The boring life of Jerod Poore, Crazymeds' Chief Citizen Medical Expert.

Guns and Mental Illness - No Easy Answer


Whenever some horrible event like that at Newtown or the Clackamas Town Center happens the immediate assumption is the killer was mentally ill, even though more than half the time he wasn’t.  Regardless of the killer’s frame of mind, two never-implemented aspects of the never-implemented solution to prevent such a thing from happening again are to keep guns out of the hands of the mentally ill and the easier, yet less frequently discussed, to improve mental health care.

For purposes of keeping guns out of the hands of people who really aren't that much more violent than the general population, let’s define "crazy."  Sorry, “severely mentally ill.”  The first thing most people think of is either “schizophrenia” or “psychopath.”  One problem is “psychopath” isn’t a diagnosis.  “Psychopathic traits” shows up in the DSM, but mainly in the reference section.  What you’re looking for is “Antisocial (Dyssocial) Personality Disorder,” which includes sociopathy, AKA what Jeffrey Dahmer and Ted Bundy had.  We can all agree keeping guns away from the next Ted Bundy and Jeffrey Dahmer is good; except, like every sociopath, they weren’t diagnosed until after they were convicted of crimes that would have prevented them from buying a gun at a place that does a background check.  As for schizophrenia, while only a very small percentage of people with schizophrenia are violent, I can understand why everyone would want to keep guns away from someone who says things like, “God directed that bullet” and everything he learned in school was “lies straight from the pits of Hell.”  Good luck in taking away Rep. Paul Broun’s (R-GA) guns.

What about the bipolar?  You don’t want me buying a gun, right?  When I was hearing people in my bathroom and on the radio plotting to murder me and seeing fires they set in the corners of rooms throughout my house, did I want to get a gun and kill them?  No.  I did what the vast majority of the mentally interesting do: I called my doctor to talk about increasing the dosage of my meds.  I also wanted to buy every kitchen gadget I saw advertised on TV, which would have been cheaper than the Risperdal but probably less effective.  Doing something that makes no sense (to someone who isn’t crazy, or in retrospect) but isn’t violent is also a popular option.  Actually getting violent in response to an imaginary threat is rare among the mentally interesting.  It’s things like physical abuse, substance abuse, actual threats, recent divorce, unemployment, victimization, you know, the same stuff that sets off normal people, that causes some of use to really lose it.

Does taking Ambien or Lunesta count? Because people with sleep disorders do all sorts of crazy stuff.  Just ask Patrick Kennedy.  How about the epileptic? I ended up in the lock ward of a psych hospital due to a long run of complex partial seizures and having a history of bipolar disorder.  As with sleep disorders, people with complex partial seizures do all sorts of bizarre things.  While we’re on the subject of seizures, the epileptic have a suicide rate of 12%, not only that, if we also have a psychiatric condition the suicide rate can be up to nine times what it is for someone with the same condition who isn’t epileptic!  Is preventing suicide as well as multicide reason enough to keep guns away from us nutjobs?  The bipolar have a lifetime suicide rate of 26%*, people with major depression 13%, and the suicide rate of combat veterans, with or without a diagnosis of any form of brain cooties, is…rising, but even the reliable numbers I can find about what the rate actually is are all over the map, from 0.15% (the same as normal people) to 20%.  One thing is certain: about three quarters of vets who kill themselves do so with firearms.

You want to know who is really more likely to kill someone with a gun, knife, crowbar, etc. than anyone else?  Someone who is drunk.  Seriously, alcohol consumption is responsible for a huge chunk of violent crimes, especially assaults with firearms.  Even living in an area where they sell a lot of booze is dangerousCocaine makes people violent as well, and other illicit drugs cause their share of problems, but booze is cheaper, legal, and has had way more studies published about it.  The point I'm trying to hammer into everyone's skull (and I restrained myself) as often as the crazy = violent canard already is: something as socially acceptable as getting drunk is more likely to cause someone to get violent and kill people than the far less acceptable act of being born crazy.  So including DUIs and other substance-related offenses in the background check database would probably reduce the number of individual people killed by guns significantly, but it wouldn't do much in the way of preventing mass murder.  Improving the collection of domestic violence data might help prevent would-be family annihilators from obtaining guns to turn office parks into shooting galleries, as long as they don’t persuade their partners to buy the firearms for them.

Next: exactly how do you go about doing a mental health background check?  The way it works now is if you’ve been involuntarily committed to a psych hospital, or otherwise decreed a danger to yourself or others by a judge, you’re supposed to be in the FBI database that pawn shops and merchants at gun shows don’t bother with, but anyone willing to send $40 to a sketchy website can look at.  As is repeatedly pointed out, even this system barely works.  Worst case example: Seung-Hui Cho, the Virginia Tech shooter, was deemed officially crazy by a judge and he didn’t make it into the database.  Anyone who receives federal benefits via a trustee because they are mentally incompetent is supposed to be in the database, but only The Department of Veterans Affairs is currently sending those data.  Republicans in Congress have introduced the Veterans Second Amendment Protection Act to stop the VA from doing that.

Since the mentally interesting are lower than undocumented terrorists who illegally enter this country in order to steal the jobs of domestic terrorists, the simple answer is to put our medical records in the world’s least-secure database full of all the information you need to steal someone’s identity.  Screw HIPAA.  Anyone diagnosed with a no-gun-for-you mental illness is immediately flagged.  As is everyone currently diagnosed with such.  Which means everyone’s medical records need to be scanned for brain cooties to see who needs to have their guns taken away.  Those paranoid teabaggers were right!  Obamacare does mean they’re coming for our guns!  And everyone thought they were crazy.

Adam Lanza had no history of being mentally ill.  A week after the shooting there is still no proof that he was mentally ill, so he wouldn’t have been in the nutjob section of the FBI background check database.   Even if someone in that database wanted to go postal, what if that person does the same thing Lanza did and use guns that belong to his mother?  Are relatives to be included?  Spouses?  Parents?  Siblings?  Children?  Aunts and uncles?  Nieces and nephews?  In-laws?  And why stop at the mentally interesting for that one, as felons sometimes have families.

Even though we are not much more violent than normal people, just perceived as such, the mentally ill are a convenient scapegoat to explain the inexplicable.  The only proof most people need that someone is crazy is the fact they killed a lot of people.  Most people can’t accept a motive that doesn’t involve voices in someone’s head.  It doesn’t matter if the shooter survived like Anders Breivik, or it was obvious from his history like Wade Page.  Racism and idiocy aren’t enough, so crazy has to be involved.  When Bruce Pardo dressed up like Santa and, on Christmas Eve 2008, killed his ex-wife and almost all of her family with a homemade flamethrower, the overwhelming rage many people feel when you combine a messy divorce with severe financial problems apparently were not motive enough.  Add shame and failure to the mix and the same can said for every family annihilator who kills a bunch of people he feels were responsible for getting him fired, his family, and himself.  Mental illness is the only acceptable explanation because people are afraid to confront the fact that humans are inherently violent creatures; that our hands evolved to use fists as weapons as well as to hold other tools.  They are afraid to confront how easy it is for the veneer of civilization to slip away; that anger and alcohol disinhibit more effectively than an abnormal psyche or neurological architecture.  They are afraid to confront how a neighbor, coworker, family member, spouse, partner, or they themselves could be just a couple more drinks or one more bad performance review away from being the next person to go on a killing spree.  It’s far better for the mentally interesting to be the sin eaters than to face that possibility.

Still, the unknown motive is the worst of all.  It’s better to have some reason, any reason to explain what happened.  Otherwise the universe is a random, uncaring place that could have already sent a gamma ray burst our way that will destroy all life on Earth just as easily as someone can send a message in the blood of the innocent while neglecting to tell anyone how to read it.

Has anyone considered how counterproductive the constant equating of mass murder with mental illness is?   How many people who are already skittish about seeking help for a mental health problem because of the social stigma will want to seek help if there is a chance, real or perceived, that their name, address, phone number, and social security number, along with the indication that they are crazy enough to kill their family and coworkers, are all going into an FBI databaseOne recent survey of crazy people found that 38% of the severely mentally ill who didn’t bother to seek treatment cited structural reasons: lack of money, availability, or the inability to get to where the services are; while 21% said it was due to the stigma of being crazy and 26% because they thought the available services weren’t good enough.  Of those who started treatment and then quit within a year, 30% dropped out within a year due to structural reasons, 36% dropped out due to stigma, and 35% quit because the available services sucked.  So, yes, improving the mental health system will benefit a lot of people who, while somewhat more violent than everyone else, are also ten times more likely to be the victims of violent crime than you normal people!  We will never be a protected class, the NRA will never use us as an example of people who need concealed carry permits in order to protect ourselves, and loudly using the prevention of gun-related violence as the reason to expand access to improved mental health services will probably scare off more people who would have otherwise sought treatment.

Talk about shooting yourself in the foot.


* No wonder Ian Curtis hanged himself.  I'm damn lucky to have made it to 50.  

5 comments:

Anonymous said...

I want to know how a mentally ill person can have the thought process to be able to make a flame thrower and kill people.

I want to know how a mentally ill person can make sensible, logucal plans of any kind.

I read somewhere that mentally ill people are more likely to kill themselves than others. T. W.

K said...

The last statement is true. But there are all kinds of crazy, so there isn't really a way to explain your first two statements. It's possible to have a psychotic episode without losing all control of your mind. The mentally ill are just as capable of committing senseless acts as normal people. Which is kind of the point, I guess. There's no reason to jump to the conclusion that a person who goes on a killing spree is necessarily mentally ill. Well, there isn't a valid reason. People make up reasons all the time. Whatever helps them sleep at night.

Jerod Poore said...

Latest brilliant idea from someone: assign a full-time guardian to all of us nutjobs.

Better than preemptively locking us all up, I guess. Plus it would make a huge dent in the unemployment problem. If we got some say as to who would be guarding us, and I could choose a lonely hottie, I might just buy into that stupid idea.

Misty said...

Would it be okay to try sending this to my local newspapers? Not sure how I'd do the citing, but I'd add a link to this at the end.

Jerod Poore said...

Misty,

Go ahead.

I managed to get a shorter version published as a letter to the editor in The Missoulian.