doctor should be entered in a registry restricting their current firearm rights?
To do so would fly in the face of logic, privacy, and have zero impact on the problem of gun deaths. There is no linkage between seeking mental health care and dangerousness, and any such registration would only serve to deter individuals from addressing issues that might then go untreated.
Any mental health professional possessing appropriate humility knows that their record of predicting dangerousness is little better than the general public.
The public depiction of some of the recent mass killers certainly describe strange individuals, who before their act are not unlike those that one might find in large numbers in any high school class, software, Star Trek, or dare I say, Psychiatry convention. Hindsight bias, where something suddenly becomes obvious after the fact, is simple but misguided.
The proximate cause of gun deaths are guns and bullets. Killers armed with less lethality may be less dangerous toward others and themselves.
Do we collectively as a society have the political will and common sense to at least confine our arguments to reality?
Read More at: The Economist: “Why the NRA keeps Talking about Mental Illness, Rather than Guns.”
Geoff Masci Dc says
Ok Brian, I’ll bite…I hope more of my collegues in the IME business will respond.
I believe that your editorializing is out of place here in this forum…if indeed it’s a forum and not your personal blog…as a psychiatrist (you not me), I cannot fathom how you can minimize the “mental illness” componet of this issue. To me it is the paramount factor. I see the issue in a number of facets. One primary on is the reporting of mental issues that could lead to such tragedies. Granted (that’s a pun), that would be hard, as clearly we have no predictors, nevertheless wouldn’t it be in all our best interests to develop some screen for a spectrum of disorders that might lead to such frightening outcomes? More time spent looking into this issue looking for predictors rather than resisting and sloughing the blame on the organizations that are, in a clumsy way-led by heavy-handed mis-speakers (had to slip Nixon in there), fighting for the preservation of the Second Amendment that protects you from a heavy handed government? I do dispute your claim about the guns and bullets but its a circular argument, too steeped in ingenuine sophistry to be adequately answered in this forum ( is it still a forum ?-see above).
i do believe that this POLITICAL issue is misplaced in this venue. I, personally, have strong feelings about this issue, as I can see that you also have. My concerns as to the “mental health” component also are surrounded by confidentiality concerns and no clear scale to assess this on. However I place this at the feet of the uber-professionals who could do the research, properly, to create this scale.
I remember when an insurance carrier, foolishly, wanted a scale for mental impairment like the Lowback and Neck impairment categories, for all mental conditions affecting injured workers…that didn’t go over too big, now, did it? Maybe such a scale is not possible. Maybe it qualifies as does Walker’s desire, and really belongs on the Idea Scrap Pile of History. I don’t know, coincidence isn’t corelation isn’t causality.
So, my friends are we now drawing up the “sides” in this issue? Are we including politics and irrationality in our IMPARTIAL decisions and allowing us to bepoliticized by the Feds ?
Very emotional issues should be recognized by us as such and eliminated from our descision tree, or at least put aside from our jobs.
Nuff said-I got rather windy there.
First of all Geoff, thank you for responding thoughtfully and in detail. There are far few comments in this forum, so I owe you thanks and invite others to respond to any post they wish. You address many issues. Should this be a forum for such discussions? Since it is a blog and has no specific parameters other than a general focus on health, illness, disability and society – gun control and the rhetoric seems reasonable. I do not seek to offend, and wish to be respectful. But as a forensic psychiatrist, when the head of the NRA spouts nonsense, attacks the mentally ill, and presents false information, responsible people should not remain silent.
Gun control is a hot issue and I know and respect many gun owners. I personally bought an archery set for target practice recently, at Cabelas. A trip to that mega-store or any similar place focusing on the outdoors that has a gun department makes it quite clear that the US is not going to disarm citizens. But common sense suggests that data driven discussions need to replace mindless rhetoric. And looking at the experience of other democratic countries that we respect, like Australia and Canada, should be part of this data. Too many innocent people are dying from firearms, not to mention suicides, and noise needs to give way to change.
There is simply no way to screen for dangerousness other than looking at history of prior dangerousness, which is the best predictor. And be careful what screens one looks for, since any such screen would likely identify as false positives, a number of current proud and responsible gun owners.
Thanks again for writing.
Perry Kranz says
P Kranz DC
I as well think this is not the place for this conversation. In my opinion not appropriate!! Shame on you.
I appreciate your views but feel no shame in addressing a compelling public health issue and would welcome your take on why the article in this forum is not appropriate. Views can differ but the ability to discuss them civilly should remain. Anyone is free to offer their own responses, as some already have. Clearly the gun issue is perhaps, along with abortion, two of the hottest topics in our current social discourse.
James - Boise says
Of all the people that have committed attrocities with guns in the recent history of our country, I am willing to bet that 95% were/are on psychotropic drugs of some sort. (http://www.ignatius-piazza-front-sight.com/2012/12/17/front-sight-special-blog-psych-drugs-not-guns-doing-the-killing/) I grew up in a small town Mountain Home ID. in that town, prior to my option to do so, several young kids would ride their horses to school, put their rifles on the gun rack, in the school, and go to class.. Oh, and they didn’t kill their class mates, or teachers, or administrators. These kids understood guns – the rights and responsibilities. They grew up with them. Kids today, are made to fear guns that they are bad, and are told “NO.” What do your kids do when told No? right, they are drawn to what ever it was they were told no about. With zero knowledge, training, respect for the weapons (other than games and Hollywood) they kill themselves or others, without knowing what can and will happen to them or others. Between myself, my siblings and exteneded family I am sure we own guns numbering in the hundreds. My kids (3,5,12) all shoot with me on a regular basis, they know that they don’t touch them without a parent and they understand (to their own understanding abilities) that they can die from them. The are not intrigued by guns they do not want to find dad’s guns and play with them. I will say it directly here that Guns are not the problem, the lack of respect and intrigue society has built into guns is part of the problem. Mind altering drugs are another, family dynamics come in to play too.. BUT Guns are not the (actual) issue. The problem with gun laws is that only those that follow laws will follow them. While I agree that there are too many people dying needlessly from violence in general, the gun is not the issue with violence. Guns are only a tool. Other tools are still in use as well, but the other tools are not demonized; baseball bats, knives, fists, brass knuckles, steel-toed boots. They are kill people too, right?
Guns are going nowhere. So when the rest of us legal, moral, ethical, and trained gun onwers are disarmed from an over-reaching army of legislators; who will go to for help? I assure you the Police will only get busier and have less time for you. in fact, the US has 698,460 Officers with 293,058,940 population.(http://www.fbi.gov/about-us/cjis/ucr/crime-in-the-u.s/2011/crime-in-the-u.s.-2011/tables/table_74_full-time_law_enforcement_employees_by_population_group_percent_male_and_female_2011.xls) that means that each officer in the US has to keep watch for approximately 419 people. I like numbers, these numbers tell me that I can be trained and have a much faster reaction time than that of even the fastest of police officers. Odds are that each of them has one of the other 418 people to deal with. I would rather be alive, than a statistic.
Thanks for the comment. I have seen no evidence reported to support the assumption that the majority of individuals using guns for atrocities were or are on psychotropic drugs. Also not sure how atrocity is defined by you. Does this include a murder of an innocent person. Also the term psychotropic drug is wide-ranging and would include antidepressants, sleep aids, anti-anxiety drugs and more. A quick web search demonstrated that a substantial number of Americans have used antidepressants:
Of these many millions, it is reasonable to assume that many are gun owners and that the majority of these gun owners are responsible owners of their weapons. And most who believe in freedom to own a gun likely believe in their right to medical privacy. Therefore, one is left with no evidence that the use of psychotropic drugs is predictive of gun violence, or the lack of such use ensures that an individual is somehow immune from misuse.
And any suggestion that one should waive their privacy or other rights because they choose treatment over non-treatment will not only go nowhere with the public, but if it were put in place would have such a chilling impact on the seeking of needed treatment as to be very counterproductive.
The remainder of your thoughtful comment speaks for itself and is appreciated as a well considered view held by many.