Only a "good" psychiatrist with a gun can stop a "bad" guy with a gun!
4
What mental health system?
12
In early 1960 I was a sophomore in high school in mostly white Montana (not counting the Indians, a subtle bias I was blind to). I was vaguely aware of sit-ins staged at a Woolworth's lunch counter in a Southern state, and how a small defiance by four black students soon led to mass sit-ins throughout the South. In some ways that was the true start of the Civil Rights movement, just as I sense the current outrage by today's high school students can lead to real change in the mass production of rapid-fire weapons.
In 1960 the black students had a long struggle ahead, the first strong legislation not coming until 1964 as guided LBJ's legislative know-how: how to swing a vote from senators and congress leaders who would one day need their own favors. And even with that passage it's been a decades-long struggle to battle the bigots who still find ways to short-circuit the laws. (Gerrymandering, etc.)
High school students, please persist. You can make the difference that the rest of us have failed to make.
PS: You can gain some valuable tips by watching the Independent Lens study of the Civil Rights struggle on PBS.com, "Tell Them We Are Rising."
21
The greatest mental health problem in America is our culture of denial in not showing the disturbing and grotesque images of the bloody aftermath of events such as the one that occurred at Marjory Stoneman Douglas High School in Parkland, Fla.
Witness what a president can do, how quickly he can act, and the force with which he can respond when he is shown actual images of human suffering:
“63 Hours: From Chemical Attack to Trump’s Strike in Syria.”
That is the headline of the April 7, 2017 New York Times story on the timeline of events surrounding a Syrian government chemical weapons attack and the time it took for President Trump to respond with the launch of 59 Tomahawk cruise missiles at Al Shayrat airfield in western Syria .
“Mr. Trump was already shaken by photos his staff had shown him of children dying after the Syrian government’s chemical weapons attack — far more graphic than those the public had seen — so the president did not need a lot of convincing.”
“The bombs fall on the town of Khan Sheikhoun, in the rebel-held territory of Idlib Province. Video footage of the attack quickly surfaces, showing women and children gasping for breath and foaming at the mouth as they fight the effects of what officials later say is sarin gas, a brutal nerve agent.”
63 hours.
When America awakens from its American dream and confronts the graphic reality of gun violence, change will occur.
Larry O’Toole
Wilmington, Del.
9
Watching America go by for 70 years I see an obvious change which clearly explains why Dr. Barnhorst and other mental health folks have tossed in the towel.
We used to be a "don't play with guns", "every gun is loaded", "guns are dangerous", "don't ever point guns at people" society, without assault weapons on TV except the Thompson machine gun used by the mafia and a few Army films which our mothers wouldn't let us watch.
We had essentially zero school shootings.
Now we see gun worship run amok; "second amendment rights" GOP threats on the other party, "open carry" everywhere, "bring it on" war swagger, every soldier a "hero warrior", machine guns galore on TV and movies, video shoot 'em up games wholesale, "my button is bigger than your button", "shock and awe" , "fire and furry" military, and mandatory claims from publicly gun waving politicians about what all they've shot and skinned.
And you wonder?
23
Mental health care will did not stop the creation of so many trump voters either.
10
Excellent Amy. And please don't stop advocating your position! As a lawyer, I'm sometimes on the "other end" of the situation, e.g., opposing a relative or social worker advocating psychiatric commitment on the basis of, ie.g., surliness, rants, anger, etc. But what I dread are new laws giving authority to elected and administrative authorities to institutionalize even"potential" threats. Here in Pennsylvania judges are elected and, fearing the headline he/she released a mass shooter, will always choose lock-up. Persons with just a fraction of your "young man"'s portfolio, postings, etc., would be taken into custody and overwhelm our resources - with no guarantee of success. Even if we have different perspectives, we probably agree ....hey .... "It's the guns, stupid!"
12
Angry Young Man Syndrome isn’t a mental illness. It’s a personality disorder for which the only known cure is a good butt kicking.
6
I agree whole heartedly. I would like to see every high schooler in America have an opportunity to gather and form a March on Washington an march for sensible gun control. no assault weapons, no bump stocks, no guns for kids under 21. Let's get real... It was bullets that killed those kids. And i agree "The Mental Health System can't stop mass shooting." I applaud Emma Gonzalez for her courage to speak out. She was great! And so brave. From A Mom, Grandmother and Great-Grand.. PS: I'll march with you.
11
you guys simply fail to understand, it will be civil war if the government comes calling for the guns.. Its not going to happen and its not going to stop people from doing evil.. Allow teachers to choose to carry and stop advertising soft targets full of unarmed news footage..
3
Dr Barnhorst writes that she examined a man who exhibited no signs of mental illness. She placed this individual in a hospital against his will,i.e., she lied claiming she believed he was a danger to himself or others even though her examination revealed no evidence of this being so.On her admission request what false diagnosis did she enter, what signs and symptoms did she list to support this involuntary detention? Who paid for this hospital stay? What truely ill patient was denied a hospital bed because of her actions. Why did the times editorial board not investigate the veracity of her claims? Is the medical board of her state interested in her actions?
4
Thank you Dr. Barnhorst. If only more would read this and listen.
1
The last two paragraphs say it all--keeping guns out of the hands of the mentally ill is the issue.
2
yes, yes, yes! as a mental health professional, I second Dr. Barnhort's frustration whenever "mental health treatment" is identified as the solution to gun death. The term "mental health" is as specific as the term "physical health"...not specific at all.
5
I support increasing the minimum age at which you can buy a semiautomatic. If it was enforced (lately nonexistent enforcement allowed two massacres that could have been prevented) that would substantially lessen the havoc an "angry young man" could create.
Dr Barnhorst, clarify, I thought that California has been trying, or maybe even had succeeded, in passing a law allowing police to confiscate a firearm from a person, who had demonstrated violent tendencies, as attested to by an acquaintance and/or family. This was, I thought, meant to supplement the commitment authority that physicians have for suspecting the patient presenting in a clinical setting - especially a hospital ER - has a diagnosable mental condition and may or may not have access to a firearm. Here, in your acct., this particular young man had recently bought a gun, per his brother. Would you clarify?
2
Majority rules and if we continue to elect government officials who support the N.R.A we can continue to see these gun pour into our society. If Americans don’t want these guns on our streets, or in our schools then why are we electing government officials who support the N.R.A and are against strict gun regulations. We can talk about this on social media, we can address the mental health issue but the bottom line is that we seem to be voting against our own interest if we want stronger gun laws. If it is a mental health issue, then why are we voting for officials who refuse to fund our societies mental health system?
1
I am a psychiatrist with 35 years of experience, and politicians and others who blame mentally ill for these mass shootings are, at best, ignorant. Majority of the shooters of this kind have a character flaw, not mental illness. When the 2nd Amendment was written, our ancestors had no notion of the automatic weapons of mass destruction--had they known it, they would have specified them to be excluded from the Amendment. Assault weapons have no role in a civilized society except in the hands of the military and the law. Ban the weapons and block access to such weapons by all private citizens. Common sense laws for regulating access to other weapons must also be passed.
19
A very compelling article, to which I would add this one observation:
To those that say, "Guns don't kill people; people kill people", I would reply,
Ok, but then that also means that:
"Slick ads that distort fact to advocate mass ownership of AR-15s don't endanger innocent lives. But the NRA and its paid politicians really do."
5
Canada, which has little history of mass shootings, and limited gun violence, allows ownership of most of the same guns we have in the US, but mental screening is required to buy them. In addition, legal venues for buying guns are controlled, and do not include gun shows. We have so many guns out there now that requiring mental screening before legally buying a gun may not limit access in a meaningful way.
6
No, mental health systems can't stop it, but real law makers, not part of the greed factory could.
4
Excellent piece. Unfortunately, even the father of one of the girls murdered in the latest school shooting does not see this as a gun issue and thinks we need to focus on other actions. Let's also not forget that the Vegas shooter appeared to be of sound mental health...aside from mass murder. Removing guns is the most immediate and most cost-effective solutions for our kids.
11
Given the current state of the art I think the best mental health contribution to the problem is simple. You want a gun, you don't get a gun. It would be effective! It's fine with me and better than what we have now.
3
As a psychiatric nurse who has spent years working on specialized inpatient units for persons with severe character pathology, I can identitify part of the problem as clinical naivete on the part of some therapists. The Columbine mastermind, for example, dutifully and politely reported for weekly therapy sessions (court ordered as part of remediation for some relatively minor lawbreaking) before going home after each session to refine elaborate plans for his ultimately successful murders. The therapist made such optimistic notes as "progress", "working hard," and "now has insight" in his mental health record. Meanwhile, the real record, his diary, revealed the shooter's stated contempt for the "stupid" therapist and others he was able to so easily manipulate. Clearly in retrospect red flags (and maybe more tightly connected dots) should have sent him to a clinician sophisticated in assessing severe personality disorders and potential levels of danger, rather than taking his bland deceptions at face value. Had anyone actively looked during this time they could have at least as first measure ACTIVELY REMOVED THE GUN STASH.
3
What would be the logistics of this background check of the mentally ill? What about the privacy issues? The confidentiality of the doctor-patient relationship? I’ve been seeing psychiatrists and therapists since I was diagnosed with bipolar disorder 25 years ago. Is the FBI going to contact my doctor? Is my doctor going to be required to report me? Suicide prevention might justify some level of intrusiveness (suicide being the leading cause of death by firearms). Fortunately I myself don’t know the first thing about guns. Fortunately I was never exposed to them.
1
The mental health system which Republican, pro-gun types evoke is the state-run, expensive, involuntary, potentially lifelong brick and mortar hospitalization system that their idol Ronald Reagan dismantled. Nothing else would work. Grave injustice would be done to numerous individuals involuntarily hospitalized for life at great cost such that extremely destructive weapons normally reserved for the military could be made available to the general public.
Republicans are not going to institute this kind of healthcare system. The current mental healthcare system cannot enforce the outpatient consumption of medications and the separation of these individuals from guns.
Basically, the logical shortcomings of the Republican position are being exposed
5
I would go further. This is a societal problem. Yes, mental health is an issue. Yes, easy access to semi-automatic weapons is an issue. But at the end of the day, this is the result of a culture that values competition above community.
Our culture values winning at all costs. We want to be the strongest, the richest, the prettiest. We want to own the most expensive car, the biggest house, designer clothes. But what happens to those who are not winning?
Those feelings of worthlessness that emerge may lead them to turn to drugs, crime, road rage, child or spousal abuse, school shootings. Just to feel big, just to feel powerful in a society that seems to constantly beat them down.
We've lost our sense of community. We value the individual over the collective. We emphasize personal responsibility, but ignore the fact that our neighbors and our fellow citizens are our personal responsibility.
We can't continue to ignore the fact that we're a community. We need to work together. We need to help each other so that no one feels so worthless that they feel compelled to destroy another's life. There's no teamwork when we're all trying to win. And we can't all win.
2
People are focusing on the wrong problem. It's not our mental health system or guns. The problem is that these politicians - they keep doing nothing and people keep voting them in. The problem is the politicians and lack of voters willing to eject them. They aren't going to change so we must force them out.
3
Enter the ERPO ...
There are too many shades of "mental illness" to rely only on diagnostic commitments by mental health professionals. A formal study at Duke University in 2017 shows that a Connecticut State law based on RISK of suicide-by-gun was effective in actually reducing these suicides when initiated by testimony of family members and/or law enforcement officers in local courtrooms.
California, then Washington, then Oregon have already passed legislation where family members, roommates and Law Officers can bring evidence to a local court to request issuance of an Extreme Risk Protection Order (ERPO).
If the evidence is sufficient, the judge can order the Respondent to voluntarily give up all guns for a period of 1 year. If not surrendered, the court can issue a search warrant for all guns to be collected by a law officers. The "respondent" may or may not choose to appear in court, but is given sufficient notice before the Hearing, and may return later to court to present evidence for termination of their ERPO.
An ERPO may be issued for potential suicide, domestic abuse, or harm to self or to others.
The NRA likes to say laws "confiscate guns without due process". But an ERPO is, in fact, DUE PROCESS. The US Supreme Court has already ruled that States may pass such gun control legislation, and the ERPO is not permanent, but may be extended until the causal risk is reduced or removed.
Some 20 more States have already introduced similar such legislation.
3
Here's something mental health professionals might help with.
Google "suicide by cop". Depending on whose research, the frequency is around 10-30% of police shootings.
Since most mass shooters don't expect to get away, what is the likelihood that armed guards in schools might make shootings more likely?
School shootings have a "going down in a blaze of glory" quality. The "glory" part of that is a reflection of the larger gun culture.
And, then, there's something that hasn't happened yet, as far as I know, but certainly will, if the NRA prevails. That's innocent death in a hail of friendly fire from supposed good guys with guns.
Mental health services won't stop it and more armed guards may well make it worse.
The solution is fewer guns. Fewer suicides, homicides and accidents.
Accidents outnumber justifiable homicides. That is, more innocents are killed by accidents than criminals are killed by a "good guy with a gun".
Pathological gun-love is the problem. Gun lovers need to accept that exercising their "right" to shoot at targets with semiautomatic weapons is not as important as the right of other people not to get shot. Instead, we repeatedly hear nonsense about mental health, armed guards, lip service regarding background checks, and ambiguity of gun-type. All of which, ultimately, resulted in an youngster with a mental health history owning multiple guns, including the AR15 he used to kill the students in Florida.
3
Who among the psychiatric community has the courage to knock on American doors and say "Hello, I'm from the government and I'm here to take your guns."? With several hundred million firearms already in the possession of Americans, the vast majority of whom have no intention of committing mass murder, proposing to seize all firearms is naive. That horse is already out of the barn so better to work on the laws that prevent people from being forced to take their psychiatric medications or get better mental health treatment. And yes, improve the gun laws - do away with the gun show loophole, ban assault weapons, and even seize the guns of people with outstanding restraining orders for domestic violence. There is a middle ground.
2
It's worse than that. To call what we have in this country a mental health "system" implies far more organization, access and efficiency than actually exists. The deinstitutionalization started in the 50's and 60's has climaxed with a failure to replace those resources with community mental health providers, particularly in smaller cities and rural communities. Acute mental illness, the classic "nervous breakdowns" are handled in emergency rooms and perhaps a few days finding a medication that reduces symptoms, at least as long as it is taken as directed. We have far too few psychiatrists, and having worked at a teaching and training institution I can tell you that many psychiatric residents chose this path because they found out being a doctor is too bloody messy. As of now, our mental institutions exist in the form of prisons, and there is a prison "system!"
1
Makes sense, based on clinical experience (see piece), research (limited clinical treatment efficacy; Monhan, et al, Clinical Prediction of Violence book: can predict with moderate accuracy over about 8 weeks), mental health law (evidence of imminent dangerousness of self and/or others), the yawning gap between current needs for mental illness assessments and treatment and the number of mental health professionals & between need for adequate funding for mental illness care & the very limited available funding.
"Instead of hoping that imposing mental health treatment on everyone who shows “red flags” will put an end to mass shootings, we should focus on ways to put some distance between these young men and their guns."
2
A lot of responses here by mental health professionals and while I agree there is no test for violent behavior nor a back ground check that can identify ill intent. Americans are simply desensitized about violence or immoral acts. Everyday we're subjected to graphic violence in games, movies and television. It's ok for politicians to lie, cheat and steal. Our legal system protects the criminals throughout their life sentences at a great cost to us taxpayers. Combating escalation will require multiple approaches. We need tighter gun laws, better parenting to limit the over exposure to game/tv violence, and consistent criminal sentencing. The death penalty for life sentences is a good start ad it should only take 18 months not decades. I get it, not all convictions are un-biased but this one is concrete.
I applaud Dr. Barnhurst for sharing insights on why her chosen profession is not suited to crime prevention. Nevertheless, I feel the current mental health industry will benefit society more if it mindfully reforms itself.
While I agree w/ Barnhurst’s observation that 2nd Amendment purists routinely target the fields of psychology & psychiatry as being where one should focus their attention after every new Parkland, I beg to differ that it is a wrong move unilaterally.
Yes, the NRA has a titanic chokehold on Congress. Yes, Barnhurst has completely valid concerns that the majority of the public are not fundamentally grasping how complex & restrictive the experience is for docs in trying to help people who are dangerous to themselves & others.
How to reform mental health? Big question. I propose by seeing it as part of a larger multidisciplinary mosaic: local governments, community groups, law enforcement, student activists and mental health centers.
Spielberg’s Minority Report envisions a future where Pre-crime exists. Tom Cruise portrays a cybernetic Sherlock Holmes. Advanced holograms pooled w/ paranormals utilizing psychic powers assemble sneak previews of murders before they happen, allowing Cruise to disrupt tragedy. Obviously, this is science fiction & a form of popular entertainment.
However, is it not possible to make even 1% of this imaginary Pre-crime into a reality one day by starting a substantive conversation between a diverse collective?
Study the future.
As a licensed psychologist, I've always thought it a red herring to claim "mental health treatment" would stop these slaughters. People with these problems will not seek treatment. If they did and I became concerned and reported them, some "system" created by well-meaning but fallible human beings would probably just anger them and make them more paranoid. And once they got hold of a gun, who do you think they would shoot first?
Guns are the causes of these shootings. No red herrings. Listen to the young people and start sensible controls.
5
I don't understand those who think in either/or mode. We need better mental health care and we need to ban automatic weapons. The two don't cancel each other out.
3
I find it ironic that many politicians and lobbyists who support the sale of semi-automatic weapons and continue to block legislature which would strengthen gun control (in order to protect all lives), live their lives protected behind private security or body guards. I guess all lives are not considered equal.
1
I may be the only one working under this assumption but when I think of mental health care to combat gun deaths I always assume we’re discussing the 60% of gun violence fatalities that are suicides. I do like the idea of some sort of Baker Act for those considered a threat, but overall this article points out the weaknesses of relying on mental health provision for mass shootings.
Sad to say, i blame those disability rights activists who insist that severely mentally ill people not be instiutionalized and rather have them walk the streets ready to explode without much warning. Just look at all of the incidents in NYC where mentally ill people have pushed innocent commuters onto train tracks. It's so hard given the courts also limiting the government's or even a relative's right to ask for confinement to an instution for the long term. Add To that, mentally ill people aren't required to take medications that will stablize them, often what happens many will just stop taking their medicine and then commit some horrible act of violence upon someone. There has to be a drastic change to the current policies regarding severely mentally ill people.
Allowing private ownership of military-style assault rifles is inconsistent with public health and safety.
The United States spent nearly $600 billion on national defense, and cities, counties, and states spend billions more on police, sheriff, and state patrol law enforcement. If that isn't enough, then tell me what is.
We don't allow people to own their own personal nuclear devices, even though they make a pretty mushroom cloud when the blow up. We don't allow grenade launchers, anti-tank weapons, machine guns, and a host of other neat stuff.
Assault rifles are not good for target practice either. Just ask anyone who has been to basic training in the military. I qualified expert and can hit a knat's behind at 300 meters. But an M-16 is not for target practice. Basic trainees fire at pop-ups - because close is good enough when you are trying to kill or maim an enemy soldier.
Military assault rifles are good for one thing. Killing people. That is why they are the weapon of choice for mass shootings. When people are able to get them, they use them. We don't allow anyone except the president to carry the nuclear button for a reason (and it should be taken away from Trump, for that matter, but that's another subject). There's a reason.
When people have'em, they use'em. Other countries figured this out long ago. By the numbers, no assault rifles = few or zero mass shootings. Only the United States allows this, and we are the world leaders in gun deaths.
4
The risk of blaming "mental health" (whether rightly or wrongly) is that the next step is to kick kids out of school because they are perceived as a risk. That's a truly horrible path. It will inevitably be unjust. Especially as it's clearly not the cause of the problem.
1
Thank you for this.
Anyone who has had the misfortune of being in the position of having a friend or relative who is mentally ill to the extent that the need to be committed, because they are a danger to themselves and others, knows the commital process is not a cogent way to manage much of anything. Its a very small percentage of the mentally ill who are incapable of presenting themselves as sane enough to meet the legal standards that insure their freedom.
There are always going to be sick people in the world, always have been. We can certainly improve mental health care to more help them, but the chances of preventing massacres are pretty slim.
Mentally ill people can get assault rifles. And unless you change the laws, this will continue.
They say there were no "red flags", but they ignore the biggest red flag known as an AR-15. In the 50s and 60s, school children used to have "Air Raid Drills" to prepare them for Russian Bombs. And our government would defend us if such a thing ever happened. Now school children have "Active Shooter Drills" to prepare them for American Assault Weapons. And our government defends the assault weapon makers. The Russians don't need bombs anymore.
4
The NYT and its readers show compassion of everyone except those with mental health problems. The shooters mother is dead, so we don’t know what she went through. But a few years ago they interviewed the parents of a shooter. Their life had been hell. Not only was someone whom they loved suffering, but he was ruining the lives of everyone who loved him. They could not get long term help for their child. Society’s solution was wait until he commits a crime.
3
Very thoughtful article. As several others have mentioned, blaming school violence on mentally ill people is an inadequate explanation. Most forms of mental illness (i.e., schizophrenia, bipolar disorder) are not associated with violence except when people are untreated and unstable - they've stopped taking their medications and stopped attending therapy or other community mental health services.
How would we define who is mentally ill and/or what is an appropriate level of day-to-day stability to allow gun access? Psychiatrists have enough trouble defining mental disease states as it is. Would we include people with post-traumatic stress disorder, major depression, or panic disorder? How about anorexia and bulimia?
The need for better and more restrictive gun laws couldn't be clearer. But if we're equally concerned about the adequacy of mental health care, we should be directing more funding to mental health research and community care. We should be training community volunteers, teachers, religious leaders and coaches in how to recognize the incipient signs of violence in young men. We have some good systems of long-term mental health care in this country, but many, many people cannot access it.
9
Most of what I've read of the motives and mental states of people who have "gone postal" are due to school bullying and perceived workplace unfairness and injustice. These problems are not, repeat NOT, mental health issues. They instead are about a lack of decent attitudes of others, or sometimes a perception of lack of others' decent attitudes. That can't be cured by counseling a victim of unfairness, but could be better addressed by topdown requirements from school officials and corporate bosses to not be unfair, mean and so forth to those who might otherwise be subject to negative words and deeds. The best things a therapist might do for a victim of bullying are to somehow enable a victim to put up with it, move to a better social environment and fight the abuse in legal ways if possible. But this also requires the leadership of institutions and society to have good kind values and stand up against abuses.
10
I completely agree with the author’s thoughtful editorial as well as many of the thoughtful additions made by colleagues in the comments. I would add, to those of you sincerely arguing that mental illness is a realistic approach to reduce gun violence (as opposed to those using this as a “fig leaf” for your 2A fanaticism) psychiatrists like me don’t reject the mental illness route for ideological reasons. Our views are strictly pragmatic. If I COULD play a constructive role in reducing gun violence, I would. But from the absurd prospect of “mental health gun clearances” to the slightly less absurd and common scenario described by the author, we don’t have the skill set, tools or resources to help. I happen to believe in the repeal of the 2A or limiting guns to shotguns 22’s and muskets. But that does not color my expert assessment of what we are capable of.
14
The United States has no more or less mentally disturbed young men than Japan, England, France, Germany, etc. However, it has 25 times or more as many school shootings.
The United STates has many times the guns, it allows private ownership of assault weapons, and it lacks the gun registration and tracking of other developed nations.
If I were a GOP politician, I would not be able to see how these two paragraphs are related.
18
Brilliant highlighting of cognitive dissonance by a large segment of American society! How do you cure that?
6
The American mental health system is too clumsy to deal with such situations, same goes for the law enforcement community.
Everyone involved in these events shifts responsibility to another entity or concept, like "mental illness" or the NRA. It's blame shifting throughout, at every level. We hear and see the blame shifting after the worst has already happened. Then the blame shifters want and expect our laws to be changed to conform to what they want after disaster has already struck.
Take Nikolas Cruz. It has already been established that everyone knew, predicted and expected that HE was the one who would do the shooting, but...
Now it is the fault of the NRA and crooked politicians.
So we should listen to these emotional people and do what they say in regard to changing our laws?
These incidents can be prevented. Blame shifting and shirking responsibility prevents it from being effected.
2
Let's focus on the more obvious shared traits of mass-shooters: they are almost exclusively white males - we just need to keep guns out of their hands! The risks seem to be far less with other demographic groups...
16
76%
Percentage of mass shooters raised in single parent households
The overwhelming majority with no fathers in their lives
The majority with a history of domestic violence
The majority with mental illness (themselves or their parent)
The majority from divorced or separated parents
23 Million
The estimated number of children in this country separated from one of their parents and their family members as result of state sponsored trafficking of children, family court corruption and the $50B Divorce Industry. All fueled by SSA Title IV-D federal dollars.
If we want to stop mass shootings – let’s end the antiquated and horrific practice of keeping children from seeing and being EQUALLY raised by BOTH of their parents and ALL of their family members after an adult relationship ends.
Perhaps if our state "family courts stopped trafficking in children and destroying families enrich a very small number of well connected divorce attorneys and family court vendors, we'd see far fewer shootings.
Peter Szymonik
Constitutional and Civil Rights Activist
Autism Advocate
Glastonbury, CT
www. erasingfamily. org
www. fixfamilycourts. com
4
Peter
Two Words for you
BIRTH CONTROL
If Americans just stopped having kids we wouldn't live in terror of being killed by them.
As a teacher, I am accustomed to the buck of all societal ills being passed on to "professionals" ill prepared to solve the catastrophic educational, economic, familial, and political failures which abound. Parents themselves are often left out of the equation because they're the ones who elect the idiots of the various legislatures while the rest don't vote. These idiots mirror their supporters, i.e., Trump and company. But he's not alone;
Trumps are in every legislative body. He's become an unnatural force of climate change.
4
Of course a shrink will have his or her hands tied. HOWEVER no one should be getting to this type of mental breakdown or psychotic thinking to being with. Early intervention and therapy of various kinds helps people mitigate people from acting on such thoughts, because it helps build self esteem and self awareness. That requires regular therapy. That requires more supportive social worker type of health in schools. There is a larger picture here that the shrinks are missing. If someone is even getting to this point as a society we've failed. Can we prevent all of this no, but the human condition is frail and currently it's abundantly clear that we are not supporting those that may be falling behind in various areas. We need to pick people up the first time they fall, not when they are so broken we end up in situations like these. We cannot force institutionalizing people but the heck if we can't identify the loners or socially isolated at a younger age and help them.
5
The majority of the 30% of Americans who "keep and bear arms" do not cause any problems. The minority causes serious harm, not only to those that get killed or injured, but the law-abiding, non-trouble-making gun owners because we are reminded that guns have the purpose of killing people (even target shooters fire at human shaped targets looking to score kill-shots).
My take is that allowing the first clause of the second amendment to be ignored by the states is a large part of the problem we have today. That "well-regulated militia" makes gun owners come together for screening, training, qualification, as well as socialization. Those who have committed the murders that happen almost every day have a common characteristic - they are social isolates with real and imagined problems that would stand out in any militia meeting. Since the state would have liability for what the militia members do there would be an incentive to weed-out the malefactors before they do harm or at least make sure that their arsenals are sequestered until they no longer show lethal tendencies.
It is time to reinstate the Citizen Militia as the second amendment calls for and regulate the militia and thereby the problems will be lessened.
7
Thank you for this insightful piece. Even with consistent mental health care, as in the case of Eliot Rodgers, there's precious little families, law enforcement, or caregivers can do to prevent someone from carrying this out if they have a mind to do so. And so the simple answer is to deny access. Ban these weapons now before some other angry, entitled, and scorned young man decides to take his rage out on others to prove his manhood.
7
Let's also focus on creating a society where the definition of "manhood" and "success" are more inclusive, so kids don't feel so worthless that they decide to kill other kids.
1
I can only imagine the rightful outcry is we were to commit everyone who makes some angry statements against someone.
of course someone who looks 17 innocent people is mentally ill. but so are many other people who will never harm a fly.
and while many of the shooters are awkward, they don't always sure outright dangerous until the day they show up with an assault rifle at a cinema.
nobody needs an assault rifle. period. teachers should teach ABCs, not shelter in place. forbid assault rifles, forbid guns 500 m from schools and playground, sports arenas, bars and churches. forbid guns at political rallies and allow guns in Congress and the White House. that will smarten up our politicians real quick.
2
There most definitely is a "cure" to senseless school shootings that any one who claims to know anything about psychology understands. A less intellectual indication of what is really wrong is that a few decades ago when guns were as available as they are today teens did not think it was 'cool' to shoot dozens of innocent people. These childish acts to gain attention and celebrity mass-murderer bad boy status can easily be stopped by societal elites and the media teaching moral values (its wrong to kill innocent people), and indoctrinating the virtue of self discipline into the nation's population, and then publically shaming and damning the individuals who do these horrific acts! As opposed to the 'if it bleeds it leads' mass media giving these individuals celebrity status (which creates copy cat behavior), and essentially proclaiming that the murderers are somehow victims who deserve all manner of sympathy - while the majority of law abiding citizens are somehow to blame. That the society is to blame for the fact that murderous individuals can get guns, cars, knives, heavy objects and things to blow up to kill people. All the incentives are opposite to those needed to produce proper behavior, so no wonder our children and young adults who live on a diet of violent video games, whose parents and teachers were told any kind of discipline is equal to child abuse, and that children are entitled to do what ever they "feel" like doing are committing these horrific acts.
If only the mental health system could address pathological gun-love in otherwise sensible people.
You might have noticed that these attacks never involve poison gas.
Presumably, that's because poison gas is harder to get.
I think it's also because poison gas doesn't appeal to that macho image thing that has shooters posing with their guns.
7
Designating someone, anyone with so-called tendencies toward violence and psychiatric disorders is sampling labeling. The label may temporarily remove someone who does indeed belong in the mental health system but it may also wrongly place a label and restrictions on people who are sane, in control and without any mental incapacity or defect. This is like the attempt to designate all people who receive Social Security through an agent or power of attorney because of health problems, as unfit to own firearms. All we did was create a class of people with fewer rights and privilege. It was trial without a jury.
There are valid cases of many men who are wrongly accused of domestic abuse and find themselves the victim of Protection From Abuse Order and restricted from entering their own home, seeing or even communicating with their spouse and children and also unable to access bank accounts and other things that we ordinarily take for granted. In those cases the PFA orders are used vindictively and they destroy the rights and lives of innocent people.
Using the mental health system to label anyone for any purpose is a path to certain destruction of basic human and civil rights. Whatever we do end the slaughter by guns it must not be at the expense of civil rights.
We are better off to pass age requirements, impose taxes, and insist upon training and testing for everyone who purchases guns. AR 15 type rifles and semi-auto pistols should not be sold to anyone under age 25.
4
I have drafted behavioral health legislation. There has been no mention of whether the Florida shooter aged out of services. This happens all too often, not just for behavioral healthcare, but also for other services that a young person alone in the world may need.
6
I just want to add my voice to the chorus.
Speaking as a Psychologist with nearly 40 years experience, mostly in hospitals, I want to confirm that this article is accurate.
Well done, Dr. Barnhorst!
7
Putting the burden of 'solving' the problem of gun violence is not only too heavy a burden to put on what a mental health care system can deliver, it has the potential to seriously undermine the civil rights that are at the core values of our American culture. When you have civilians, much less mental health professionals, 'ratting out' people they think might be dangerous, you set up a scenario in which anyone can be victimized by accusations based on assumptions or perceptions that may or may not have any validity. Even in the case where, as the author states, you have all the attributes that might serve as red flags - you still cannot persecute, prosecute, or strip civil rights for 'thought crimes.' A crime and anything more than very temporary confinement can only be based on action. And, having worked with patients for over 20 years as a clinical psychologist, I can tell you exactly when we'll be able to accurately and precisely predict destructive behavior before the fact: Never. Looking to mental health professionals for a solution to this epidemic of mass violence is understandable. given the horror, desperation, and sense of helplessness evoked, but unfortunately, it is wishful thinking.
4
Data has been collected, and the evidence is overwhelming: more guns equal more gun deaths. Google to find out how Australia reduced its number of gun deaths dramatically by passing a law that restricted gun ownership after a 1995 massacre.
7
Thank you for the fine discussion. It seems like those who would like to put the onus on the Mental Health system lack the willingness to fund it. But more importantly, I think some folks believe a mental health issue is an "you-have-it-or -you-don't" type phenomenon, and those who are sane and buy an AR-15 (or several) will remain sane for the entirety of their life, and never fall victim to mental illness or uncontrollable hatred/anger. Life isn't like that, and mental illness isn't like that. Our gun-loving culture and the availability of weapons of mass destruction like the AR-15 need to change if we have any hope of stemming the tide of violence.
7
Instead of passing more silly new laws which, in essence, say "this time we really, really, really mean it" we should enact Federal legislation which will require all gun owners, from manufacturers to dealers to final customers, to carry firearm insurance and hold them STRICTLY LIABLE for ALL harm caused by their guns regardless of who uses them. That's vicarious liability, as with cars.
We need all guns and ammo to be traceable. As with cars, guns should have Certificates of Title so we know who owns what gun at any given moment. And the ammo? When I buy eggs at Trader Joe's each egg is imprinted with a code. We can't do that with ammo so we can see who is buying what and in what quantities?
Do this and people will safeguard their guns and transfer them legally. Of course if the guns and ammo are stolen and the owner was not complicit or negligent in allowing the theft to take place the gun owner would be off the hook. You're not fool enough to leave your car parked on the street with the windows open and the keys in it are you?
Nothing that I have suggested conflicts with that pesky Second Amendment.
11
Can you imagine how many people in our country fit the "shooter" profile (i.e., angry, resentful, disenfranchised, posting these feelings on social media) AND also have guns readily available to them if they want them? It must be in the tens (if not hundreds) of thousands of American citizens. Could you detain and/or incarcerate them all? Compel them all to undergo mental health treatment? The overwhelming majority of them will NEVER be violent. So these "red flags" (touted by the media, law enforcement, teachers, mental health professionals, etc.) do not predict which one of the thousands upon thousands will actually engage in a heinous act. This is what we find so troubling after yet another mass shooting tragedy.
2
Gun control is needed. Mental disorder in this country is treated with pharmaceuticals almost exclusively. These drugs do nothing more than cause harm (e.g., suicidal thoughts). What probably would work better is to use nutrition. Abram Hoffer, back in the 1950's was successful in treating schizophrenia with high dose niacin and other nutrients, with no side effects. No money in it for Big Pharma and the psycho establishment, so the treatment protocols were buried.
Buried? Then how do you know about the treatment protocols? It is highly unlikely that there is a single treatment for any serious disease (mental or physical). I challenge you to name a certain treatment for any serious disease.
1
The AR 15 itself and its ubiquitous availability are the problem. Any attempt to deflect these simple facts to better locks, armed civilians and mental health is NEA propaganda designed to prop up our NEA marinated legislature. There is no effective way to screen out the deranged. The only way the to decrease the effectiveness of mass murder is to remove the weapon of mass destruction.
4
Republicans in their zeal to place the blame anywhere but upon the weapons of war have placed the mental health community in a impossible position of predicting the future with a 100 percent accuracy. Which we all now is impossible and hey if they could do that they would most likely be working on Wall Street not mental health.
6
From one mental health professional to another, thank you, Dr. Barnhorst for clarifying for the general public the constraints under which we operate when determining risk of violent behavior.
6
Mental health costs $$$.
Does anyone think Red America is going to fork over one Russkie ruble for someone else's kids health issues?
Good luck.
$$$ Trumps all. Profit Uber Alles.
Guns, God and Gold is all that they acknowledge.
Gee, too bad about those dead children.
Free-dumb.
(Until it is one of their own.... then, maybe.)
4
Every country has guns. Even though other countries may have fewer guns, there are more mass shooting per capita in the USA. What is it about our culture that creates this kind of mental illness? Is this madness due to Behavior Modification in advertising - and Fox News channel? (Research B.F. Skinner.) Is our Puritan culture snapping because of years of sublimation?
1
If anything it's the mainstream media. It is well documented (though seldom discussed) that nearly all of these mass shooters are registered Democrats.
1
This discussion reminds of the 'precogs' in the movie "Minority Report"... people with gifts that allowed them to identify a perpetrator before they've committed a crime.
Laying this problem at the feet of mental health professionals (or parents of children with mental health issues, as some might) ignores that it is an imperfect science from identifying the illness all the way through treating it. That's not due to a lack of commitment or effort. The specifics of a given case of mental illness simply fall across too broad a spectrum to allow for meaningful predictions of that person's future behavior in the vast majority of cases.
With those limitations, relying solely on a mental health approach remains little more than a pipe dream... especially since 'precogs' exist only in fiction.
3
it may not help BUT we can't blame the Taliban,,,,, sooo lets find some other thing to blame
2
Indeed, the "improve mental health screening" idea from the NRA backed politicians is simply a deflection from the real issue of easy access to military grade weapons. But our politicians seem to be heading toward "doing something", just to say they did something. I seriously doubt the NRA minions, like my Texas Senators Cornyn and Cruz who took many thousands of NRA dollars, will do anything truly effective. "Police suspect (Nikolas) Cruz was armed with at least one AR-15-style rifle and 'countless magazines' ... designed to fire off bullets very, very quickly ... in most states, the rifles can be legally outfitted with high-capacity magazines that can hold 60 or even 100 rounds." (Huffington Post) There is no legitimate civilian purpose for such weaponry. But " ... gun industry executives have admitted mass shootings are good for business."
3
Every physician sees patients they are unable to help who are "troubled," "angry," "do not work well with others," "have a bad attitude," are "mad at the world," or even hostile and abusive, has referred some of them to psychiatrists only to find that the psychiatrists are equally unable to help them. Such people are not necessarily "mentally ill." Cruz clearly would have been dangerous, even he were carrying only a crowbar or a rock. But this is no excuse for selling him an assault rifle.
10
Psychiatrists should examine why some people have such an obsessive love for assault rifles. Is it irrational fear? Feelings of sexual inadequacy? Child-like wish to be a real combat soldier, but too afraid or physically out of shape to be one? Maybe they are the ones needing serious mental health attention.
7
Excellent article. The push to keep "mentally ill" people from getting guns is scapegoating and dangerous. Scapegoating because those diagnosed with "mental illness" are no more likely to be violent than others. Dangerous because some have called for the release of social security data on those disabled due to mental illness--data which are legitimately protected by privacy laws.
And this scapegoating has a purpose: to take the focus off the real problem: the epidemic of guns. I have recently concluded that the second amendment must be repealed.
4
We are like a man trying to get out of a burning building by clawing through a wall, or digging a tunnel, when there is an unlocked exit door right in front of him. Is it really not obvious to people what the problem is here? Why it is that these mass shootings occur with regularity here, and never in places like Japan, Great Britain, or Australia? But with each shooting, it becomes clearer and clearer to me that we are never going to use the door...
11
Good article; conclusions should be intuitively obvious, particularly to anyone familiar with mental illness.
Other truisms:
- The country is highly unlikely to take away the 300 million guns already out there.
- There are substitute weapons that can kill as fast as the "automatic" weapons (not to say they shouldn't be more tightly regulated).
In a 2/16/18 Editorial, Holman Jenkins at the WSJ came up with a new idea: apply the terrorist-type surveillance technologies to this problem. Obviously nobody wants to be spied on by the Government, but perhaps there is some middle ground that let's us identify and assess probabilities w/r/t potential shooters. We seem to have gotten very good at this activity for terrorists.
The Entertainment industry is filled with violent movies, videos
and children see hundreds of violent scenes all the time and every day.
It's easy to understand what is right from wrong.
from nothing also comes nothing and where there is less of such entertainment lives styles improve.
The mentality ill are far less likely than a "normal" person to commit gun violence. Less than five percent of shooters are "mentally ill." However, over 60 percent of shooters have a history of domestic violence.
So, our focus needs to be on what really is behind most of the shootings, a violent person who does not respect or treat others lawfully.
What is behind the shootings, motivations, is not really an issue. It is a red herring, a stall.
Several things must be addressed: The size of magazines and type of ammunition available to the public, and background checks, testing, and registration (like cars) for all gun owners, along with waiting periods for those purchasing a gun. Aiding/abetting charges against straw buyers. Confiscation and jail time for smugglers. Confiscation and fines for failure to register.
9
Nothing is being said about bullying. If someone had been bullied for their entire school life... Well how should they react? How many times do they to deal with the school doing nothing? A other side that sadly is not being reported....
Mental health services can do a little bit to alleviate the risk of mass acts of violence, but they are not the solution. What seems to be widely forgotten is the notion of free will -- that people have free will, and that they are going to make decisions for themselves regardless of what their therapist tells them to do. Even if a therapist wanted to impose their morals and goals on a patient -- and many who adopt a client-centered approach refrain from doing this -- the patient doesn't have to listen to what their therapist says and comply. People often think that therapy is a silver bullet that will cure all a person's problems. But this is far from the truth. The patient needs to buy in. The patient needs to be open to change. Sadly, I've seen far too many people hop from therapist to therapist, not securing the solutions or changes they had hoped for.
1
We have to spend the money for staff to intervene in the very young lives of these future mass murderers. Watch for children that are lonely, bullied, or whatever other criteria are established. Help them with social skills. Teach kindness. Conflict resolution. These skills now need to be taught to all students, as social media encourages division, tribalism, and bullying.
4
Louisa -
Please forgive the off-topic comment here, but I just wanted to say that we love your show and can't wait for season 9 (there is a season 9 to come, isn't there? We have but two episodes left in Season 8 to watch, and don't want it to end.)
Say hi to Ruth and Al for us, won't you?
Cheers,
Billy
1
As was said previously, the mental illness issue is a red herring in this debate. Anyone determined to harm or kill others will find a way to do just that, be it with a knife, a handgun, a hunting rifle, a car, or even a rock. The harm they cause will be tragic, but it will probably not be catastrophic. Mass murder like occurred in the Florida high school, Las Vegas, Sandy Hook, and so many others can only be accomplished with weapons of mass destruction, like explosives, bombs and assault weapons, the latter being the weapon of choice for most psychopathic killers. Our spineless, ethically-challenged politicians need to say NO MORE to the conspiracy-addled NRA and ban assault-style weapons, large magazine clips, silencers, and armor-piercing bullets. That's the only way we're ever going to end these mass killings.
19
First of all, the patient you are referring to committed a crime by posting online threats. That should lead down one of two pathways, jail or mental health treatment.
I'm willing to bet that given that choice you would have (correctly) diagnosed him as mentally ill with some variant of personality disorder. The reason why you are reluctant is because society doesn't want to pay to treat mental illness so we've created an extremely high threshold for mandatory treatment.
How do I know? I've personally treated and released a lot of marginally crazy people who 'didn't meet criteria' for an involuntary hold, but I knew in my heart of hearts, if I were their father, I would force them into treatment and pay for it in cash if the insurance company wouldn't.
The DSM is the outlier in medicine. A lyric poem on a shelf full of physics texts. The criteria of what constitutes a danger is just as flexible as what constitutes sexual deviance. Just as homosexuality is now 'normal', personality disorder with "insecurity, resentment, entitlement and hatred" can be reclassified as dangerous.
Claiming that there is a lack of reliable treatments is a canard. 40-55% of patients meet the criteria of treatment resistant depression. That doesn't mean we don't treat it.
Your patient would probably benefit from cognitive behavioral therapy. Once he is detained for treatment California AB-1014 provides for confiscation of his firearms.
1
With respect, maybe you’re not very good at your job. Maybe a lot of psychiatrists aren’t very good at their job, which may mean that some decisions should not be theirs to make.
1
The 'mental health' angle is just a charade practiced by the NRA/GOP. It keeps us distracted by a really complicated solution that has no chance of becoming reality while ignoring a simple one that works all over the (rest of the) world. In the mean time they can sell more guns to more people.
5
Barack Obama had signed a regulation to make it very hard for anybody with pre-existing evidence of mental illness to buy a weapon. A prospective buyer went into a gun store, selected a weapon & filled out a 4473 form, which the seller, who must be an FFL (Federal Firearms Licencee) to sell weapons, sent into the government while the customer waited so a check can be run.If it came back clean, you are allowed to buy the gun. Under Obama, evidence of a significant mental history was a disqualifier.
People forget that the first regulation Donald Trump signed when he became President was to rescind Obama's mental illness prohibition so that mentally ill were no longer disqualified from buying a firearm. Now Trump & the NRA are cynically trying to blame the almost uniquely American phenomenon of spree shooting on mental illness instead of the millions of assault rifles already sold & still for sale.
3% of the country owns half of all firearms (over 15 per person). Most of those who own 1 or more AR-15-style or AK-47-style weapons will never be spree killers. They are conspiracy nuts who believe they will have to rise up in sedition against the government (huge amounts of ammo were bought in the 2 days before the expected Hillary victory). The guns not yet used are the biggest threat out there. The biggest cause of the 90 firearm deaths a day is suicide, followed by accidents, people who get into disputes (which used to lead to just a fist fight), & finally criminal attacks.
6
Under Obama: Fast and Furious.
I'm not a fan of guns, but the tone of the article rubbed me the wrong way. Plenty of young men have legitimate grievances about their relationships that should be validated instead of mocked, or worse treated as a mental disorder. I could be really snarky and ask Barnhorst if there's a cure for insensitivity and hubris too, but those are enduring traits for doctorate-holders such as ourselves, sadly.
1
Rather that facing the fact that this country will never rid itself of arming to death, they must have an out. Let's just "nail" mental health issues as they are so complex to pin down. Time to take a look at the real issue. Americans are armed! Time to disarm them.
6
All the more reason to take the NRA and its minions (politicians who have the power to change laws and regulations) out of the mix. This is the key: only vote for people who haven't already been bought and paid for by an organisation that only cares about guns, not people.
4
When the 2nd amendment passed, arms were single shot, front loading, and smooth bore. Certainly these will kill someone. They won't kill many.
Existing laws limit my access to machine guns, silencers, and a huge variety of other weapons (grenades, chemical, nuclear, etc). So, it is clear that arms can be restricted. We simply have the line drawn in the wrong place. Let's let the 2nd amendment cover what was available at the time.
6
It is totally ridiculous to think that social systems designed to help individuals who are suffering from a wide variety of socially centered Illnesses can be even a small help in preventing such actions. Treating even a small portion of the the effects of a violence centered population such as the one in which we live is overwhelming our health systems already.
Solving problems with violence is a learned behavior that is reinforced daily. For example, football is a game of extreme violence. A regular professional game will last for about 3 tension filled hours. 17 million people attended football games and another 135.4 million watched football games in 2017. A new study shows; 94% of the most popular movies since 1985 contain at least one violent scene, and half of those involve a gun. https://www.cnn.com/2013/11/11/health/gun-violence-movies/index.htm
The "cure" for this is the fact of an expanding consciousness on the part of our citizens that is gradually revealing the ignorance of violence as a problem solver for any situation or circumstance.
Absolutely banning the sale and or possession of a military style weapon which is designed to inflict deadly harm on any thing it is pointed at is an immediate pragmatical thing that can be done. Every gun of any kind should be immediately licensed for a big fee and not be able to be sold or transferred with out having the new owner getting a licence . There is lots more stuff that we can do now.
This option needs to be taken one further step. Yes, we need to have the applicable gun lover register via a background check, but this is not good enough or should I say the end of the issue. Most of us know that we all go through frustrating times of change but a few of us even go through very serious mental changes. Due to this fact if we are to adopt a better screening check it should include a repeated checkup every six month. The Vegas killer was most likely stable when he first purchased guns but something, like a prescription for stress or anxiety, flipped a switch in his brain at some point. Hence, a regular gun rights checkup needs to also be required if we are ever to get closer to eliminating these societal damaging habits of the few.
Maybe what we should be talking about is not strictly "mental health" care, but a broader "crisis care." There are many people who do not meet the criteria for a specific, diagnosable mental illness, but who are in crisis and at their breaking point due to unbearable stress and lack of support. Maybe we should stop asking why psychologists can't predict who will become violent when they snap, and focus on keeping people from snapping in the first place.
In this young man's case, his mother clearly couldn't handle his problems, but little support and assistance was given, and then she died. We now had a high school dropout, essentially homeless, unable to cope with his problems or get help -- not necessarily limited to mental health care, but including housing, job training, anger management classes, and perhaps grief counseling. If he had had reason to believe that someone cared about him and that he might have a future, he might not have done what he did. Many others in his position don't shoot 30 people, they simply shoot themselves or turn to drugs. Is that not a tragedy too? Shouldn't everyone have the support they need to feel wanted, connected, and hopeful?
16
Every time there is a shooting, the GOP, FOX news, and gun lovers remind us that these incidents have nothing--absolutely nothing to do with guns per se. The real problem, they tell us is mental health. If that is true, one could reasonably expect that they would be willing to tackle that problem, given that our current answer for mental illness is the prison system or homelessness.
So where are the proposals for treatment of the mentally ill? Rhetorical question--there have been none. No steps to restrict access to guns, even automatic weapons. And--no ideas forthcoming for treatment of the mentally ill. Defies credulity, but the only conclusion is that they really just don't seem to care.
4
As the author says, "there is no reliable cure for angry young men who harbor violent fantasies." Very true, as my sister who is a psychiatrist repeatedly tells me. I suggest we look at this differently: every society has angry young men. But going from anger to violence doesn't happen in all societies. We have to include in our conversation what in our society drives young people who face "insecurity, resentment, entitlement, and hatred" to violence. Going one step further, are young people in our society more likely to feel insecurity, resentment, entitlement and hatred compared to some other societies?
8
Thank you for this. When my youngest child was in in pre-school, she lost a little classmate whose father, a handsome, charming, solid citizen with no criminal or mental health history and friends on the police force, destroyed her little body, shooting it with a gun; then shot her 2 yr old brother, who according to the autopsy their tormented mother shared with me, crawled to the body of his big sister with his mortal wounds and frightened heart; then shot himself, on a sunny Friday afternoon, days before Mother's Day. Their mother was leaving him and this was his response. She said he had never struck her or the children, although he was emotionally abusive. Angry, entitled men appear mentally stable until they don't. Yes, we need to get between them and their guns. Thanks again.
6
I see some kids are walking out of school in protest. What they should do, everyone one of them every school in Florida for one day, is walkout and not go to school. Wouldn't that make a statement.
2
What about guns and "crimes of Passion"? I am, and always was, a perfectly sane person. I'm over 90 now, but if I would have had a gun when I was in my thirties and horribly abused by my husband, most probably,
I would have used it on him.
2
I think people caught selling firearms illegally should get no less than 20 years, and must serve the maximum sentence. I think we would see less illegal gun sales.
2
What I have not heard mentioned at all with regards to mental health counseling is who the heck can afford it? I can't. I have insurance by my deductible and out of pocket mas is so high that I can afford to use it ... for anything. I pay hundreds of dollars each month for something I cannot use and that includes mental health services.
15
America: we can do both. We can infuse our mental health system with money to provide better coping skills AND have useful restrictions on assault rifles.
As a child psychiatrist, I boil it down to frustration tolerance and poor coping skills. Each of these men don't have ways to manage their anger. The best way to teach them is via therapy that starts from birth and continues yearly until death. Add on common sense gun rules (background checks, banning assault rifles) and you then have the ability to (over a generation) decrease unnecessary death and suffering.
Brava to the author for very eloquently providing 1/2 of the solution.
7
These overlapping responsibilities admissions and hearings are an invention that allows for failure to eradicate simple issues with reasonable solutions. If a person is admitted because they're deemed a danger to others then why does an administrative judge walking off the street have a veto on psychiatric medical opinion. If a patient was admitted on medical opinion but subsequently held on reasonable medical cause then why complicate the matter by applying the other failed standard. We know how far probable cause received diligence as revealed in the last incident to apprehend a shooter.
1
Our country is run on checks and balances. For example, if all LGBT were declared mentally ill at a mental health facility, a judge would be able to free them.
This is a thoughtful commentary, but it ignores everything that happens before someone with mental illness reaches adulthood.
When a parent has a child with mental health problems, they get very limited help. The system needs to start treating them when they are children and they have a good chance of responding to the help.
4
I am a long time advocate for those with mental illness and dual diagnosis. For almost 30 years I’ve been working and educating myself through NAMI and Alanon. It is impossible to identify and hold or start a data base of “dangerous” people who are likely to commit violence. Also any kind of mental illness waxes and wanes with better and worse periods. Statistics prove that people with mental illness are more likely to be victims of crime than to commit crimes.
I believe that limiting assault weapons is the only way to stop these mass murders. It’s been done in Australia and Great Britain.
When people can’t buy these weapons or if we could have an incentivized turn-in program we could breathe easier. The only impediment to this happening is the unwillingness of our leaders to be brave and take a strong stand. To save the lives of our friends, our children and our grandchildren we must ban assault weapons.
9
The mental health system as it exists (or more accurately, lack of mental health system that now exists) certainly is inadequate to stop potential mass shooters. The problem is pointed out in the article, perhaps unintentionally: the threshold for determining that a person is a danger to self or others is set too high. If it were easier to hospitalize certain individuals the threat would diminish. More importantly, since danger to self is more prominent than danger to others, loss of family to suicide would be reduced. Lastly, homelessness would be reduced. The way we treat our mentally ill persons in this country is criminal.
1
The so-called mental health treatment I received was a wallow in life's unfairness, encouraging me to see myself as the enfeebled and wounded victim, thus reliant on the soothing of the powerful, sagacious therapist. I can't imagine this engineered sympathy helping a seriously distressed kid and might even ignite a suggestible youth to strike back at a world that so cheated him. I won't even speculate on the widespread medicating of today's students and whether all this is part of the solution or part of the problem.
3
I have some questions for all the mental health professionals who are chiming in on this:
Exactly what clinical criteria will you apply to "diagnose as mentally ill" someone who has been marginalized, ostracized, or otherwise pushed to the fringes of society for the simple "crime" of being shy or socially awkward?
And just how many shall we put on a "protective watch list" to insure they don't reach that state of desperation and torment to commit these heinous acts?
And what would you recommend we do - and teach our children to do - to treat each other with enough respect and dignity to keep THAT from happening? For at the moment, we seem to have forgotten everything humanity has ever been taught on the subject.
True leadership would help, unfortunately our Divider in Chief is not - and never will be - the answer, he is only making things worse.
1
Without question, if you yell "bomb" on an airplane there are serious legal consequences. If you say "I'm going to kill all these people" in an airport or on an airplane, you are going to be arrested and hauled off to jail: 49 U.S. Code § 46504 - An individual on an aircraft in the special aircraft jurisdiction of the United States who, by assaulting or intimidating a flight crew member or flight attendant of the aircraft, interferes with the performance of the duties of the member or attendant or lessens the ability of the member or attendant to perform those duties, or attempts or conspires to do such an act, shall be fined under title 18, imprisoned for not more than 20 years, or both. However, if a dangerous weapon is used in assaulting or intimidating the member or attendant, the individual shall be imprisoned for any term of years or for life.
Dr. Barnhorst is correct in her assessment of reality for school shooters under the current law, but Congress should make threats of violence with explosives and firearms just as illegal and punishable in schools as in our air traffic system.
In addition to training and arming certain school personnel, in addition to raising the age limit to a minimum of 21 for an AR, in addition to absolutely destroying the lives of anyone who would threaten to become a school shooter, we also need to look at the other causes, which are far beyond guns and figure out what is happening.
3
Very good analogy. Any threat of gun violence should be taken seriously. Very seriously, like bomb threats or yelling "fire" in a crowded place. No leniency for claims of bravado.
Mental illness is no less prevalent in any nation around the world than in the US, but the US is an outlier on mass killings. Calling the nation’s mental health system “broken” is a common refrain after the Newtown school shooting in December 2012. Too many people inaccurately characterize the system as "broken" and wrongly conflate a link between mental illness and violence. Validity of risk assessment for predicting and preventing homicide violence is not established. It has been introduced into mental health care not because of scientific evidence but because of social and political factors (excessive, exaggerated and distorted media coverage of catastrophic events). Vast majority of mentally ill persons are not violent. Only 4% of violent crimes are related to mental illness. Lifetime prevalence of violence among people with mental illness is about 16%, compared with 7% among non-mentally ill individuals. The proportion of “high risk” mentally ill people (having risk factors for homicide) who go on to kill is extremely low. People with mental illness are far more likely to be a victim of violence than a perpetrator. Substance abuse is much more likely to be associated with violence than is mental illness. Non-mentally ill people abusing alcohol/drugs are more than six times as likely as non-substance abusing persons to commit violence. A substantially greater tragedy associated with mental illness is suicide.
3
According to the APA, "The behavioral threat assessment model is an empirically based approach that has since been adapted by the U.S. Secret Service and U.S. Department of Education...for use in schools, colleges and universities, workplaces, and the U.S. military. Threat assessment teams are typically multidisciplinary teams, trained to identify potentially threatening persons and situations. They gather and analyze additional information, make an informed assessment of...whether the person poses a threat of interpersonal violence or self-harm..."
This behavioral threat assessment model could be used by school communities to identify high risk individuals for special restriction of their otherwise legal right to have access firearms.
These potentially dangerous 1%, so identified, could be prohibited from owning, or having access to, firearms until they have demonstrated responsible conduct, or have reached the age of 35, or both. This new "no firearms access" list would require the normal due process court procedures that are invoked when other constitutional rights are abridged.
This targeted approach could reduce mass shootings by severely disturbed individuals without preventing the law-abiding 99% of our population from protecting their families under the individual right to self-defense prescribed under the 2nd Amendment as set forth by SCOTUS in Heller. Confiscation of all law-abiding citizens guns seems an over-reaction to these deplorable shootings.
Excellent explanation of what mental health professionals know: focus on the perpetrator's "issues" alone is not nearly adequate to address this public safety issue. People who are mad and sad are often open to help; people who are bad rarely are.
2
Agreed---the emphasis should be 'to put some distance between these young men and their guns." Meaning what exactly? How much 'distance'? How much distance? Only young? What age? Only men? Why?
Let's face reality and discuss how we lag the rest of the civilzed world. Use other nations as a model. Has any TV news show ever mentioned strong gun control abroad, how it works, and that all their parties support them?
They might explain that the gun makers in other countries don't subsidize their lawmakers and direct policy. Here, the politicians have to find ways to rationalize their dependence on NRA money, while their constituents are getting murdered.
And the media can't criticize too much, lest they look too radical for gun reform.
So what's avoided is that our system thrives on big money. Politicians and lobbyists are afraid if the gun maker donations are curtailed in any way, that this might then spill over into restricting other big money donors---to our health care system, climate change, tax and regulation policy, jobs, taxes----yikes, where will it end? That's why our system doesn't want to restrict gun money. MIght start a trend to change America's big money politics.
For some, the dead bodies are a worthy sacrifice, but they won't admit it to themselves.
1
Thank you for this insightful article.
"Getting help" is in many ways a pipe dream. In my life experience, the cost of counseling and treatment and the stigmatization of seeking help are prohibitive for most people. Those who are able to receive enough support to improve, often are then dumped back into life situations that destroy whatever progress has been made.
Then there is the issue of individual rights - a mentally ill person can terrorize neighbors with bizarre behavior, but unless he/or she actually threatens or inflicts physical harm, there is nothing social workers and police can do to stop them. The same is true of alcoholics and drug addicts - they can make the lives of their families miserable, but ultimately they cannot be forced to get treatment until convicted of a crime. The evaluation and treatment processes are so fraught with red tape, to say nothing of the difficulty of commuting to the services, that disturbed people cannot manage any of it.
Disturbed people usually get that way because they do not have a healthy support system to begin with. I believe that stricter gun control, the banning of assault weapons, and reducing the numbers of guns in society can help cut down gun violence. We also must consider the impact of violent entertainment and negative news coverage on the human soul. And finally, promoting time-proven values of civility, compassion, and personal responsibility on all social levels is of paramount importance.
2
"The 19-year-old who is accused of killing 17 people and injuring dozens more when he opened fire on a South Florida high school Wednesday afternoon told investigators that he heard voices in his head, giving him instructions on what to do to conduct the attack, law enforcement sources told ABC News."
The argument seems to be that treating these people would be difficult, therefor of no value. Having worked in the mental health system we had prior to 1970, when it was easier to treat people without their consent, I have first hand experience that it worked.
The mental health industry has since WWII, has seen the advent of medications to can control the most debilitating symptoms of psychotic disorders, allowing patients who would formerly have been institutionalized to instead be treated by less restrictive means outside of custodial care environments like psychiatric hospitals. Indeed, society was quick to embrace the savings from closure or reduction of institutional treatment infrastructure. In addition to cost savings, those patients treated in the community avoided becoming dependent on institutional care and could live symptom-free lives in society at large, presuming they maintained their outpatient treatment & medication. Indeed laws about commitment likewise evolved in this less restrictive way. But here's the rub - it is not easy to force a deinstitutionalized patient to take the steps necessary to manage their symptoms of mental illness, as comments here will attest. So if society wants would be school shooters "off the streets" it will find the hardware for that no longer exists
They will find the facilities that existed in previous generations for such an institutional strategy no long exist
2
Absolutely. Sure, you can kill some one with a knife. But killing people is not the main purpose of most knives. We all use knives to cut food every day. Guns are primarily for killing people. With the easy availability of guns here in the USA, It's actually amazing that we don't have more murder than we do - & I'm not necessarily talking about 'mass' killings. Actually, individual killings are a lot more common. I mean, people get angry every day, & there's no earthly reason for most of them to have guns.
2
Want to end school shooting? Ban schools. Want to keep everyone law abiding? Keep them in cages.
There are lots of solutions and each one is as useful as gun confiscation and as stoopid. And No, I don't believe for an instant that the libbies want "common sense" restrictions but if they truly think that they do then:
Why not apply each and every "common sense" restriction on the right to bear arms to the right to vote? After all they are "common sense" are they not?
The mental health of politicians and the gun lobby needs review. Anyone who believes that a weapon of war in the hands of ordinary citizens is ok, needs their "head examined"
1
There was a very interesting article on how Israel handles this. It’s VERY much worth reading. And at the very least, until we can come up with a solution, up the age to 27 to purchase. That can be changed with a phone call. And yes, I’m an NRA member. Start the process now.
2
In a gun culture like ours, there will never be enough red flags to protect us. If we are to continue supporting people's right to own semi automatic killing machines, the only dependable predictive device would be a crystal ball.
2
Brava! Thank you for describing the fallacy of the "mental health" canard. Fewer guns mean fewer gun deaths. Period!
4
Sociopaths, those who abuse and torture animals...are unlikely to be helped by traditional mental health interventions.
2
If one is completely sane but full of hate, is that person mentally ill?
1
Random shooter. The most dreaded words in our language.
Thanks, NRA/GOP. November.
1
Outstanding perspective from a seasoned clinician, bravo!
And many equally articulate comments from even more.
Tidbits from my own practice: Violent behavior is often incredibly difficult to predict. Statistically, the odds are that it won't happen. But socially, when it does, the cost can be death. Truly psychotic persons can get fairly effective treatment, but the kind of behavioral, emotional disorders in play in so many of these events, not even close. Trick is to try to keep them alive long enough to "grow out of it". To facilitate that in the 1970's and 80's, I routinely recommended others in the family to clear the house of firearms. (As a Vietnam vet, I knew full well what guns could do.) Here in flyover country, there were lots of guns. Doubt if I could get away with that now.
But again, with my huge respect for your work, it's preaching to the choir.
The people that need to know it won't listen.
And the country will never triple funding for mental health treatment, or lock up a third of our young people. That's about what it would take. So what do we do that we can do? (That's rhetorical...)
5
"Arms themselves can prompt a man to use them."
Book 16; Father and Son
The Odyssey by Homer
Emily Wilson, Translator
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I strongly agree. Mental health is an issue that can not be solved. It will only get worse, especially with Trump's discount of the importance of research in science and medicine.
The Human Connectome project was perhaps the most promising development in understanding and ultimately curing Brain Disorders. Until we humans get a handle over the science and cure of disorders that inflict ever increasing numbers of people with mental illness, this illness will only get worse everywhere in the world. The problems will be even more severe in the USA.
How in the world the rotten Republicans and the corrupt Conservatives who are sleeping with NRA keep blaming everything else but guns and the idiotic masses fall to such nonsense is beyond comprehension of anyone who can think.
4
As a nurse I know that the mentally ill do not volunteer their crazier thoughts even to family because they know their strange ideas simply won’t be accepted. Some are secretive till they explode violently. Most lie to health care workers and colleagues. The paranoid buy weapons.
The Republican Party seems to think that the mentally ill are obvious and easily spotted. Yet they themselves support a dangerously inappropriate and sick president. They either don’t notice how sick he is, or like family members pretend not to see with fingers crossed.. A shameful and dangerous mistake!
13
Yes there is a reliable cure for insecurity, resentment, entitlement and hatred:
the 12-step program of recovery. If it works for alcoholics and addicts of all
types, it'll work for anybody.
2
I'm not aware of anyone stating improved mental health services can stop gun violence, are you?
What people want is more powerful background checks and that means mandatory reporting such as is in force for teachers and others who work with children. Fail to report and you could loose your job. This goes for those who receive reports to.
The Florida shooter should never have been allowed to buy a gun. He was and is so plainly mentally ill.
Another article on NYT suggested that financial institutions might be able to bring pressure to bear - and mentioned that Lloyds of London is recommended by the NRA as a provider of insurance to gun shows. It seemed worth putting pressure on Lloyds, so I started a petition at change.org - since this directly aligns with editorials run by the NYT, maybe you could give it a nudge?
https://www.change.org/p/lloyds-of-london-lloyds-of-london-to-stop-provi...
1
A couple flaws in this article:
"No reliable cures..." Yes there are. Psychotherapy.
"Mental illness is rarely the cause..." It's been the cause (or at least a major risk factor) for most or all of the mass shootings that have happened in recent years.
As a psychologist who specializes in violence risk assessment, I would almost certainly have been able to identify these folks as being at increased risk of violence over the long-term. They meet many of the criteria common to violence risk assessment instruments. One problems is that those most qualified to make these assessment (typically forensic psychologists) are not used due to the resources that would be required. (Few psychiatrists have the necessary training or experience to assess this kind of risk; they tend to focus on imminent risk.) The other problem is that civil rights and confidentiality laws prevent the kinds of inter-agency communications that would be necessary to alert law enforcement. I've seen this happen first-hand: We predicted that a patient (being released) would commit murder, we were prevented from alerting law enforcement, and the predicted act occurred.
I agree that we should find ways to put some distance between these young men and there guns. The mental health system could do much more in this regard.
1
"The (white) shooter has mental health problems.", was never anything but a bogus effort on almost everyone's part to assure the white public that this has nothing to do with you. He's not like you at all. No connection to your beliefs, attitudes, emotions, or votes. No one does terrible things but Others. Now, go back to sleep, darlings.
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This article does a very good job of explaining why the existing mental health system makes it so difficult to treat the mentally ill. We have stepped to far in the direction of civil liberties. Families with mentally ill members know full well how impossible it is to get treatment for their loved ones. One psychiatric nurse explained to us that if the patient can recognize a banana as food, buy one, peel it and eat it, they are not unable to care for themselves, never mind all the self destructive behavior they have already exhibited. Any danger from or to the mentally ill person must also be imminent.
Denying guns to someone who doesn't fit the legal definition of insanity as it stands now simply isn't possible. It should be much easier to deny someone access to guns who exhibits the kind of indicators these shooters almost always have. Courts should be empowered to declare someone unfit to possess a gun under certain circumstances without reference to mental health. Online or personal threats of shooting violence should qualify. The killing of domestic animals should qualify. Domestic abusers should qualify. The list could be longer, but you get the idea.
We deprive criminals of their liberty. Why should it be impossible to deprive someone of their right to a deadly weapon?
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"... we should focus on ways to put some distance between these young men and their guns."
In the words of an expert on the subject:
"It’s much harder than it sounds."
"Gun violence" tends to be hugely concentrated among certain communities in certain, urban municipalities. We KNOW that guns aren't the problem; if they were, the blood would routinely run in the streets of places like VT and NH, which respect their citizens' freedoms, as opposed to places like Chicago, Newark, and Baltimore, which don't.
It's difficult, because the left throws around phrases like "assault weapons" -- which don't exist. One comment contends we need to rid ourselves of semi-automatics: rotsa ruck banning probably 90% of all firearms.
And how, precisely, would we enforce that law? By sending lots of young men with fully automatic weapons, who happen to work for the government, raiding people's homes? Leave aside that many cops and soldiers would openly defy such an unconstitutional -- and stupid -- proposal. America exists because the people of Concord and Lexington rose up against the gun-confiscation of a tyrannical government. (Remember when the people of MA actually supported freedom?) Does the commenter want a job reprising the role of the Redcoats? It didn't end well for them.
it wold really help, in this discussion, if the left's position weren't dependent upon magic wands and unicorns. Hundreds of millions of Americans are NOT going to give up their freedom. Deal with it.
Michael,
So your answer seems to be more dead children.
Do you admit that a problem exists?
Or is more civilian deaths since '68 than all US wars combined, ever, just the price of your version of free-dumb.?!
Most Americans by % are asking for less dead and wounded.
Most Americans are tired of billions being spent each year cleaning up and taking care of those killed and maimed by bullets.
You want guns.
Police them.
Prevent and lessen the carnage.
You have proven unable or unwilling and actually seem to pursue just the opposite.
You wish to pretend you can overthrow the largest MIC the world has ever known with non-military hardware, then fix the civilian carnage existing.
If you don't, we will.
Deal with it.
Our dead children so you can play pretend is not America, nor patriotic freedom. It is simply selfish behavior.
1
With the mental-health and law-enforcement systems hamstrung by this long-standing catch-22 that prioritizes the high-probability mass-killer over his likely victims, it seems that a rethinking of what constitutes civil liberties is in order, and starting a database of high-probability mass-killers becomes an imperative.
3
The mental health system can't stop mass-killers, but neither will taking away their guns. Cars and homemade bombs, for example, are readily available alternatives and arguably more efficient.
With the mental-health and the law-enforcement systems hamstrung by this long-standing catch-22 that prioritizes the high-probability mass-killer over his likely victims, it seems that a rethinking of what constitutes civil liberties is in order, and starting a database of high-probability mass-killers becomes an imperative.
2
Connect the dots. Look at the numbers. Your argument doesn't stand up to the mildest scrutiny.
A functioning automobile costs more than a gun. Stealing one is an option but that either requires skill, or threat of violence, best achieved with a firearm. A bomb also requires some skill. Both require taking risks to the perp's person that are very easily avoided buy just buying a gun, in the US. It's as easy as Amazon or Craigslist.
Guns are easy, and in the US both low risk and cheap.
1
True that "imposing mental health treatment on everyone who shows "red flags" will not put an end to mass shootings. The author might also have mentioned that a range of drugs, including psychiatric drugs, can cause the person taking them to become suicidal and/or homicidal - another risk factor observed in a number of the shooters, through history and toxicology reports.
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The blame game , the panacea of those who are in denial about the reasons of mass shootings . Violence in our society has become commonplace , it is not only mental illness that needs to be addressed but making weapons of mass killings easily available . Our politicians bow their heads in fake prayer whilest they do nothing to address what needs to be done . There is much anger in this country and angry people do things that they later regret because they can easily assuage their violence with a gun.
2
Not to mention the mental illness epidemic that is being created by gun violence.
3
The mental health system can help/assist/advise in bringing issues to the forefront and combine that with our educational system and Law enforcement ....the time for conversation and debate is over.... and throwing money at this problem that has existed for decades is not the answer....the solutions are there..... what we do not need is the dragging of the feet of our elected officials as they have done in the past
..... this is a crisis.... not isolated....
How’s the “throw more law at it” approach working out in the war on drugs? Right, I also forgot how well the automobile licensing/liability insurance laws are protecting us. Fact is that drugs and cars each kill more Americans annually than guns. Legislate that!
The whole mental illness defense is just an NRA Red Herring.
They know that our mental health system is not designed or equipped to deal with angry frustrated people.
Guns kill, but that is not the correct answer to those enthralled to NRA money.
Maybe it will take another high profile assassination attempt (ala Reagan) to give Congress enough inertia to ban weapons of mass death.
Open carry in the US Capital Building would be an interesting idea for the good guy with a gun crowd.
3
Spot on. Let's not forget too that even if Cruz had been commited to a mental hospital, and received treatment as an adjudicated "mentally ill" person, he would have been able to legally purchase assault werapons. One of Donald Trump's first executive orders after being elected, was to proudly sign an order to ensure that the mentally ill had at their dispossal, with no questions asked, the most sophisticated and deadly weapons to inflict the most carnage-- this order reversed a previous Obama executive order keeping the mentally ill from purchasing such weapons. He must have felt that all Americans must have equal opportunity to become the next mass murderer. Thanks Mr. President, Senator Marco Rubio, Gov. Scott and a very long long list of other hypocrites. You have blood in your hands and we will remember in November.
Bravo for the young people taking political action to stop this lunacy! where do I send money to support and join your movement.?
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The vast majority of mentally ill people are not dangerous and therefore should be allowed to possess a gun. Where I live, their gun rights can be restricted if they are found to be dangerous.
Where is your proof that knowledge will not be gained to fix the minds of
mentally ill people? I am discouraged with the pervasive mental attitude of many that what is not already known will never be known. This attitude is retro.
The “proof”, as it were, is that it while may be abhorrent to harbor homicidal tendencies against one’s classmates, colleagues, or co-citizens this does not necessarily mean one has a psychiatric illness.
wait you just said you cant predict which young men will become a mass shooter, so how do you propose to "put some distance between these young men and their guns"? if you think its hard identifying people w mental illness, its going to be 5x harder collecting ALL the guns so that they aren't available to these young men.
this is a societal need, if you don't know how to screen mass shooters then figure out how to do it.
Thank you so much for this message, especially:
"...there are no reliable cures for insecurity, resentment, entitlement and hatred."
(If there were a cure for these feelings, 1/2 + of Dumpf's supporters would be in therapy.)
Blaming 'mental illness' for gun violence seems similar to blaming gun violence on 'Islamic extremsites'. The common denominator here is 'GUN'.
Please note how the right-wing Supreme Court, in D.C. v. Heller, expanded the 2nd Amendment word, "militia," to include "just anyone who wants a gun".
We applaud also Darlene Moak's statement: "Blaming shooting on mental illness is a smokescreen that avoids looking at the real issue - America's devastating and destructive romance with firearms & the pervasive misinterpretation of the 2nd Amendment. "
3
Excellent article. Mental illness is not the cause of mass shootings…. Semi-automatic weapons are. This is just plain common sense. Look at other countries where with weapon bans…no killings… but I am sure they still have people who are mentally ill.
1
I would be interested in the psychiatrist readers' opinions on whether the young men in the throes of "insecurity, resentment, entitlement and hatred" are narcissists vandals who use anonymous human "objects" and guns to counter their feelings of impotence and social incompetence. Rather than spray the school walls with profane graffiti they go for the body count to prove "I am not a nobody....you are all wrong about ME"
Depriving them of the "oxygen of publicity"(Thatcher) is the place to start.
I should not know Nicholas Cruz's name, just as the next shooter should not be inspired by his newfound fame.
No but it sure helps fill up our jails. Today’s Prison are yesterday’s Bedlam.
Amy, are you really serious? There is no mental health diagnosis for angry young men who are likely to carry out violent fantasies? There ought to be. And Cruz showed MULTIPLE warning signs, as most mass murderers do. We don't only have to rely on mental health professionals, but what about social services, parents, adoptive parents, neighbors, FBI, Broward County Sheriff's office that all let Cruz slip through the cracks? How many "shots on goal" do we need to identify these angry young men as dangerous?? We need to fix all of these processes NOW.
1
Alienation is not the only cause of these young men going berserk? Fatherless, from an early age. Also, if soldiers are discharged or charged from the service due to mental issues and/or anger management why is the standard lowered for civilians. Young women are not pulling the trigger. There is some chemical imbalance ie either via drugs, alcohol, or genetic defect, ie alcoholic syndrome that could be present. Born violent as the Las Vegas shooter was according to his brother, with a psychotic father, there are many flags to stop the ownership of a firearm with a family history disposition. Since Mr. Cruz was adopted, his counselors had no inkling when his cork would pop in his teens as he was violent and threatening with his adoptive mother, shooting neighbors chickens, a family judge should have put him in a home or facility for juvenile delinquency at the age of 12.
Neither a diagnosis or a cure for said diagnosis is the real issue here, at least from a policy basis. However, a diagnosis such as intermittent explosive disorder may frequently become viable, with enough dialogue with family and or friends. Saying mental illness is not an answer to the problem of violence is an inadequate response to this issue. Researchers and policy specialists need to continue research and recommend appropriate legal changes. Clinically speaking, this young mans' history demonstrates more than enough risk potential to hospitalize him. So Dr. Barnhorst certainly made the right decision. The fact that he was hospitalized for 2 days, providing him with a cooling down period, may well be the reason he did not follow through on his reported threats.
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I worked as a crisis psychologist for 10 years in New York City. The writer's comments couldn't be more right or more vital to the public conversation. Most of us likely remember odd loners from our time in high school. Only a handful of these across the entire country will go on to engage in an act of mass violence. Psychologists and psychiatrists have no way of consistently singling out which of those loners will become dangerous much less-even among those who will-when they will act.
As the writer said, there is no medication for resentment and hatred and participation in psychotherapy requires some degree of insight and commitment which these individuals almost invariably lack. The most reasonable bottleneck is at the junction where these individuals and guns meet. It will never be 100% successful but requiring that gun owners prove to their neighbors that they are capable of responsibly exercising their second amendment rights remains the best option on the table.
5
We have now sunk to a depth at which restatement of the obvious is the first duty of intelligent men (and women).
1
Most people no longer believe in the supernatural. Anything that is beyond the visible observable universe is considered a myth. But God is real and so is Satan and his demons. The late Reverend Billy Graham certainly believed in Satan and his powerful influence in the world. Much of the evil that we attempt to attribute to mental health conditions may, in fact, be the work of the devil. Demons were certainly real when Jesus walked the earth as He had to deal with them on several occasions. If they were real then, they are still present today and active.
1
Evil lives in the hearts of men. Morality demands that we all look to our own behavior rather than only looking to call out others, or passing off blame to non-human entities. Evil is destroyed by good; by both individual commitment, and the commitment of from many and all, to good action in response to evil acts, to care and concern for others,to love and charity.
We no longer live in a culture in which individuals strive to be and promote the good. Even the religious among us proclaim their personal “faith” but don’t, and haven’t been taught how to by ever more political and self interested leaders, practice moral action. They think in terms of personal salvation with no requirement of moral action and moral responsibility in dealing with others; what they owe others and why they have an obligation to discipline their own behavior and thoughts. Jesus, in the lesson of “turning the other check”, wasn’t asking for passivity, he was speaking to the need to respond with the powerful practice and promotion of the the good rather than giving into evil with anger and pride; qualities that destroy the good -- in culture and society as well as in the hearts of individuals..
1
I think all of us who work in the mental health system, and I am in Forensic and Correctional settings, share your opinion without reservation.
When mass shootings occur, aimed at no-one-in-particular but at everyone-in-general, the blame is placed on the easily faulted “failure of mental health services.” A palliative sound - but as usual, looking in the wrong direction.
It is not about “mental illness” - we who work the halls of psychiatric units can assure you. Violence aimed at everyone is meant for everyone. For nothing in particular and everything in general. It is born of resentment, hatred and anger. It is not a gentle soul seeking salvation. Or a psychosis that was missed.
We in mental health do not have a way to measure seething anger becoming homicidal rage. Even if the person is in treatment, there is a small chance. (Remember the Aurora, CO shooter? His psychiatrist missed that call). Because killers don’t announce they are about to subject a crowd to mass murder. It takes away the surprise. It deprives them of the kill.
Isn’t this a “duh!” kind of moment? Does it really need to be said? It is an egregious insult to all we know, and for all (the shootings) we have been through, that last week an 18 y/o kid was able to purchase an assault weapon. Why in God’s name would a HS dropout need such a thing? Maybe to shoot up a school. Duh.
71
Well said. Reasonable, and (as a lay person-citizen) I find it most persuasive. Now it will take strong, widespread and persistent political action for this view to become public policy. Let’s do it!
2
"Do not have a way to measure..." Yes, we do. It's what my job is at a state psychiatric hospital. But this resource is not being used outside of this setting.
I would think that 39 911 calls made in regard to one person should merit a closer look. If people can prove they are not the target of a vindictive neighbor or that the calls are gratuitous, then fine. But when a mother has to call the law repeatedly over a teen, that is a predictor in itself.
17
You are looking through blinders. There are many mass shootings involving adults who haven't had these sort of indicators. The murderers are not just teens.
The Parkland shooter had been evaluated by social workers and his mother minimized his anger.
Perhaps the 48 hour hold was exactly what this patient needed to re-assess his future behavior? Certainly if he lived at home his family would be able to use the time to determine if there were guns in his room, etc. Police could have been involved to help assess public safety. Imagine if Holmes in Colorado or Loughner in Arizona had been placed on 48 hour holds? Perhaps the time would have allowed a psychiatrist the proper time to evaluate them?
nevertheless, there is no denying the logic that eliminating guns in America would reduce the problem of mass shooting, but until that happens, I applaud your decision to place your patient on a 48 hour hold.
PS -
1
Since the mental health issue is so opaque and subjective, the best solution is to do what practically no one wants to hear-overturn the second amendment, which was meant for militias following the Revolutionary War. Our nation should be ashamed when you look at common sense anti-gun laws in Canada, England and other nations. Even Switzerland, with its liberal gun laws, still has restrictions on owners. Perhaps we need to wait until the 2020 election unless the incumbent gets a second term.
3
"But there are no reliable cures for insecurity, resentment, entitlement and hatred." Which every human being experiences in their lives, and the vast majority never shoot up a school. It's the nearly unfettered access to semi automatic weapons that results in incidents like Parkland and Newton and Las Vegas. It's just got to stop.
6
Dr. Barnhorst makes a compelling argument. There are millions of people suffering from depression. It's logistically impossible to screen them all for thoughts of harming themselves or others. We could just round them up and place them in "facilities" but that's what totalitarian regimes do. The idea flies in the face of what this country is supposed to represent. That's without getting into the millions more who suffer from personality disorders, for which there is no known cure. Psychopaths tend to remain psychopaths, the same with anti-social, narcissistic, paranoid, passive-aggressive, and the others listed under DSM-V. There's no pill, at best one hopes years of therapy might change the patient's perceptions and behavior. Insurance companies don't really pay for therapy anymore, they prefer ten minute appointments every three months to refill prescriptions over hourly weeklong sessions "on the couch."
However, the author claims success in areas that aren't quite accurate. "The psychiatrist responsible for his care would know how to treat delusions, paranoia, mania, suicidal impulses, self-injurious behaviors, auditory hallucinations and catatonia." That flies in the face of my experience as a physician. It's a crapshoot hoping the patient is given the right psychiatric diagnosis with the right pill to cure their ills.
It's obvious that we don't have an army of psychiatrists out there protecting us from gun violence.
Even if we did have an army of psychiatrists, these doctors themselves have told us that they can't reliably predict who will actually commit the horrible gun crimes we see over and over and over. They are the experts, and they're telling us that this gun violence can't be stopped this way.
Thank you to Dr Barnhorst for telling us once again.
I find hope in the reactions of the students in this most recent tragedy. I imagine a movement lead by these students, seeking at the most basic level to protect their own lives. Let the rest of us follow them. We know what must be done, and the majority of Americans are for it.
54
The author's statement that "mental illness is rarely the cause of such violence" is factually incorrect. I contend it would be more accurate to say that the mentally ill are rarely violent. There is a big difference. Adam Lanza, James Holmes, Cruz and others might not meet the legal definition of insanity for the purposes of criminal defense but there is widespread agreement each are diagnostically mentally ill. Mass shooters are quite often mentally ill.
The author says it is "much harder than it sounds" for mental health professionals to stop these disturbed individuals. Well, I'm sorry it makes her job difficult but it might be worth the effort to keep kids from being slaughtered. Perhaps psychiatrists need to step up when a parent brings a child, such as the one mentioned, in for evaluation and state that they could be a danger to themselves or others and keep them for as long as possible.
Psychiatric treatment is largely based on a paradigm that patients are truthful and want to be well. In the case of the mass killer their motivation may be to avoid detection of their intentions so they can carry out their plans. Better forensic psychiatric skills are needed along with courage and accountability by providers.
So what does this mean exactly? Better psychiatric treatment INSTEAD OF gun control? Or IN ADDITION TO gun control?
(1) Important not to lose sight of the issue: diagnosis, if indeed these prople are mentally ill. Stephen Paddock (Las Vegas) displayed no known symptom> (2) Equally important not to parse the consequence we are trying to address: dead children.
You misunderstand. It's not just "harder than it sounds". It's impossible. I could possibly hospitalize him for two weeks, conceivably for a month {if I unethically exaggerated a lot of things in my recommendation to a court) and then -- what? THERE IS NO SYSTEM AVAILABLE that we can use to protect us from guys like this until they've committed a crime.
Mass shootings account for less than two percent of gun deaths. Most gun deaths occur in small, daily encounters, where the problem is easy access to guns of all kinds, plus lack of responsibility for the consequences of ownership. Mental health is another red herring thrown out by the gun rights crowd. Let's not get dragged into arguments that only nibble at the edges of the problem. Responsible gun owners and all of us who are appalled at the carnage, let's get behind two laws that would get at the heart of the problem: 1) Treat all semi-automatic weapons in a similar way under the same laws as fully-automatic weapons.
2) Regulate gun ownership and usage the same way we regulate car ownership and usage.
See for more details: https://www.alternet.org/news-amp-politics/two-simple-laws-could-solve-a...
Reducing gun violence will require demand side as well as supply side solutions. Some of the studies using suicide by firearms as a proxy for gun ownership end up with a lot higher rate of gun ownership than surveys, in the range of 45% to 50%. About 40% of male Democrats, almost 60% of Democrats in rural areas and almost 60% of Democrats who are veterans are gun owners, so it isn't just a GOP/NRA issue like the media has everyone believing. During the debates on gun legislation after Sandy Hook when the Democrats had the Senate the assault weapon legislation didn't pass due to votes by both parties. Neither did legislation on strengthening background checks and mental health, as the Democrats didn't want a bill strengthening concealed carry.
Strengthening mental health requirements won't stop mass shooting and an assault weapons won't either. One of the last mass shootings in the UK was committed with a double barrel shotgun and a bolt action .22 rifle, 11 were killed and 12 were wounded before the shooter ended the spree by killing himself. The UK didn't follow up on additional laws because about the only thing that they could do would be a total ban.
More stringent mental health requirements will help, as will other gun legislation. Gun control advocates will need to be willing to negotiate with gun rights advocates; you aren't going to get much for nothing.
I agree the mental health system can not stop all mass killings.
By making mental health services available we can prevent many of the massacres.
Many troubled persons might voluntarily seek help if it were available and that help might help the troubled person decide not to commit a violent act.
Given that there are disturbed persons the question remains.
should assault like weapons like AR-15 AK-47 be available to the general population.
These weapons are not needede to hunt or for self defense.
We banned or severely restricted machine guns [single trigger pull causes multiple firing] and sawed off shot guns in the1930's and the world did not come to an end and no one lost their freedoms.
Bump stocks make semi automatics effectively machine guns.
Why not ban bump stocks.
Yes some law abiding peoples' ability to own assault weapons will be infringed.
Which is more important.
Reducing these massacres or restricting ownership of some guns that no average person needs.
Consequences of long-term low level lead exposure include shoddy thinking, paranoia and anger. The damage is irreversible and cannot be detected by a blood test for lead.
The social context for those wishing to inflict harm on others is appalling
and chief contributor, beyond anything else, to the carnage going on in
the nation’s schools. The good counseling can do is more than offset by
the daily inundation of tv and the movies by shows of gunplay and violence, in almost every play, in almost every movie ! Killers often look forward to reports of them committing atrocities, albeit a dishonorable distinction. In the movie “Bonny and Clyde”, Clyde Barrow eagerly looks through the papers to exult in reports of his killings and robberies.
Gun control is treating the symptom not the disease. This is worthwhile because the symptom is killing people. However this still leaves the disease untreated. The disease is that we don't care. We are so wrapped up in our lives that we can walk by someone homeless or starving on the street and not even pause. We will do worse, we will demand that our officials get "This Filth" off of our streets. This not caring also allows angry people with access to guns to justify slaughtering people because someone wronged him.
Our current president is actually doing us a service. He is holding up a mirror to society and showing us what someone who is totally self centered and uncaring about the people around him, looks like. We are not there yet, but we are well on our way.
If we want to stop the slaughter restricting access to guns is a start, but only a stop gap measure. The real solution is to create a society where people respect and care for each other's welfare. We can begin to make the change by changing how we deal with people in our own lives. "Be the change you wish to see in the world" Is not just a coffee cup slogan. It is literally true.
Excellent survey of the balance between civil liberty protection and identifying and then (here the word used matters: hospitalize, incarcerate, detain....) We must never forget how the Soviet Union enlisted mental health professionals to legitimize the imprisonment of those whose values were a risk to the stability of their society.
There is a film available on Netflix, entitled "Super." I viewed again after the recent massacre by Cruz and had a personal epiphany. The main character in this film in the beginning described his life of early abuse, and living in depression until he met a rare woman who was sensitive, needy but loved him. When she was seduced by a drug dealer, the film's genre changed but the stars transformation into a cartoon super hero also drove him hate all people who broke the law, even as slight as keying a car was cause for killing him.
What I realized is that those who commit mass murder have a deep visceral hatred for those they kill. In the recent case perhaps being insulted and demeaned. The Oklahoma bombers (no weapons needed, which we should keep in mind) imagined federal workers were complicit in burning to death the Branch Dravidian.
Millions of people live lives that include hatred of others, and are functioning outside of this propensity. "Mental Health" if it is to be of use must not be conflated with any part of law enforcement.
This problem resides in the deep nature of our culture, with no easy solutions.
This may be a little off topic, but I'm really surprised at how little discussion I see about how American culture glorifies violence, and how this just seems to get worse. Just turn on the TV or look at the virtual reality war games kids are playing. Is it any wonder that some unstable people or vulnerable kids, some of them under the influence of mind altering drugs, may end up emulating the violence all around them? The rise of military TV shows is particularly noteworthy. I think DePaul professor Nathan DeWitt, whose research focuses on Television and Media Studies, put it aptly when he said the following: “The Pentagon and Hollywood have a long-standing relationship in which the former grants the latter access to information and state-of-the-art gear while the latter glamorizes the work of a soldier, violence and the theater of war,” and, “These shows are a huge part of the propaganda machine at the heart of the U.S.’s military industrial complex, seeking to emphasize the glory of war and minimize its ugliness.”
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There is no evidence to suggest that the US has more mentally ill people per capita than the other western industrialized countries. A 2015 study shows that only 4% of gun deaths could be linked to mental health. Nor does the US have higher rates of crime. The only variable which explains the astronomical number of mass shootings is the number of guns.
Mental health is a smokescreen for the GOP to hide behind the urgent need for gun control in the US. The idea that background checks would prevent mass shootings is another falsehood.
First let me say that I'm not a member of the NRA, enamored of gun culture, or a shill for "second amendment rights." However, I have profound doubts that anything meaningful would come out of a ban on semi-automatic weapons like the AR15. 90% of the handguns in America are semi-automatic and there are many hunting rifles that have the same functionality as AR15 or Sig Sauer military style weapons. Untold millions of these have been sold already and removing all of them from circulation is inconceivable, not to mention the legal questions such an endeavor would engender. Even if one could prevent angry men intent on mayhem from buying a semi-automatic rifle I imagine they'd simply switch to semi-automatic handguns and tactics that would match those weapon's capabilities.
The real problem we have is one of a culture that's created a perfect storm to incubate violent behavior. We live in a culture that glorifies violence and is fascinated with it. All aspects of our entertainment media are saturated with it. Political and social violence throughout the world has become so pervasive there's little meaningful cultural push back against the idea that violence is an acceptable response to feelings of inadequacy, entitlement, etc. Social media use exacerbates all the feelings that make men feeling justified in embracing violence. There's no easy answer to this problem I'm afraid.
Dr. Barnhorst, if one were to evaluate your mental health based on internet communication only, what would it reveal? I believe the Goldwater rule for your profession advises against such practice. You have to personally see the patient, which you did, and the subsequent clinical session did not support a finding of mental illness. Isn't this how the system is supposed to work? What would be a better method? More weight attributed to second party testimony?
I understand and support the need to evaluate patients based on online comments that indicate issues, but you appear to practice confirmation bias here, and not the clinical evidence. In the future, I could see this evolving into a roundabout way to circumvent inconvenient rights. Thank god for professional processes, else how many of us might be judged for our online comments?
I understand the point - nicely summarized by her headline - Ms. Barnhorst is trying to make. However, the common thread running through the vast majority of these mass killings does seem to have a basis in mental health. Even if a comprehensive psychological screening cannot catch every mentally challenged individual, even preventing just one from acquiring the weapon(s) necessary to carry out their act of terror would be better than nothing. Also, the parents, family and friends of those who exhibit seemingly unusual behavior like that shown by Mr. Cruz must not hesitate to intervene in some manner. As a society, we can no longer take that risk.
You have two choices. Do everything you can to keep these mentally unstable people from obtaining a gun. This solves the immediate problem, assuming they don't find another way, which they usually do. This also leaves them loose in society to try to find another way to inflict harm and make a name for themselves. Or you can remove them from society by changing our laws. Neither is a fully satisfactory answer, but since many of these individuals seem intent on inflicting harm on others, I would choose the latter, since it actually significantly reduces the problem
All assault weapons should be banned except for military or law enforcement use. There is no need for anyone else to have a weapon which can kill many in a few seconds of firing. These guns should be illegal and there should be a national obligatory buy back where the government would by back from civilians at a fair price. These weapons would be given to the military and law enforcement who need and use this type of weapon.
There is no question but that we control. We need laws that restrict automatic weapons, and high capacity magazines - anything that will pass constitutional muster. We also need to amend the Second Amendment, which is easier said than done.
However, mental illness, and how society manages it, is also an issue. We should prohibit those with mental illnesses that pose a risk of violence from acquiring guns. There is a tension between the rights of the mentally ill, and the rights of society. The Times generally supports the rights of those with mental illness to own guns (e.g. https://www.nytimes.com/2014/10/19/nyregion/mental-reports-put-34500-on-... ); I believe the Times is incorrect, and the right of society to protect itself is more important.
There is also a tension for health care professionals, who must balance the rights of their patients with those of society. In general, I think that when a person with mental illness threatens violence, that person should be hospitalized in a secure facility, if necessary involuntarily. If we need to amend our laws to permit involuntary hospitalizaation in this circumstance we should do so. Just as health care providers are required to report suspected child abuse and contagious diseases that endanger the public, they should also be required to report people who credibly threaten violence.
"Mental health" is just a ploy to distract us from the actual problem, the easy availability of firearms.
The movie "The Wizard of Oz" had it right: "Pay no attention to that man behind the screen."
I heard a Florida congressman say on NPR yesterday, following the party-line vote against restricting assault-style weapons, "it won't help to restrict assault rifles; the perpetrator would simply use another weapon."
Huh? If rapid-fire weapons weren't available, what would a perpetrator choose: a shotgun, a handgun? Wouldn't the whole point of a ban be to reduce the killing capacity of the perpetrator?
This essay describes poignantly what is essentially a common sense conclusion, as evidenced by all the countries which struggle with mental health issues but suffer far fewer gun deaths. I agree with others who say the emphasis on mental health is a misdirection from the real and obvious issue.
The world has no shortage of rejected and aggrieved young men, doesn't necessarily mean that are also mentally ill. In fact many are very sane to go under detected. The images, sounds, and words they encounter daily from an over the top culture doesn't help. Psychotropic pharms prescribed to misbehaving children, mostly boys can have long term effects.
The FBI data base is backwards, it sits and waits for input, rather than search the internet for clues and records.
In this case government failed, and when that happens it is rewarded, bigger budgets, more weapons, more personnel.
There are three dynamics at work here, the 2nd Amendment and the NRA, neither of which is going away any time soon. The third dynamic is angry aggrieved young men. Those are the parameters of the solution.
The standard for owning a gun (any gun) should be MUCH higher than simply not being mentally ill. A potential gun owner should be required to demonstrate emotional maturity, a calm disposition (not prone to fits of anger), and absence of drug and alcohol abuse, etc. And he, or she, should have a good reason (e.g. part of the Wisconsin hunting community mentioned by one commentator, or membership at a shooting range, or be a farmer/rancher with a vermin problem etc).
Furthermore the burden of proof should be on the potential buyer to demonstrate emotional and mental fitness, not the authorities to demonstrate unfitness.
Could this be practically implemented - I think so - especially in this age of data analytics: single male, under 30, antisocial Facebook posts, reported to have angry fits of rage, unable to have a teacher, pastor, commanding officer (or similar) vouch that you are not an antisocial loner - sorry, to many high-risk flags, you don't qualify.
Would this be perfect - no. Would some people who would NOT have gone on to commit mass shootings be denied - probably. (We can send them our "thoughts and prayers" instead of grieving families.)
Some might object that this won't address the problem of guns already bought and that's true. We could, however, apply the same standard to the purchase of ammunition, requiring the same permit to purchase that.
I have no doubt it would save many lives.
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Another antidote to this problem is to ask our Conservative Supreme Court Justices who claim to be "Originalists" to be intellectually consistent:
"A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed."
If we are to be literal and original, Arms = single fire muskets and rifles.
Even stalwart liberals like me would embrace originalism if its advocates demonstrated internal consistency.
1
I don't think mass shootings are rooted in mental illness so much as I think mass shooters are *thrill seeking*. I would hate for psychiatrists to shut down the conversation about mass shootings, concluding there's nothing that can be done. This conversation needs to continue and needs to include other facets of behavior.
It is physically impossible to cause the kinds of mass shootings we are seeing without an assault or other rapidly firing gun. Other guns can kill but cannot continually fire so fast that it precludes escape by many more people than in these assault-rifle shootings. Guns are the fundamental requirement for mass killings, and rapidly firing guns are the worst. Mental problems are secondary, but the gun lobby seeks to make this the main issue.
If legislators at all government levels are not willing to support and pass laws restricting these types of weapons, we must vote them out of office as soon as possible.
We might start by changing the militaristic foreign policy of the USA and trying to solve every problem by force. We might also stop the glorification of violence in movies, TV, music and video games. The guns are a problem and we have to stop giving disturbed people access to these weapons. But clip fed semi-automatic weapons have been around ever since WWII and I don't remember schools being shot up with M1 or M14 rifles in the 1950s or 1960s. Better gun control is needed but this society has to start working on the larger problems in a holistic manner.
Desperate people need expert psychotherapy that actually reaches them, not symptom management.
Psychologists and some social workers with therapy skills are best suited to this task. But the bullying piece at schools has to be dealt with. Too many shooters are ostracized loners with many personality quirks.
The Florida mass murder shooting was a premeditated act by a self indulgent insecure individual seeking notoriety. No new law would have stopped him; the mental health system did not fail us. The seemingly endless debate and media coverage of these tragedies will no doubt spur another event.
1
Family doctor here. Agree that psychiatry is being made a scapegoat by those who are ignorant or of bad faith. We see it in other fields as well--insurance companies that want to ding us for poorly controlled diabetics when said diabetics don't take their medicines, eat 4000 kcal per day, and miss their office visits.
Not your fault, doctor, but they need somebody to blame.
" The Mental Health System Can't Stop Mass shootings" is like saying mosquito netting can't Stop Mosquitos. Of course it can't (stop it completely) but it can reduce it it greatly. The Deinstitutionalization that occured under the banner 0f "community Mental Health" has reduce the # of Mental Health Hospitals by two thirds and cronic patients are being discharged to hostile communities without adequate care. Their is no silver bullet-even complete and absolute gun control with total confiscation. We could actually provide the same type of armed security that we have to protect our (money) banks, Court houses, Govermental buildings and professional sports venues, but that might actuallly reduce the problem to nothing and take away a political issue...
For anyone who has spent more than a week outside the US, it is so patently clear that trying to cherry pick who gets a gun and who doesn't will have limited results at best.
We have to directly challenge the 2nd Amendment. We have got to get rid of these guns. Or at least make it much, much harder to obtain one. Especially the assault rifles, which, other than a firing range toy, serves no beneficial purpose in our modern society. It has taken thousands of lives and cost billions of dollars.
It's not actually that hard to stop most of these crimes: you just need universal backround checks, a national database of gun purchases, and an improved mental health system.
You can pretty easily build a checklist to assess risk--male? White? Young? Socially isolated? History of expressions of violence? Fascination with ciolent imagery? History of domestic or other ciolence? Recent trauma?--and so on, to assess underlying risk.
Then you look to see if they've bought guns such as ARs or semi-auto pistols and a lot of ammo in the last or so. If they have, you yank the guns and offer psychiatric help.
Oh, well, good luck getting universal checks and a national registry out of this Congress and President.
The mental health system cannot stop mass shooters, very true. But what it needs to do is to be able to identify potential mass shooters so that laws can stop them. Banning the AR15 because a miniscule percentage of them are used in mass shootings is like banning the 767 and 757 because a miniscule percentage of them were flown into buildings on Sept. 11.
1
Your analogy is flawed. Those who commit mass shootings with AR-15's are using those weapons exactly the way they were intended. Not so in the case of the 9/11 hijackers.
Really? I guess I missed the ad that said buy an AR-15 to shoot up your school.
A dear friend was murdered in a random act of violence in Seattle in 2006. He was driving home from work and saw a teenage boy by the side of the road at a busy intersection who looked very upset. My friend stopped to help him. After my friend rolled down his car window to ask the boy if he needed help, the boy pulled a short barrel shot gun from under his coat and shot my friend point blank in the face in his car.
Mike left behind his wife and their 14 month old baby girl.
The Seattle Police arrested the 17-year old within 24 hours. He told the police that he’d wanted to kill someone, anyone, just so see what it was like. Earlier in the day, he’d gone to his uncle’s house (he had a key) to get his uncle’s shotgun under the bed. His uncle had a license to own the gun and had purchased it legally for home protection.
The boy had a history of mental illness and violence and had been committed to a psychiatric hospital by his family before. His mother called the police the morning my friend was murdered to report that her son was angry and irrational and she feared he would hurt someone. The police did nothing because he hadn’t done anything yet.
The uncle’s gun had no gun lock. It was not secured in a gun safe. He had not followed any gun safety procedures; it was easily accessible to anyone who was inside his house. We can all figure out many ways this tragedy could’ve been prevented, but expecting a psychiatrist to stop someone isn’t one of them.
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Mental Health is not a panacea for gun control. It is only one aspect of many forces working together to solve the gun issue. As much as the Republicans and the NRA talk about mental health the other side does much the same talking about it will not work. In the case of the Florida shooter their were too many warning signs that were missed. Mental and potential criminal. The problem we face is that there are too many guns available that have been sold in the past to make bans almost unworkable. Assault weapons, for example, too many are on the streets now it would make a booming black market. I do not think our politicians have the will to ban the ownership of such weapons outright. But that is what is necessary. Only one purpose to own an assault weapon is the power to be able to kill.
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As someone with understanding of mental health-- would strongly echo concerns of the author. The overwhelming evidence suggests violence is more likely than not directed against patients with mental health issues. Most state statues regarding involuntary detainment or treatment are very limited with regard to time and interventions and the criteria are fairly strict-- given concern with infringing on civil rights (historically not a trivial concern in mental health).
The evidence fairly convincingly supports reduction of access to firearms--especially those with more lethal capabilities as the most effective intervention. We can choose to decide how to implement around that as we see fit.
I'm so glad that a member of the mental health community wrote this opinion to demonstrate the limitations to assistance that are imposed by individual rights and applicable law. This makes it clear that each mass shooting has some area where one type of intervention or control could have helped, but what works is still unique to each case and does not lend itself to a formula or law that makes provision for every instance. What the writer fails to mention is why there is no provision for tracking this individual via local police when there is a strong indicator of violent tendencies. She doesn't conclude with any outcome for this individual other than that he left in the same state he arrived. Where is he now and what kept him from being a mass shooter? It's important to know where to draw the line, since it seems different for each person.
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What the doctor forgets or more likely is too young to know is that 30 years ago when I worked at a private psychiatric hospital which accepted both private and public pay insurance, kids were hospitalized for at least a month at a time. When the young man was still under age in 2016 it only required a parent's or social worker's (with foster kids) signature to get the required treatment. He wasn't hospitalized because the insurance companies have changed our definition of medical necessity and it has bleed over into public health care as well. The medication, treatment methods, and human psyche haven't changed enough over the last 30 years to warrant the drastic reduction in intensive care these teens need. The kids were in care with daily psychiatrist sessions, multiple group therapies, and on-site school. If they were still dangerous from the staff's and families perspective there were even longer term treatment options which essentially don't exist today unless one is wealthy. We have and can treat kids much better than we do today. Unfortunately, greed once again wins over quality health care.
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While I agree that the ready availability of weapons is part of the problem and perhaps there are some perpetrators who suffer from mental health issues, the one thing I haven't seen mentioned in this latest discussion of horrific mass shooting incidents is the effect of movies, television, video games and social media on society. The violence, sexual violence, rampant sexualization of everything, the less-than-modest (decent) way many women dress (I"m a woman) supposedly to express their own "power", etc., has to have a negative impact on what our society sees as normal. I read somewhere, but can't verify, that after 9-11, many young people thought the fallen buildings in New York would suddenly go back up because they were so used to to that happening in the games they played. What are we allowing to happen to us? I'm hoping someone is able to convince the students from Florida to wrap these issues into their gun control protests/demands because we older folks seem to have failed to see the problems or do anything about them.
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Although the discussion in America tends to be consumed by defining "rights", doesn't the second amendment also mention the necessity of a well regulated militia, which is a "responsibility"? Why not invoke the second amendment's wording to create legislation defining the responsibility of owning weapons appropriate for a militia, crafting regulations around registration and training? An example of such a regulated militia is that of Switzerland where possession of military weapons and ammunition is carefully controlled through almost universal conscription. Even something much less comprehensive than the Swiss system might be effective and entirely consistent with both the "rights" and "responsibilities" aspects the second amendment.
10
Amen. If people want to own military grade firearms they should be required to participate in a well-regulated militia.
1
I agree that imposing mental health treatment on anyone who shows red flags is problematic, for a number of reasons, but how many visits from social services, how many calls from concerned neighbors, how many emails from the school district, how many threatening posts, etc., does it take to permanently ban someone from buying a gun? I know everyone is concerned about civil liberties, but one thing that stood out to me in the press conference immediately after the shooting was that Superintendent Runcie said he couldn't comment on Cruz's school status or situation because of privacy laws--this while 17 people lay dead. Maybe someone like the young man this author references--the one who posted online threats and promised a "Day of Retribution"--forfeits his right ever to own a gun, whether he meant to act upon his threats or not. Red-flag the hell out of anyone who poses or makes a credible threat. Years ago I was comparing insurance quotes and the representative from one company asked if I had a trampoline. I said yes, and the system immediately locked me out. The woman said once you put in the word "trampoline," it automatically shuts down. No insurance. Period. It is apparently far easier to purchase a gun than have a trampoline.
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People who can't buy guns legally will figure out ways to get them illegally from people who bought them legally. Adam Lanza (Newtown) is a perfect example of using guns that were bought by someone else (his mother).
Yes he should be considered as giving up his right to own a gun.
The question that has to be asked is taking the ability to buy a gun from a
unstable person do any good if this unstable person can get access to a gun
without going to a store to buy one.
If a person who is unstable can get a gun using illegal methods then these laws only stop the sane who care about the law from getting a gun.
Therefore the only solution is to take guns away from everyone so these unstable people can not get access to a gun
The prevailing discourse among amoral, power-hungry, NRA-bought Republicans and their ilk confuses “mental state” with “mental illness.” You won’t find White Male Lethal Aggression in the DSM. Armed militias taking Native land, KKK mobs lynching Black citizens, Nazis gassing 12 million Jews and other non-Aryans and homosexuals, centuries of domestic violence (this, a cross-racial, cross-cultural, cross-class pastime). Not. Mental. Illness. Social sickness? Yes. Sanctioned crime? Yes. Moral failure? To put it mildly.
There are undoubtedly mentally ill individuals among mass murderers as there are in the population at large. But in the case of mass shootings, this is not the primary problem, and oddly, never comes up when the perpetrator is Muslim, black, or brown. In fact, the mentally ill are 11 times more likely to be victims, not perpetrators, of violence. Moreover, other industrialized nations—where mental illness can also be found, but the population is largely unarmed—experience strikingly less gun violence.
The problem is that, unlike most of the aforementioned scenarios, a single individual can now inflict the devastation and murder that used to require a mob or a regiment. The problem is our gun laws, the problem is the NRA lobby, the problem is gun “enthusiasts,” the problem is the uncontested misinterpretation of the 2nd Amendment.
Republicans: Stop re-stigmatizing the mentally ill, sending thoughts and prayers, and cozying up to the NRA. Start saving lives!
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Terrorism is pushback from losers in a winner take all society.
I'm all for getting the guns, but I think we also need to recognize that people that think it's a good idea to shoot up kids in schools are severely disabled and do not have the ability function independently in society. Just like someone with severe physical disabilities they require lifetime care and close supervision. We know who these kids are by the 4th grade. That's a devastating diagnosis to get for any family but it's real and families need lifetime support to manage these individuals...just like they would need to handle a severe physical disability. Otherwise they get kicked to the curb and become society's problem. Peter Lanza wouldn't even claim his own son's body after all.
3
Continued:
I would also point out that at age 17 years and 30-1/2 days, these people are considered minors, and miracuously, overnight, they turn onto rational, legally-liable adults with a knowledge of good and evil and ability to reign in their emotions. We need rational mental health treatment laws, as well as rational gun control laws.
Charles Manson had an abusive upbringing, was placed in several foster homes, and ended up being the definition of pure evil. Yet he did not deserve the hand he was dealt at birth, nor did the millions of children born into trauma worldwide. This is not a defense of Manson or sympathy for him. It reminds us where we should begin our prevention efforts.
Several years ago, I read about a case of physical abuse in an adoptive home (not uncommon). A mental heallth professioal at the trial stated that there were three tragedies - the tragedy of the child being born into a dysfunctional society, the tragedy of adoptive parents who were helpless in the face of his behavior, and the ultimate tragedy of physical abuse. The Florida case should remiind us of this. To prevent or at least mitigate the risk of mass murders, we need to look at solutions in all three layers of tragedy.
If this sounds like a tall order, it is. And until we prevent, recognize and treat the underlying social causes (which is a long way down the road, I admit), we need to be vigilant in keeping these people well away from weapson of mass murder.
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The short answer: vote for someone that is against the NRA this fall.
14
Europe is not different: anywhere you go you can find young men who feel as they have nothing to lose. Frustrated with society they will lash out.
The only solution is to ban all forms of weapons of mass murder such as most guns.
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Thank you, Hans, for boiling this down to it's essence.
Angry and frustrated people exist everywhere. Access to guns is what makes them angry, frustrated- and dangerous.
And thank you, Dr. Barnhorst, for a rational explanation of the challenges of treating mental disease in this population. The Venn diagram for the number of mentally ill who shoot up schools etc is incredibly small.
Take away the instruments of death, and identify those in need of help.
It has been my experience that everybody has some kind of mental heath issue, everybody.
12
And pretty much everybody has access to guns.
1
Interesting article and we thank the doctor for her public service but there is a glaring omission. This contributor is a doctor from California, not a lawyer. She apparently is not aware that in 2014 California passed a law to address the very shortcomings of the state legal system that she describes here.
Four other states have similar laws on Gun Violence Restraining Orders. This recent Reuters story is from the invaluable NY Times website; I would urge the editors who oversee these submissions to use this resource:
"Gun Restraining Order Might Have Thwarted Florida Shooting: Experts
(Reuters) - A few U.S. states have laws allowing police and family members to obtain orders barring people suspected of being a threat from possessing guns, but Florida does not. Some gun control proponents and legal experts said Wednesday's school shooting might have been thwarted if it had.
Suspected shooter Nikolas Cruz's history of violence in school and disturbing social media posts would have allowed authorities to prevent him from legally obtaining a firearm in California and Connecticut, which have gun violence restraining order (GVRO) statutes, the experts said...."
https://www.nytimes.com/reuters/2018/02/15/us/15reuters-florida-shooting...
This would be a great opportunity for the Times editors to identify and evaluate solutions that have already been implemented instead of running a piece bemoaning a problem California addressed in 2014.
3
The United States does not harbor all the mentally ill young men in the world. Every nation has mentally ill people.
A lot of mentally ill people have never shot or harmed anyone. The killer at the Colorado theater is in prison for life, not a mental hospital.
Mental illness is the knee-jerk response of the NRA. It is the only flimsy excuse it can find for promoting the sale of front line military war machines at places like Walmart.
Fear is a political strategy of the Republican Party. Fear of minorities, non-Christian religions, immigrants, women's equality and unbridles violence. They stoke fear by lying about the level of violence, the dangers of equality for all Americans. Then they try to soothe that fear with the promise of guns to protect yourself when no one else will.
A gun will not save you from cancer after Republicans deny healthcare, a gun will not save you from poisoned water or air after Republicans deny environmental protection, a gun will not save you from rising waters/wildfires/tornadoes/hurricanes after the Republicans deny climate change.
The only thing we have to fear is fear itself-and the promotion of fear as a political strategy.
30
The psychiatric profession can be used to manipulate political dissent. It is too easy to put political prisoners into well defended facilities and call those facilities mental hospitals instead of calling them jails.
It would not take much for Dr. Barnhorst to start including young insecure men who felt entitled into the same basket as those who are clearly filled with resentment and hatred. It is easy for a psychiatrist to precipitate confrontation in a testosterone filled and sexually unfilled 20 y/o male. If the federal government gave Dr Barnhorst a 350 bed psychiatric hospital. I'll bert she could fill it.
The difference between Pelican Bay and The state hospitals in Napa and Atascadero is only a difference in architecture and geography, not substance.
2
Maligning the messenger is a flimsy response to this matter of life and death of fellow human beings. It’s long past time to address the merits. 2nd Amendment philosophy must give way to reality - the deaths of so many innocent human beings. When ideas so violently conflict with real life, the idea should die, not humans.
May we adopt a “culture of life” that shows genuine commitment to humans after they are born.
What mental health screening can do is identity some of the high risk individuals far from all of them will lie to cover up their problems. Further, I think wse need laws mandating counseling for those identified as high risk. There is an analogue here to the mandatory supervision of sex offenders. None of these intervemntions will stop them all, but taken together thry hold the promise of reducing the carnage.
You can not regulate mental illness. You can regulate guns.
256
Exactly and those who make online threats can be arrested and charged with making threats.
11
great idea!!!!! disarm everybody that didn't do it!
1
Public opinion that mental illness is the main problem underlying most shooting tragedies is a common misconception of roughly half of Americans. Polls show they either believe that failing to identify people with mental health problems is the primary cause of gun violence or that addressing mental health issues would be a major deterrent. Widely accepted research by mental health experts show these popular conclusions are myth/incorrect.
In one research example, analysis of 235 mass killings, many carried out with firearms, 22% of the perpetrators were considered mentally ill. Overall, mass shootings by mentally ill is only 1% of all U.S. gun homicides yearly, according to “Gun Violence & Mental Illness”, by the American Psychiatric Association. Alarmingly, suicides by firearms are much more prevalent than are gun related homicides & mass shootings.
Banning sales to people deemed dangerous by mental health providers could help prevent mass shootings. Experts say more measures to ban assault weapons & ban sales to teenagers & convicted violent criminals are effective. Most important to understand is that Americans do not have more mental health problems than any other developed nation of a comparable size. Other nations experience far fewer mass shootings because they have stringent legal requirements for weapons ownership . Florida and the USA can start the very long road to effective weapon control and increased public safety by banning all dangerous assault weapons
6
It is the society we live in that is causing the problem. We have an economic system that works great for about 1% of the population but not the rest. That’s the big difference between today and many years ago when wages were not stagnated and CEO’s were not making 300 times the average worker. Throw in the never ending terror threats and social media and it is a toxic stew that is making society sick as a whole. These school shootings are just a symptom of the problem and not the problem itself. Until capitalism is reined in this problem will never go away.
3
"Each mass shooting reignites a debate about what causes this type of violence and how it can be prevented."
I direct your attention to The Avielle Foundation, named after Avielle Richman who was killed in the Sandy Hook shooting. The mission of The Avielle Foundation is to prevent violence and build compassion through neuroscience research, community engagement, and education. The organization is working with world leaders in four broad areas: brain health research, public health, community engagement, and education. Please visit their website (https://aviellefoundation.org/) to learn more about their efforts.
3
Retired Trauma Psychologist of 22 yrs here: worked with combat vets, refugees, sexual & physical abuse, 1st responders. Married to an Infantry Combat Vet who trained me in PTSD/ Addictions counseling 32 years ago. Neither of us, with combined expertise, could help his now 48 year old son, whom we housed & cared for 2x, each for 6 months, in Major Depression after relationship breakups, Two women, including his wife/ mother of their child, placed an Order of Protection against him. Still, he holds a well-paying job as a CPA and was granted joint custody. He has an arsenal, including AR-15s, & yelled "you are fools to not know that ISIS is on our doorstep". We all live in suburban upstate NY! His sister, her husband & 2 kids are nonviolent & normal, as is my son & his family. My husband was physically threatened by his son, who also screamed at me in front of my son, over a hamburger! Do we worry about his continual harassment of his ex-wife & fear he will go on a shooting rampage? Do we miss our granddaughter, because his harassment prevents us from seeing her? Yes, & we are helpless because even in NYS his gun rights are protected. How did outpatient therapists miss this? How did we miss this for years? Because he lies, blames others; It's NEVER his fault. He's Personality Disordered, & Major Depression only upon "losing". These are the men with guns we should fear. Their violence is well-hidden from mental health pros, women, employers by lies..until they kill.
22
I am a California psychotherapist, practicing got 4 decades in the Bay Area. I have never seen so many patients in my practice who own guns as I do now. Some of them have diagnoses that would make me wonder why they were legally allowed to buy a gun, including one who has a diagnosis of intermittent psychosis related to drug use. I have the dilemma of reporting gun ownership in hopes of having the gun removed, or keeping him in therapy and monitoring his mental health and sobriety.I have chosen the latter course, believing it is too easy, even in California, to purchase a gun.
11
Health professionals cannot predict future behavior.
I had a patient in a community health center who was verbally abused by his former wife. She would also falsely report him to the police. He also had a legal gun and voiced a desire to end it all. I had to walk a tight line. It worked but I understood the risk I was taking.
We can however make guns scarce. Yes, it will take a long time to accomplish that feat.
The immediate effects will be there, but it will take national commitment for guns to finally disappear.
The Japanese have done this successfully.
Otherwise, we are doomed to endless school and campus lock downs, parental and teacher anxiety, childhoods filled with fear, inactivity, and anxiety and unnecessary deaths.
Our schools, campuses, other public institutions public events will remain random shooting galleries for angry young men, gun nuts, and the occasionally mentally ill individual.
What a wonderful future to look forward to! America will be great again! The American dream will have a new nightmarish technicolor dimension.
This is legally imposed terrorism upon our population: terrorism imposed by uncaring, mercenary, mendacious legislators, elected government officials, lobbyists, and not for profit organizations.
Florida has already stated that it will not limit assault rifles. The children have not yet been buried. Their graves are fresh and legislators are already suffering from amnesia.
Bohdan A Oryshkevich, MD, MPH
13
The Japanese did nothing. For centuries they forbade anyone other than a Samurai or the nobility to own swords. There were no guns to be dealt with just as there were no swords. The Army's guns were confiscated by the Allies and destroyed after each conquest. Whatever was in the homeland was confiscated and destroyed by McArthur's occupation force.
So we have a Professional claiming that because they cannot do their job properly we need to infringe upon the law abiding rights!
Perhaps then it is time we revisit O'Connor v. Donaldson because that way we can be sure that mentally ill cannot harm anyone with anything; you know for "safety!" Remember these acts were exceedingly rare before O'Connor v. Donaldson and the subsequent Slashing of mental health care funding
Let's see, person with anger issues, insecurity, resentment, entitlement and hatred watches the good guys kill the bad guys with weapons of mass destruction. He is the "good guy" in his mind so he is now empowered to kill those he perceives to be the "bad guys." Repeat...
5
AGAIN! ...... and will never get tired of asking: no question that gun ownership should be controlled but, WHAT DO WE DO WITH THE 350,000,000+ units already in PRIVATE HANDS?
1
Buy them back?
2
Any discussion regarding the implementation of gun control necessarily needs to start with the recognition that the right to keep and bear arms is an individual right protected by the Constitution. You may not like it, but the Supreme Court settled that in Heller and McDonald. If you favor the Court's decision in Obergefell and Rowe, you also need to respect the court's decisions in those two cases. Much, if not most, of the legislation proposed simply would not pass constitutional muster, as the restriction of a Constitutional right must be narrowly tailored to achieve a compelling governmental interest. While there are certainly compelling circumstances, many gun control suggestions are simply too broad. However, after each tragedy, both sides simply trot out the same talking points, with little thought as to how real results can be achieved. Until that happens, nothing will change. Either that, or repeal the Second Amendment. I have no problem with that, so long as the process set out in the Constitution is followed. However, gun control advocates would need to actually admit that is their goal in order to do so.
4
I’m in for repealing the 2nd Amendment. It is irrational.
Abortion is highly regulated. There are age restrictions, waiting periods, and forced information sessions. Would you agree to this for guns?
I’m an attorney who regularly handles these kind of firearms cases in California, and this author misstates the law in California a little.
Under current law, as soon as she admitted her patient it triggered a state ban on his possession of firearms, including the ones he currently has. Local police routinely seize guns from individuals who are committed under these 5150 holds.
Her patient would need to calendar a hearing before a local judge to get his right to have firearms back and to have his firearms returned to him; the local district attorney’s office would appear to oppose the return of his rights, and the city attorney or county counsel (whoever represents the agency who has seized his guns) would appear to oppose the return of those firearms.
In general, California has made some recent strides in balancing guns and mental health. We should be promoting some of those processes as a model for other states.
3
I am a mental health and addictions counselor who ran dual diagnosis treatment programs. Thank you for speaking out about limitations to involuntary psychiatric treatment. I've been trying to explain this to deaf ears in my community for several years.
The newest argument from gun advocates is that guns aren't dangerous, people are. But they refuse to regulate guns in the same manner that we regulate automobiles, medications and even insurance.
Psychiatric treatment is only one tool in the arsenal against violence. unfortunately, angry people generally resist treatment and are not referred before they act out.
3
If the United States wishes to deny North Korea nuclear weapons, shouldn’t it also deny assault rifles to people (even if they have a “clean” record) like Nancy Lanza?
4
In America you gotta take the bad with the good, and try to improve it. We have rights, the 2cd reads thus: "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be infringed." It's been litigated; this is a practically ironclad right to own and bear guns, so no Leftie yeah buts about some militia work here, nor are they useful as a persuasive argument.
But adding one word, "unreasonably" magically allows a Congress to improve the bad: "A well regulated Militia, being necessary to the security of a free State, the right of the people to keep and bear Arms, shall not be 'unreasonably' infringed." See how that works? That's sort of proposal would rally voters and do an end run around lobbyists.
So the problem here is that people like Pelosi and Schumer never go near proposing amending the 2cd, nor do they make that a party platform plank. They stick a thumb in gun advocates eyes instead; You all are too mean, too dumb, too violent, you should not want guns! You are bad people! None of that is the case in fact, they simply have a right and are retaining it just like I do with my right to speak. Amend the 2cd, demand that come voting time!
1
Don't sell guns to 17 year old men.
1
No mention of the P-word. Psychopaths are loosely defined as that one to three percent of the population without a conscience. Not mentally ill, they are untreatable. Many are high-functioning, holding responsible jobs and only abusing others behind closed doors. Risk-taking draws them to employment promising power, like the power of carrying weapons and controlling the actions of others. They will always be with us.
6
Until our current culture regresses to the moral levels of yesteryear, nothing will effectively stop the shooters. We don't know well enough who these sociopaths are. We can't stop the acquisition of firearms, as you can't regulate illegal sales.
Even if we ID'd potential shooters, like repeating sex offenders, wife-beaters, and durg users, they can't be incarcerated for what they're thinking and planning to do, only for the after-effects of what they just did.
We all gather round after these tragedies and say it must never happen again. But it does. Sorry, Amy....nothing can stop mass shootings. Many of us may feel better with more gun control, but we won't feel better about stopping these shooters, because we can't. Only a better culture can help, but civility is heading the wrong way.
3
Agree wii the author. We also need to ban assault weapons (to include the AR15) for public purchase. Maybe only bolt action rifles and revolver pistols should be sold to the public.
The only unfortunate thing is that maniacs do not need rifles and pistols to kill a lot of people. 9/11 was box cutters and jets, recent attacks by terrorists with trucks running over people are now common, and various other diabolical uses of normal every day items are simple to execute. So long as mankind is around, there will be random idiots around to kill people.
So because we have in this country a mental health system that is a national disgrace.
We can't even begin to hope that the system will somehow assist with the problem of mass shootings which are primarily carried out by individuals with mental health issues. Perfect!
And now here come the Gun Grabbers to tell us the only solution to the mental health crisis is to take away from me and every other law abiding American citizen my basic human right of self defense.
And of course they want to take away this right by subverting the Constitution of this great country...
And their "claim" is this may somehow, someday in someway possibly deter a person who is mentally ill from committing an act of insanity...
<Sigh>
2
300 million guns exist in America. 3 d printing of guns gets easier every year. You are not going to control guns. It’s too late. Any body can get a gun if they want to ...something needs to be done On mental health. If you can try to overrule the 2 nd amendment. You can try to overrule Civil rights. Since 1940 the government has trained 45 million soldiers on firearms. Add another 5 million cops. Who teaches people about guns? The US Government England’s army can fit in the Rose Bowl ,other countries do not have this situation.. Every year Hundreds of thousands are discharged ,some with PTSD , Isn’t that a mental health issue?If a cop shoots a black man ,you don’t go after the gun
Hatred, rage, and resentment leading to aggression and violence does not constitute mental illness. Put a rock or a gun in the hands of a person in such an emotional state and you should expect them to throw that rock or shoot the weapon. The NRA and AR-15 lovers will point to mental illness but other violent aggressors whether rapist, ISIS member who burn people alive or Nazis who killed and gassed millions were not mentally ill but just humans who chose violence and murder and carried it out. There's no pill for that. Don't blame mental illness for we are providing the guns to kill in the throes of aggression.
17
Of course the author is correct. Only a prohibition of bump stocks can stop mass shootings.
I recommend that NRA Members and supporters volunteer for guard duty at every school, theater and shopping mall in America. Since there is almost one gun for each US resident, this should not be too onerous. That way the “good guys” could prevent the “ bad guys” from taking innocent lives & could “take a bullet/s” if necessary to do so.
3
The repeated focus on mental health from those opposing effective gun laws stems from a combination of ignorance and obfuscation, probably mostly the latter. As Dr. Barnhorst notes mentally ill individuals are rarely violent or dangerous. Moreover determining in advance which among many troubled or even psychotic persons will become a mass murderer is simply not possible. Most of them provided many fewer clues than the Parkland shooter, and most have had no criminal record. None of the other first world nations whose citizens have a risk of being shot which is a tiny fraction of ours has eliminated mental illness, nor for that matter evil. They simply have reasonable gun laws.
2
In other countries potential gun owners are personally interviewed by police, and must demonstrate why they should be allowed to have a gun. This is in contrast to here where background checks are used to reveal issues as to why they can't have a gun. The gray area between these two approaches is vast. How many crazies would be willing to make an appointment to go to the police station for an interview.
1
So, let me get this straight, mental health is not part of the solution? Really. This issue granted is much larger than one panacea, however it is still part of the issue at hand. The lack of mental services, school districts passing on troubled children down the line, police departments not doing their due diligence, school security lacking, ease of high capacity clips, a sick society which glorifies violence, nearly half our children raised in single parent homes....the only way we can fix the problem is to take a multi-pronged strategy were we all work together. Instead we will just blame it on guns.....
If we do not come together and take a holistic approach to this issue nothing will get done.
28
Oh please. Having two parents guarantees mental health? Really? The research that suggests that children do better in a two-parent home is, in my opinion as a psychiatrist who has done clinical research, flawed at best. Statements like yours underscore again how blind Americans can be to the reality that this country is in every way an outlier when it comes to guns. No other developed country has anything near to the frequency of occurrence of mass violence that the United States has. Why is that? Because they don't have access to guns. Period.
5
I have o agree with you.
This article doesn't state what you say but it does imply that the only solution is to take away guns from everybody as every other method has been eliminated using the logic this article gives us.
1
Why not include a reduction in the number of guns in circulation as the first prong in that multi-pronged strategy?
What infuriates me the most about the gun apologists is their blatant disregard for the part of the Second Amendment which reads, "as part of a well-regulated militia." There was no intention for there to be indiscriminate access to weapons!
4
I couldn’t agree more. As a neuropsychologist, I see a broad range of people with every variety of personality disorder, mental illness, and cognitive impairment. Mental health professionals are sorely limited in what we can do when someone poses a threat. Support us in doing our jobs by giving us needed resources, but don’t expect us to keep you safe from angry men with AR-15s. Or other weapons of war.
134
A single shot rifle and an AR-15 are equally ineffective against a tank. The idea that we can stop a tyrannical government with light arms is laughable. The lightly armed free Syrian army has been effectively crushed by Assad’s minority forces with tanks and aircraft.
4
Yes, and the founders were concerned about defending the new nation from England, not themselves. Rulers are to be voted out, not massacred. That is actually one of the things that made our experiment in democracy so unique at the time.
No president has ever refused to leave office at the end of their term, and I think only that would have justified armed insurrection to the founders.
The idea that George Washington would have wanted to be forced out of office at gun point if The People were not satisfied is laughably absurd.
A tiny percentage of violent crimes are related to mental illness, something along the lines of 3%. A tiny percentage of gun murders are related to mental illness, something along the lines of 4%. Dancing in place and forever pointing at guns, as dangerous and unnecessary as they are to the mostly men who own them as a security blanket, obscures what is front and center: The definition of masculinity as aggressive and violent sexual predator, as well as the definition of femininity as passive, inferior victim.
Our media - all of it, from tv to movies, from advertising to porn and the internet - sells this to its most highly prized target audience: young males, puberty to age 35. This is the same group that commits most of the crime in every society. Adding in a dose of bad genetics and/or weak character will result in a few million of these entitled American young males in every generation. How to unspool these predatory impulses and entitlements is the task at hand. It has been ever since the 1970s. We've just been going in the wrong direction; the school shootings by young males began to proliferate in the 1980s. It ought surprise no one that we are worse off 30+ years later with a new generation rapists and killers.
4
The mental health system is just not designed to handle these types of cases. As the old joke about how many psychiatrists does it take to change a light bulb goes (only one, but the bulb has to want to change and it takes a long time). Aggressive, angry, resentful, maybe stupid, not psychotic young people do not objectively fulfill the criteria of a danger to themselves or others until they do, usually something hidden from their mental health provider. If they break a law they can be warehoused for a while (in our new mental health facilities: prisons. The only effective way to keep the rest of us safe is to prevent their having weapons.
1
psychiatrists know that the only valid predictor of violent behavior, mental patient or not. is past violence, meanwhile the NRA has another PR victory in turning attention to merntally ill and away from guns. there ae millions of mentally ill peope roaming our streets, of danger to noone but themselves. thereis, to startt, absolutely no need for anyone to own more than one gun and that should be an ordinary hunting rifle, not power enhanced look at gun collectors= so many of them driven by racist fears
Perhaps we should require an extensive mental health exam before anyone aged 18 to 35 can purchase a gun. 18 year olds do not have fully developed mature brains, and acts of violence are common with men in this group.
Our constitutional rights depend on society’s ability to use those rights responsibly. They are man given not god given. It would be a shame for the acts of the minority cost the responsible majority to lose their rights. But that’s the real world and why most laws exist
1
no such exam exists. A sociopath would ace it. The Vegas shooter was 63, with no criminal record.
When did everyone decide that it was no longer normal to get angry at injustice? Perceived correctly or not it is not wrong to be angry if you think you have been aggrieved.
Ditto so many other emotions our society has been slowly focusing on suppressing in favor of a false face of constant smiling and required reactions to cues given. It strikes me as a kind of grooming to behave like the sort of dystopian third world cultures adapted to millennia of dictatorship and government by fiat in which sudden and irrational violence is common.
Where did personal boundaries go? Where did minding your own business go? Where did paying attention to the facts go? Why are there so many snipe hunts on?
1
I personally know a teen who was held in juvenile detention for 5 months because of a vague threat he made (yet his Medicaid would not pay for residential mental health treatment). If the response to this is to lock up every teen who expresses antisocial sentiments, we risk creating a whole new population of incarcerated youth a la War on Drugs. Then these youth are forced to go through life marked and marginalized -- a recipe for further violence. Reducing access to guns is the only humane way to address this.
157
So the war on drugs was a failure. Do you seriously think a prohibition on rifles is going turn out any better?
1
Large scale restrictions on assault weapons purchases will not happen soon BUT a mandatory requirement that the buyers of assault type guns, large capacity magazine and armor piercing bullets also purchase liability insurance might be a help in getting guns away from nut jobs simply by putting up a financial barrier to ownership. The only thing that will really work is to elect lawmakers who are not owned by the NRA and the weapons industry.
3
Mentally ill individuals are not per se more violent than the general population.
I am a retired judge who often sat on "involuntary commitment" cases. The reality is that the legal standards used do not provide much guidance to the medical community, and vice versa.
Some psychiatrists are reluctant to bring certification cases, either because they do not understand the legal standard, or they believe that individuals should be able to make their own choices about their treatment. Judges have even more difficulty applying the medical evidence correctly.
The mental health community is split between those who favor more aggressive treatment standards, and those that are strongly libertarian. Having a serious and persistent mental illness is not the same as legal incompetency. So, should we force competent individuals into mandatory treatment because there is merely a risk of harm, as opposed to a risk of imminent harm? Good luck answering that question.
3
Agreed, thank you for the op-ed. I'm not a mental health professional, but I have some personal experience. I would add that a not-unusual, county-funded treatment for someone like this, is one hour, once a week, of CBT or behavioral modification therapy, which is frequently ineffective in these cases. The disorder manifested by this young man and many others often requires expensive, intensive, months-long residential treatment with professionals trained in childhood trauma. The older the child, the lengthier the treatment and the less likely it will be successful.
Modern neuro-development studies have shown that pre- and post-natal trauma (malnutrition, maternal stress, neglect, and abuse) affect the development of the brain. On top of this, in this case, is the loss of both the birth and adoptive parents - events which would put anyone over the top of the stress scale. My point is that this young man was the end result of tragic events over which he had no control. I am not by any means suggesting that this is a defense for his horrible act, and he needs to be removed from society. I am suggesting that the end result of such untreated mental disorders is a tragedy whose cost cannot be estimated. Pay for intense treatment up front, or let innocent people pay the price later on.
4
Women have mental health issues, too.
Yet 98% of mass shootings are committed by men.
-Mother Jones Magazine, 2017
This isn’t about mental illness.
This is about violent (insecure/fearful) men and their easy access to killing machines.
18
Thank you so much for this article. If I hear one more politician issue the platitude "we need to keep guns out of the hands of the mentally ill," I'm going to scream. I'd love to know how anyone proposes to identify the "mentally ill" and prevent them from buying guns. Are we going to have a national database of the "mentally ill"? And what counts as "mentally ill" -- anyone who has sought counseling? Antidepressants? Anti-anxiety meds? And won't that have the consequence of people being afraid to seek mental health treatment, for fear of ending up in a national database? The problem is that we are a violent society with way too many guns. The only thing that's going to prevent mass shootings is a wholesale change in our culture. I'm not holding my breath.
3
Mental health is a red herring. The focus on it is like all the other wrong focus pointed to by bad actors or those who choose not to change the status quo because it helps them in some way. It is complex enough that fools will trust yet once its parameters are explained as in this article it is very clear that the diversion is false.
The problem is access to M16 clones and the accessories that make these clone M16's so dangerous. They are not useful for hunting or anything other than killing people in large numbers.
1
The author makes a very compelling case. I say we advocate one step further: if a person makes threatening posts or conversation, such as those praising mass shooters, their guns should be taken away for six months. That is a death threat, punishable by law. Full STOP. In my opinion, anyone who makes threats such as these really should be banned from every owning a gun. You're not responsible if you have thoughts of mass murder.
Another issue: adopted children with histories of personality disorders or mental illness disorders, often because their biological parents had pathologies, deserve MUCH MORE scrutiny to qualify for arms access, be it a handgun or any armament, much less AR-15s.
Think about the stupidity of having banning alcohol for anyone under 21 years of age, but hey you can buy a military style assault weapon just fine. LUDRICROUS.
3
I expected a better analysis from this psychiatrist (or alienist).
Why does this society produce so many mass shooters? The author mentioned, in passing, 'insecurity' but did not expand on it. Does this insecurity lead to hatred? Clearly this 'insecurity' is a part of the culture and society.
Most people in this board believes the removing one vehicle of expression of hatred (i.e. semi-automatic rifles) would remove all expressions hatred. [ISIS and AQ do not express hatred with 'semi-automatic rifles' - they use cars and bombs]
You have the capability to go to the bottom of this. Please look for the real solution.
1
It is interesting to see somebody determined to suggest that America is a sick society make so many errors in basic grammar and idiom.
Every culture and people have the unstable and violent. As we are all aware, not every culture has easy access to relatively cheap, very deadly weapons. If you get into an arguement with your neighbor in many countries it can get violent but without access to guns the violence is often easier to contain and deescalate.
The Sandy Hook shooter was too withdrawn to go to school, spending his days in his darkened room playing violent video games. His mother bought him his AR-15 and took him to the range to learn how to use it. He repaid her by making her his first victim.
The couple who took in the Parkland shooter after his mother died in November knew he had emotional problems. They insisted that he keep his collection of weapons in the family gun vault, believing there was only one key. They were wrong.
Can't anyone see what's wrong with this picture?
3
It's safe to say America doesn't have more mad men (yes, mostly men) than other countries in the world on a per capita basis. Yet we have far more mass shootings. And now we have them once a month.
It's the guns. It's not the people.
3
This is spot on. Those who cry out for better mental health as a solution to the mass murders mean well but have never elaborated how 'improving' the system would actually prevent the carnage. I'm sure it could reduce it a bit, especially with regard to suicides. but it seems to me the only scenario where mental health could make a real dent would be to require every gun purchaser to be evaluated before purchase. This, of course, is not what supporters of the 2nd amendment would have any interest in pursuing. And even if we had such a system, would you want to be the person who denies someone a gun- you'd fear for your life.
1
I grew up in northern Wisconsin where hunting is the runaway recreational activity. The nine day gun deer season surrounding Thanksgiving attracts over 650,000 licensed hunters making it the most requested vacation time in Wisconsin. As a health professional I've had a fair amount of contact with mental health patients. Tens of millions of Americans have experienced a mental health crisis, most on their own. Those who are involunatarily committed are billed and their accounts handed off to debt collectors. If they didn't have a financial stress in their life they will after a commitment. Most are very reluctant to inform an employer of the reason for a sudden absence and simply quit their jobs, the shame too great. Setting up a system that essentially would create a massive data base of the mentally ill reliant solely on a practioner's best judgement call would no doubt lead to a "can't be too careful" system of over reporting. Just as we were making progress to destigmatize mental illness there is now a significant movement to again not only stigmatize but to permanently brand those who have contact with a mental health professional. I have and will continue counsel mental health patients to be very careful who they share their diagnosis with as more than a few times I've been involved in the blow back from family and employers who seriously complicated patient situations. HIgh capacity weapons and loose restrictions on hand guns are the true epidemic.
179
It's almost as if having universal healthcare that covered the cost of mental health issues would help solve some of these persistent problems :/
2
I agree with this. Also, I believe that if mental health professionals are asked to report on potentially violent patients, people who could benefit from mental health treatment will simply not seek help.
Not surprisingly, it seems like the politicians keeping quiet in the aftermath of the Parkland shooting are the same ones who were so adamant about dismantling Obamacare (which, finally, put mental health services on parity with other medical services) and who want to cut Medicaid (which is the largest funder of mental health services in the US). Their hypocrisy turns my stomach.
We have to recognize that we don’t have the kind of universal mental health system that can handle this problem; it’s not the panacea some claim (as evidenced by the many thoughtful comments here from mental health providers); there are real costs to restigmatizing mental illness; and that sensible gun control for everyone is the only effective and workable solution.
An AR15 isn’t required for a well-regulated militia. There’s no reason for an 18 years old kid to have one. Period.
1
No one can be civilly committed unless he is clearly mentally ill and a risk to himself or others. Cruz was assessed at one point and found not to meet these standards.
Cruz was also assessed by Florida's family services agency. Again--nothing could be done because he failed to meet their standards for intervention. Law enforcement were called several times over the years, but Cruz had committed to crime. The school system did what it could, but apparently could not retain him against his will in an alternative school that might have better met his needs.
Most importantly, the neonatal RN and her husband saw no signs of the tragedy in the days leading up to the shooting. I'm not sure what, 6 weeks earlier, an FBI intervention would have uncovered under these circumstances--almost surely not enough to arrest Cruz.
The Public Defender is crying that the system failed Cruz. Usually, this is true. But Cruz, who also due to inherit nearly $1M from his deceased parents, received considerable services. He is, as aptly described by the assistant PD who attended the initial appearance, a broken child, but he is not a broken child who was ignored by the educational, community mental health, and even law enforcement agencies that encountered him.
Perhaps we can debate the need for more intensive services. What we can't debate is that guns, incl powerful automatic weapons, have contaminated our society. Mass and ind gun killings must stop. Adults must remove the guns. Now.
2
I'm glad to hear a rebuke to the chorus of headlines blaming "mental illness" for this scourge. Mental illnesses are as diverse as physical ailments. Imagine a scenario where leaders targeted those with "physiological illnesses" as potential perpetrators.
Mental illnesses do not denote a predilection for violence. Yet there are statistically relevant markers that do predict who might pick up a gun in anger and use it on strangers. Those who have a history of domestic violence are one example.
We absolutely need to have a conversation about gun violence in our country. I think we need a conversation about violence in general, actually, and domestic violence is a perfect place to start.
But when it comes to enacting gun safety regulations, let's look to the evidence and listen to the experts (and yes, shooting survivors are definitely a kind of expert on this topic, ) and then make legal decisions. We need to get this right. Let's start with what we know, and then keep learning.
2
I think the title should be "The Mental Health System Can't Stop ALL Shooters". Multiple steps can and should be taken to reduce these horrific incidents. Whether mass shooting or other types of gun violence, steps can be taken to reduce and sometimes stop some of these horrific events. The country needs to get serious about taking action against this public health disaster - it's been a long time coming. Mental health is only one component. We need to install people at all levels of government that are willing to allocate the needed resources at the federal and state levels to take this "virus" on and kill it. What stands in the way of a very reachable solution are many pig headed and selfish politicians and their greedy donors.
1
Mental health is a red herring. The problem is access to these M16 clone guns.
1
Not entirely. If you look at the statistics, hand guns are a huge problem as well.
It's a very simple statistical exercise. After the fact, it's easy to assess that nearly all the shooters have some mental "issue." Before the fact, we have many thousands (perhaps even hundreds of thousands) of folks with mental "issues." From that large group will emerge a few dozen mass shooters each year. We don't even have a good set of predictors as to exactly what "issues" will lead to mass shootings. This is way harder than predicting which smokers will get lung cancer.
Better mental health care is a great idea; it just won't help with the mass shooting problem.
6
I am a psychiatrist in Portland, Maine. Thank you for your thoughtful article.
Politicians who want to focus almost exclusively on the mental health aspects of this issue should be asked if they support the 2014 position paper of the American Psychiatric Association on gun violence. If you are interested, google
American Psychiatric Association, gun violence" and you can read the PDF. The APA has made a number of thoughtful recommendations. None of them are being supported by the NRA or Republicans.
I see the mental health issue being used as fig leaf by many politicians, but if they are going to use it, they should be asked why they are not following the recommendations of the experts in the field.
174
In a nutshell APA proposes the same retread proposals of the left. Background checks and waiting periods - have been in place for years. There is not and never has been a "gun-show loophole". There are reams of safe storage and product safety requirements for guns. Gun free campuses?!?! That is what gets us into these messes in the first place. A big sign out front saying - no one in here can defend themselves.
Yes, the mental health system can be improved to identify high risk individuals and prevent some of these tragedies. In the interim, let's put guards in our schools - they are actually more valuable than most things we secure with armed guards.
3
You seem to have missed the big picture, which is that "the Left" is advocating for evidence-based solutions, recommended by experts.
Ideology does not make good policy. There were two armed guards at the Florida school most recently shot up. Columbine also had an armed guard on site. This is a guns issue.
2
Let the gun-rights advocates see the blood that comes with their "right to bear arms", just like the "pro" life folks outside abortion clinics show off their photos. Post the photos of those killed by guns in every gun shop. Include these images in firearms training. Stop suggesting that teachers, doctors, "anybody but us who love guns", can solve the problem of an overabundance of deadly weapons on our streets.
3
This goes to show that many people assume too much when dealing with someone who's posting crazy ideas about hurting people. Mental Health is not stacked with clients trying to harm others, it's usually the other way around-they are trying to harm themselves. Mental Health clients in general are not violent and are passive after years of working with mental health staff.
1
In a sane and mature society, we would put the onus on the people and entities who profit from the indiscriminate sale of firearms. The sellers and manufacturers of guns should be financially liable for the acts of their customers. If, as they say, the vast majority of gun owners are law abiding, then they will still make a lot of money selling them their fetish sticks. But, when they make a mistake and sell to a mass killer, they should pay the price. To guarantee they pay up, they should be required to carry liability insurance.
Just kidding. The premise is just not there. We are anything but a sane and mature society.
1
I cannot agree more with this wonderful summarization of the dilemma we deal with as treating psychiatrists.Everyday I see plenty of these angry and possibly violent young men and wonder which of my patient will be the next mass shooter. It is as impossible for me to predict as much as it is for the next lay person and we cannot change personalities and environmental stressor which shape these minds and behaviors.In this whole paradigm the only thing we can change is access to weapons for my patients as well as the rest of the American Society so that every time anyone is angry he cannot kill a bunch of innocent people.
1
"...put some distance between these young men and their guns." The only way to do that is to ban all guns and do a buy-back amnesty for guns already out there. Treating the lack of mental health services or anger and resentment as the cause for gun violence misses the point. The number of guns circulating in the population means they can be borrowed, stolen or bought, even if background checks are strengthened and mentally ill people are banned from buying guns. The only solution is to remove all guns from circulation in the US public. The US needs to get with the times and act like the civilized countries in Europe and Australia, where gun violence is very low due to sensible bans on firearms.
3
Cure? Who ever thought there was a cure for this sickness?
Life-time treatment and care are all that I've ever thought of, expected and hoped for. If we got that, it'd be a huge leap toward health, safety and sanity.
We need to repeal and replace the 2nd Amendment. It was written for the America of the late 1700's, not the mass murder of today. If the Thompson submachine gun (Tommy-gun) could be outlawed successfully, why not the AK-47? Because the twisting of the law by the NRA the Supreme Court have allowed it to be marketed. The same flawed logic in Dredd Scott permitted returning runaway slaves; justices see what they want to. so the law needs to be changed. The Amendments were designed to be changed over time by the Framers; and they have been many times. It took an amendment to allow women to vote, another to have direct election of senators, another to formalize abolition of slavery, etc. etc. Why not bring flintlock technology into the modern age?
Why wait for Star Wars technology to provide the next marketable death ray to be used with the same protection as the AK47? If there is profit, it will happen. Children and crowds need the protection of "life and happiness" more than some need the liberty to mow down rooms full of children, theater-goers, and concerts. The arguments about mental illness are a political swamp where quicksand will take down anyone who hopes to make change for the better.
1
Absolutely on point. Evil is not a mental illness. This is bigger (and dare I say) more complex than that. Civilians having access to weapons developed to kill people more efficiently coupled with the continual glorification of violence and individual entitlement in our collective psyche is causing this.
As a clinical social worker, I feel that this fixation on mental health is tone deaf if we don't also critically examine the societal factors that allow and encourage the development of these types of worldviews and ultimately, behaviors.
1
The mental health argument by the right has worn itself out. What happens when someone who already has guns becomes mentally ill. The only solution is the one taken by most developed countries serious about gun deaths, dont have guns.
1
Ms. Barnhorst,
The only way to eliminate civilian firearms violence is compulsory universal education on this issue.
One of my MBA professors shared an article by Thomas Szasz titled Mental Illness is a Myth. To some degree I agree with Mr Szasz.
In the US and almost all developed countries the standard of living is very high. The availability of goods and services would be the envy of everyone living in developing countries. Having said that, there are societal problems of loneliness, lack of love and being isolated, in the USA and other western countries and when persons start to feel depressed about these societal problems we label them as mentally ill. The problem of loneliness is huge and I see it all around me. High rates of divorce, both parents working and children being left to fend for themselves or in the care of apathetic carers in day care etc. or left to watch cable TV (internet TV), YouTube or Netflix.
Older persons are under so much stress from loneliness and lack of harmonious family relations that they think suicide or other drastic measures is the only way they can cope with their lives. All of this while they enjoy what one would say good paying jobs and the ability to purchase all sort of goods and services.
Look at older persons in the west, almost all are living alone in old folks homes. What a terrible life.
My solution, as a start, is to start educating persons and families that we are social creatures and we need to not be UBER individualistic, learn to be forgiving and ignoring other's short comings, and be more inclusive of everyone around us. Be kind.
I am 91 years old and I greatly admire the students of Marjory Stoneman Douglas High. It is wonderful to see people such as you determined to do something about these recent horrendous events. My generation and the two following ones have failed to do so. The NRA must be defeated.
The Supreme Court has also failed you. You have learned early in life that the Justices of the Court are mired in petty personal attitudes and stupid arguments of “original intent”. The truth is that the second amendment is wrong in the modern world. If guns are available the mentally ill will get them. All of the right wing talk of mental health is totally inappropriate for the existing gun problem. The only answer is to stop the production weapons such as the AR-15. An amendment to the Constitution will accomplish that. As one who was a member of the NRA when it was an honorable hobbyist organization I know that radicals have no compunctions about killing innocents.
This can not be accomplished in a day or a year. You will do well to complete it in a generation. Hopefully some of the restrictions and mental health laws will help in the meantime.
10
While the mental health system can't stop mass shooters it can certainly assist in identifying and treating mental health issues.
It certainly doesn't help that Congress passed a Mental Health law and then did not fund it.
1
Of course not. No one is suggesting they stop shooters. It's up to schools to identify sociopaths through testing. Then it's up to police and the courts to apprehend them and isolate them from society permanently. If the authorities continue to focus on gun confiscation instead of apprehending & removing sociopaths, then other means must be used. I support Citizen Safety Committees, and I believe police would cooperate .
Pass the buck. Is that the answer? How many people suffering with mental problems could do the same amount of damage to others without the ability to obtain guns?
Even if the entire population was subjected to mental health screening, the ability to identify and help all those with destructive tendencies would be impossible.
And being practical, all the people with all types of guns right now, either their own or with access to someone else's, have not been subjected to mental screening and so might use any of those 300 million weapons in a mass fatal manner.
As recent history shows, people with mental problems don't all become mass murderers. Without a gun it is not probable that anyone, whether sane or not, could become a mass murderer.
2
As a former licensed Psychologist, I agree--we cannot identify those individuals filled with anger and rage who will go on to commit unspeakable horrors.
However, we can do more to prevent gun deaths from suicide. Give mental health more resources, especially in rural areas.
Our once proud country has evolved into a culture of angry and bitter people. Just look at the things people say to each other in comments sections. These disaffected young men are responding to this bitterness in our culture, and are wanting some for themselves.
So, yes, these mass murders are a psychological phenomenon, one that we can't solve by hospitalizing the killers ahead of time. But we can do something, psychologically, to prevent these mass slaughters. That would be to stop the victim, hostile, angry, blaming, ugly rhetoric and start being nice to each other.
Here we have yet another critical part of the discussion that many of us have only minimal knowledge of. But the question inherent in Dr. Barnhost's article extends to every aspect of the debate on gun control: In essence, can civil liberties be taken too far when they protect the rights of one to the detriment of the many?
I've read too many comments from rabid gun owners who cry, "Freedom!", "You can't take away my rights!", and on and on they went. Yet last week, 17 young people had all of their Freedoms and Rights taken away from them forever.
4
The calls we hear after every mass shooting to address the "mental health" of potential shooters are woefully misinformed, and are in reality a reflection of long-standing societal prejudice against the mentally ill. There are no mental illnesses (save perhaps very rare, specific manifestations of psychosis) that can make someone into a mass murderer. There is no way that Nikolas Cruz's depression could have motivated him to kill 17 people, that is simply not how depression works. His mental illness is likely the side effect of the same difficult circumstances and life experiences that isolated him from much of society, that embittered him, and instilled in him such a warped worldview in which he believed mass murder was an acceptable action. His behavior seems "crazy", but that kind of "crazy" is not the same as "mental illness".
Saying that it is only further stigmatizes the many innocent people in our country with mental illnesses who need help and compassion but are likely instead to be seen by many as potentially dangerous.
Our culture fetishisizes guns and violence (I suspect that prior to the shooting most of Cruz's instagram profile would not have seemed inappropriate to many gun-rights activists). Outrage, and warped, deeply irrational worldviews have now become staples of political and social discourse in our country. I suggest we look first to see how these facets of our society influence young men like Cruz before jumping to conclusions about mental illness.
1
My husband and I have both had careers as mental health professionals. People might be amazed at how many angry, gun toting individuals there are out amongst us, but most never kill another person. This Opinion piece describes the experience of thousands of professionals trying to help as best they can, walking the line between a person's rights and an unknowable potential.
1
I think that the United States of America's obsession with owning guns and fear of the right to own being taken away shows lack of mental stability. It could be looked at this way, why is one person's desire to own a firearm more important than keeping fire arms out of various unsafe situations that could hurt many. In other words, Why is your life so much more important than the many lives that are lost? Why are you so fearful that you need to own a gun? Guns are invented to kill, let's have a lot less of them please or none at all thank you. Learn to use a bow and arrow for hunting if needed, shooting a gun doesn't take very much skill and doesn't prove machismo or courage.
5
Fantastic article. Mental health is absolutely important and undercut in this country but many with true mental illness are not violent. Anger, resentment and neglect are not mental illnesses though they are equally tragic and ignored. By all means let us support our mental health system, but let us ALSO place restrictions on firearms as well.
1
The thing that would be in our power to change is the culture shared by a large section of the population of entitlement, rage against those different from themselves, bullying, lack of respect for others, lack of caring for others, the gun culture, self-rightousness, lack of understanding of our place in the universe. A big step in that direction would be to banish social media and hate media, including Fox News from our lives.
1
Everybody from the FBI to his 5th grade teacher knew that Nikolas Cruz was a particularly dangerous individual. The problem was that there was no place to put him. No available treatment facilities, no theory of therapy, no money. As a society, people didn't care.
Restricting guns is good but changing people's hearts is the only thing that would work, if we were willing to do it.
1
The idea that mental health evaluation and/or treatment can address gun violence is a red herring floated by the NRA and GOP to distract from the obvious - that sky-high rates of gun violence are inevitable in a country awash in firearms.
It is totally impossible to predict and weed out every potentially dangerous person among a population of 320 million. Some percentage of that population is sure to unstable and dangerous. No civilian should be able to obtain the tools that make mass murder easy for these violent few.
Very well said. And schools and teachers can not make parents get mental health help for their children. There are very strict guidelines for teachers and nobody can make a parent get treatment for their child. We can carefully word our concerns, but the choice is up to the parent. And removing a child with violent tendencies is almost impossible, because the rights of the individual child outweigh the right of the rest of the children.
Other countries have the same preponderance of mental health issues, likely have worse treatment, yet have almost no mass killings. It is the guns that separate the U.S. from every other country in the world.
4
Thoughtful, informative, and cogent article.
Mental illness is NOT the major causal factor in mass shootings whether these massacres happen in a school, a theater, a church, a government building, or at a country music concert.
The precise cause is hard to identify, but the means of doing so are almost universally known, though evaded by too many, - easily accessible assault weapons in civilian hands! No civilian honestly requires such weapons. The Second Amendment, properly construed, does authorize their pervasiveness.
To argue that someone who commits a heinous act would not have done so had he or she received appropriate mental health intervention is to say that it isn't possible for someone to commit a heinous act and be completely sane. That just isn't so. Hatred can motivate people to do all kinds of despicable things. But hatred isn't a mental illness even if it masquerades as one.
189
Teresa,
While I fully agree with you on this point. I would beg to question why someone with this much hatred is not viewed a someone with a mental disorder. Just a thought I got reading this article.
The mental health system is another part of the medical profession that is gorged with fraud. The Robber Barons want to see if fully funded with OUR tax dollars so they can rob us some more. They own the whole medical complex from academia on up to insurance, Medicare and Medicaid included. They would really profit from the "counseling" ramp-up.
Those of us who have used counseling know there are some very good practitioners and some plain old crooks who are just in it for the never-ending money they rake in from drug abuse and other criminal offenders who are required to see them.
GUNS ARE THE PROBLEM. GET THEM OFF THE STREETS OF AMERICA.
Do that and most of us won't need "mental health care".
5
It seems that many/most/all people have a degree of mental health that fluctuates around a mean. Good friends/family, good health, and good careers can move the dial towards sanity, with the converse also being true.
It seems that changes can be pronounced over even relatively short periods. Those changes can be persistent or transient.
If anyone's mental health can be temporarily compromised, then what does that mean for attempts to keep guns out of the hands of the compromised? How can we measure the degree of compromise or its persistence? What magnitude of proclivity would justify restrictions, how often would that be assessed, and who would decide?
The likelihood of gun-based tragedy is a mathematical product of the probability of mental compromise times the persistence of contact with guns. This is modified by the nature of the guns involved - because that nature affects what outcome someone can imagine themselves accomplishing with those guns.
Ms Barnhorst describes the difficulty of both assessing whether a given person could be a risk, and taking action. So shouldn't we also work on the other two aspects of the equation above, ie, contact and nature of the weapons? Limits on public carry and limits on military-type weapons could carry a much higher mental health threshold for ownership, one that is proactive vs reactive.
2
All guns are in the end result designed to kill. Whether it's a deer, lion, or bird, or a teenager, that is there purpose.
When shooters claim they shoot for sport, not hunting, there is a tiny dark sport in their brain that takes a fantasy satisfaction in a kill if they put the shot in the kill zone on their target and have theoretically defended themselves or their family.
The vast majority of shooters can control this fantasy, but all to often someone driven by forces that overwhelm the tiny dark spot revert to killing to appease the grievances they perceive as being unacceptable. When armed with a military style assault rifle mass carnage can result.
To all shooters, watch yourselves. You all have the tiny dark spot and it can sneak up on you.
12
You assume and project too much. Your conception of kill and target shooting is highly prejudiced and I suspect more than a little driven by hatred.
This argument you have made gives fuel to those who refuse to acknowledge that restricted access to AR15's is not in any way tied to their second amendment rights. "A well regulated..."
Perhaps 1) the diagnostic manual needs a new category for angry people with extreme violent fantasies 2) laws need changed to recognize this threat and prevent and remove access to guns, regardless of whether the person gets treatment.
4
A new category of mental illness will NOT protect us from guns!
I'm a gun owner and I have 4 guns. A 20 gauge 12 gauge shotgun. A .30-30 Winchester rifle and a 50 cal. muzzleloader. Everyone keeps asking, "So what is the solution?".... Here's a solution:
Ban ALL handguns. Ban all rifles that shoot more than one bullet and use a cartridge system for loading bullets.
Shotguns and single shot rifles would be the only legal guns available. The shotgun and rifle would provide citizens with a gun for home protection and for hunting purposes. (And for fighting a tyrannical government, if needed)
Implement a gun buy back program that would last for 1 year and would be paid for by the US government. Funds for this would be directly taken from the defense budget. All the guns purchased would be destroyed. After the 1 year buy back program is finished, any person caught with a hand gun or banned rifle would get a mandatory 10 years in prison. 2nd offense is 30 years.
Insurance for each gun owned would be mandatory also.
79
I'm beginning to suspect that the NRA begot the mantra that better mental health care would stop gun violence to detract folks from the oh so obvious problem and its solution. Our country is awash in guns. Guns are easily available, legally and illegally. Until the ubiquitous idolatry of guns is confronted, angry, and not so angry people, impulsive or depressed or fantasizing or lonely men -primarily, will be killing their fellow humans, and coyotes, and most anything that crosses their sight with their death dealing, false security blanket, their gun.
We who work in the mental health system must
14
When we hear gun freedom people react to a mass shooting, we understand that the first inalienable thought in their minds is that the gun culture they promote cannot be responsible for the tragedy. Cannot. It must be something else. More law enforcement officers on campus. Arm the teachers. Build a fence system around campus and screen all entering thru a metal detector. Train conceal/carry permittees to be campus protectors. Radically change the environment and relationships that students experience during their education years. Force teachers to abandon their pure educational ethos in favor of a more practical approach focusing on the ever-present threat of an armed confrontation.
To me, that looks like a lot of change. It looks like we would be giving up something pretty valuable, something we take for granted, but will regret it once it’s gone.
What do we get in exchange? We get the preservation of unfettered freedom for a minority within our society: gun owners. Everyone else must accept that their freedom will be unabridged. Everyone else must accept the possibility of senseless, wanton murder of children, teachers, mall shoppers, government employees, elected officials, etc. etc. etc. Just accept it. And shut up.
9
If violent fantasies were a mental disease, most of humanity would have to be hospitalized. If depictions of violence were a causative factor in mass shootings, we would have to censor all of world literature, including the Bible and Shakespeare. There are excellent studies of perpetrators of mass atrocities and of serial killers out there. Most of those people, including those who calmly shot toddlers in the Holocaust, were normal, ordinary people. Violence is a result of a combination of means, opportunity, and some kinds of trigger that removes social prohibitions. Violence is also pleasurable and addictive because it gives you the ultimate power: power of life and death. None of these factors can be controlled except for one: means. Take away the guns and there will be no mass shooting. Give guns to “law-abiding citizens” and some proportion of them won’t be law-abiding anymore.
34
Very, very, well said Mor. Your comment is one of the densest concentrations of "inconvenient truths" that I can recall reading in relation to these sort of events. If brutality could be limited to such honesty we would all be much better off.
"There’s no reliable cure for young men harboring violent fantasies. Keep guns out of their hands."
I don't think you get it, Ms. Barnhorst. NRA people, who value guns more than the lives of their own children, are one who need to be confined inside the mental health system. The NRA folks are the ones who promote, not violent fantasies but, violent realities.
7
She gets it! It’s obvious.
Mental health is not the key issue in mass shootings.
America’s addiction to guns and violence is a disease. Too many innocents have died. But the fact remains that NOTHING has been done on the issue of gun related violence.
The key issues are the proliferation of and the easy access to guns. There are an estimated 357 million firearms . An estimated 31% of households, or one in three Americans, own guns. And what are guns used for ??? Guns are used for no other reason than to kill !!!
The high and unacceptable incidence of gun related deaths in the US is not only a scourge and cancer in America it is a National Security and National Health risk issue adversely impacting all Americans.
But debates in Congress and the Senate continue to be focused on peripheral issues, like magazine size. But the facts remain that the culture of gun violence is out of control !!! and NOTHING has been done !!!
The reality is that all of the debates on the need to improve controls on guns and gun ownership are DEBATES ON THE MARGINS. Any new legislation to strengthen gun controls will affect only new purchases of guns. Any such new legislation will leave the remaining guns already owned unaffected, grandfathered by earlier laws. Tinkering on the margins has not and never will work. There is only one solution to solve the issue of gun violence and deaths.
The Second Amendment must be repealed.
The new law should be called: “The Innocents’ Law.”
Bring peace to America.
9
Mental health is a distraction, a ruse created by the NRA and the military industrial complex intent on creating a huge market for the personal ownership of military assault weapons and ordinance. The controlling issue is the 2nd Amendment which has been bloated out of any logical interpretation to mean, the unfettered right of citizens to buy any kind of weapons and carry these weapons in the open or concealed in public, for self-protection - from what - the United States government?
It is time for responsible journalists to focus on the actual language and intent of the 2nd, and expose the NRA's interpretation as propaganda, as a lie by a lobbyist for manufacturers of military weapons. It is time for the Fourth Estate to relentlessly objectively create informed public opinion regarding the 2nd Amendment.
The 2nd Amendment was about the right to own a musket and form a militia at a time when there was no National Guard, no standing army and no police departments - the 2nd is not about a "god" given right to buy military weapons of mass destruction, or even a flame thrower from Elon Musk.
21
It doesn't matter what you think. The Supreme Court ruled on this already. Case closed. There is an individual right to own guns.
The idea that a better mental health system can "catch" all potential shooters is a fallacy cooked up by the gun lobby to keep gun laws the same. Also, no Republican has ever brought to the floor a proposal for better mental healthcare or healthcare in general. I hope the conservative members of Congress read this opinion.
18
AMEN from this retired psychotherapist. Angry young men should not have such easy access to such guns. No one should. In my professional opinion.
4
‘’Focus on ways to put some distance between these young men and their guns”
The author must be talking about gun control.
Unless there is some special meaning to the 17 deaths that occurred in the recent school shooting in Florida, I have no idea why she would think any new legislation would be passed.
I’m not saying it’s not sad that these kids were slaughtered, I’m just saying this sort of thing has happened before and I think, generally speaking, America is OK with it - The deaths are not worth compromising their freedoms over.
I know this sounds barbaric, but that’s the way it is. It’s
Thank you for a no-nonsense, experiential assessment of the oft-mentioned "panacea" or scapegoat for the problem that will only be affected by restricting gun sales and ownership. As you have written, "Even if all potential mass shooters did get psychiatric care, there is no reliable cure for angry young men who harbor violent fantasies." Now let's get real!
3
Most of these shooters are on psyc meds. These people are prescribed drugs to dampen their behavior. But, if we are trading a depressed person for psychotic person, maybe we should rethink these meds.
If opiods are more problematic than the beneficial, the AMA and doctors are willing to cut back on these scripts. Maybe the same needs to be done for these pysc patients.
1
Amen. Over 15 years in community mental health and I concur with this author 100%.
2
Unfortunately, these young men will always have access to deadly weapons in the form of vehicles, hand held weapons, and easily made guns like the ghost guns or the "Home Depot" gun made from plumbing pipe. The tech is out of the bottle and it cannot be put back in. We may need to put in place the Israeli model and train/arm some of our teachers to have an immediate defense for soft targets like schools.
1
"...train/arm some of our teachers..."
It only works if it's done. Let's do it. If these gunmen don't know who is armed, they may want to rethink their jihad. There is no reason why students and teachers need to be bullet magnets. Self defense is a human right.
7
Mike,
What kind of weapon should a teacher have at their disposal to stop a shooter with an AR-15? Didn't we already go through this arms escalation with our police? We decided not to end up looking like a militarized state with every bank guard and cop on a bike having an AR/M-16 slung over their back or at the ready.
What if we remove the AR-15 BEFORE we send a lesser armed teacher in to fight for our kids lives?
2
So teachers who are already stretched thin doing actual teaching along with mountains of administrative work will now be required to spend hours learning to shoot guns. Sounds great. The United States already lags far behind other countries in terms of educational achievement. This "solution" will just exacerbate this situation.
4
This is so true! A Community Psychiatrist has weighed in. Let me, a retired Clinical Psychologist also weight in:
Decades have been spent, many researchers have tried, but there is NO reliable or trustworthy method for predicting Violence. Not unless someone advertises it - openly, along with desire, intent, a plan and a methods that is available to them. Let me repeat: Unless someone says so, out loud, to a professional, no amount of psychological testing, hospital observation or known, tested method, can assure the prediction of violence by any human.
That means we cannot simply assume that mental health professionals - alone - will prevent the next mass child slaughter.
That means these assault weapons must be dealt with.
That means the Second Amendment worship by some must be dealt with.
That means we are derilict if we fail to amend the Constitution or pass strong gun control legislation.
That means Congress is especially derilict to just sit on its hands and fail our children. (And since we all start out as children, it fails all of us.)
Shame on the GOP Cowards failing this nation!
13
Exactly. The options for mental health professionals are perfectly articulated here. Now, if only all angry men could not access AR 15s or similar weapons and ammunition, or only use them in regulated ranges there might be fewer deaths, injuries and trauma for all us. I believe these continued tragic events traumatize all of us. While mental health funding is critically important it is folly to think it will even begin to address this problem or prevent future horrors like Sandy Hook, Las Vegas, Pulse and Marjory Stoneman Douglas.
111
Who decides who is "angry"? I see idiots all day and I get angry at the stupid things they do to make life harder for others does that mean I need to be "examined"?
Get a grip, mental health is a red herring.
The problem is access to M16 clone guns and their accessories.
1
dear AKM, why not have the assault rifles stored at the shooting ranges?
That was my intention, if not clearly stated, that they only be accessed and used at a regulated range.
It would be hard to make a statistically reliable case that the US has more unstable or mentally ill people than all other countries. However, we have far more guns than other countries, with many elected officials who are arguing that more guns in more places (schools!!) will make us much safer. Maybe the problem is simply that we have more unbalanced, mentally ill elected officials.
12
Why did it take a week for someone to say this? We can talk finding and treating people with mental health issues (or just evil intentions) all we want. But, how truly successful is treatment of the mental health conditions that would lead one to kill? I would challenge those promoting this issue as the means to the end of gun violence to prove the probability of success is anything greater than de minimis.
Consider this simple equation: Mental Health Condition x Gun(s) = Deaths
Given the difficulty of finding and treating the first variable, it is quite clear that the only way to quickly and effectively reduce the final, tragic outcome is to take Guns to zero.
Now, I'm not making a 2nd Amendment statement here, that is more complicated and I happen to have many responsible gun loving friends. I quite enjoy going to a shooting range and shooting at targets. I do not think gun burning is the answer.
But, this math is real and should not, or rather cannot be ignored by anyone to society's great risk. However adapted (e.g. wider vs. targeted limits) the simple and clear answer is the need to control guns.
2
It's characteristic of the socio-economic system we've "chosen" that we err too readily on the side of individual rights rather on the rights of the society to promote LIFE, liberty, and pursuit of happiness. There's a fine line between being an angry young man w/poor impulse control, and one who also harbors violent fantasies. It's only when that person acts out either toward animals (pets) or other people (significant others) that we can clearly witness a line crossed. In the latter case, that individual should never be allowed gun ownership. In a sane society, "individual rights" do not include threatening the health of the society writ large. The issue of those who fantasize but never act out is a far thornier one as this column rightly elaborates.
2
I'm not in the mental health field but have been a longtime activist working to pass sensible gun laws. What Ms. Barnhorst states here seems spot-on to me.
Clearly, people who commit violent crime have some emotional/mental traits that are very unhealthy. Perhaps these traits don't rise to the level of a definable mental illness, however. Still, for their sake and that of society, they do need, and deserve, help.
But I can see how expecting the mental health services community to effectively disposition these persons (in a front-line effort to avoid violent acts) is folly.
WE NEED SENSIBLE GUN LAWS AND WE'VE NEEDED THEM FOR YEARS.
3
Perhaps intensive violent video game cognitive therapy is the answer. Lock kids in a room and bombard them with exposure to a culture of virtual violence. That will no doubt snap them back to reality and help them see normally again. Maybe technology can be our friend.
There is an important information in the February 17, 2018 issue of the Economist, pg27. It is claimed by the right that the increased mental health issue in the US is responsible for these mass shootings.
The fallacy of the argument is that the toll of gun violence in other rich countries, with comparable health indicators, is negligible by comparison!
Ergo, it is the availability of guns, especially assault weapons in the hands of murderers that do the carnage, NOT the health condition of the perpetrator!
4
Powerful essay.
What you are describing, Dr. Barnhorst, is what we've read about "lone wolf" terrorists: angry, lost people.
Let this be a wake up call.
I find it off-putting that the resentful guy who is being regularly bullied is the one to be treated and locked up in a mental institution, but the bullies making his life a nightmare are the normal ones and not part of the problem at all.
1
If that guy has taken it into his head to randomly kill people (most of whom didn't bully him) it is warranted. Since plenty of girls get bullied(myself included) yet they don't go pick up a AR-15 and kill people, let's not pretended this is about bullying and retribution.
1
All other countries have people with mental illnesses and their psychiatrists apply the same rules regarding involuntary hospitalization.
The US gun death way surpasses all other countries . MAGA! Thanks to the NRA and Republican Congressmen prostrating themselves.
Availability of guns IS the only variable. Not Hollywood, not the FBI, not treatments of mental illness.
Thank you Dr. Barnhorst. I hope our legislators and our president read your op-ed.
1
There is growing suspicion that legal drugs like anti-depressants in the class of SSRI's contribute to the problem in young people.
No single solution will work to prevent these mass killings.
Better gun control (e.g., a ban on high capacity magazines) would help. But there will never be enough gun "control" to prevent these killings. There are too many guns out there, won't confiscate them if legally owned and we can't wish them away--a person who wants a gun will get one. In addition to whatever gun control we can get the country to accept, we need laws that provide for court-ordered search, confiscation, detention, evaluation, counseling, and, if necessary, confinement. Whether any such legal scheme would be constitutional, I don't know.
If the FBI had acted promptly to notify Florida authorities about the information it had received, and if the Florida authorities would have acted promptly to do whatever way the law allows, that killer would not have gotten into that school, gun or no gun.
The gun control advocates will get nowhere in this country by beating only that drum. We've got to do whatever we can, and everything we can.
1
perhaps if we give more attention to those kids who don't fit in we can address their problems more directly...after all, there are gifted kids as well as disruptive kids who are bullied and cast out of the mainstream...some of the gifted are written off as "weirdos," some of the disruptives as "anti-social."
programs that re-frame studies and behavior norms are worth exploring (one "gifted," in recent memory, allowed to progress outside the restrictions of a graded curriculum, earned respect from his peers as a tutor and occasional project leader among his once-antagonisitic peers), very often "aggressives" can be redirected by other forms of "opposition," personal challenges within dependable structures...where it was once popular to offer "incorrigibles" a choice between jail and the army, (not a good prospect, but those of us who've had some of our rough hewn habits shaped by military service and discipline can appreciate the notion) programs similar in nature, active, interactive, team-based, physically challenging projects, a mix of discipline and assigned responsibility, etc., might help to heal a frayed spirit and focus an otherwise dis-integrated personality.
the key to avoid losing these kids is to listen to them before assigning them to baskets.
1
Hmm, are you suggesting no girl has ever "not fit in" because I assure you that plenty of girls fall into the weirdo basket. Yet this has not led women/girls to shoot up schools or commit other sorts of mass murder and very little regular murder as a rule.
So spare me. This is about something different.
1
I hope everyone reads your piece!
This is why all the Republican claims that the key to treating our problem with mass shootings is about getting guns out of the hands of mentally disturbed people is a bunch of baloney.
After the shootings in Parkland the hue and cry about the FBI missing a chance to stop the shooter was completely inappropriate. The community of Parkland did the best they could to corral this disturbed person but there is only so much one can do, just like Dr. Barnhorst has said. Access to these guns are the problem because in the land of the free, you cannot commit someone to a mental hospital just because they display the signs of a mental illness. They can't be incarcerated or committed until after something occurs.
And don't get me started about the lack of funding for mental health services...
4
Absolutely the proper response. Catastrophic mental breakdowns resulting in unbridled mass carnage cannot be predicted, period. The symptoms for this type of event are non existent, the symptoms displayed by most of these people are broadly found in any population.
I agree that guns should not be handy to unstable people for hundreds of reasons, but if those symptoms become a disqualification and they are adjudicated fairly, well over 250-300 thousand people will be included.
It’s the guns friends, it’s obscene massacre power of the guns. Every murderer is mentally deranged, uncivilized and a true danger to society.
The rationale of some gun owners is they need them to kill the mentally ill. This is “rat wheel logic”.
We need to make possessing the tools of Catastrophic carnage a serious crime. I will remind the responsible gun owner that if a person shows up with 100 rounds on clip your shotgun, or pistol will not suffice....get this military equipment off of our streets, out of our homes.
Consider how unfair it is to ask our law enforcement professionals to be prepared to combat criminals that have the “legal killing equipment of a battlefield soldier”..... you can’t be serious in thinking that these weapons are retail home protection equipment.....we have escalated the death level flying in the face of common sense.....
1
“Make the possession of the tools a serious crime” do you own a car, truck, steak knife, or a pressure cooker? Those are the tools of mass carnage in Europe and elsewhere where guns are not as available. People are the common element not their choice of tools. People with mental problems, no matter what you call those problems. Average people don’t shoot themselves or others for no reason because it’s not normal!
2
Despite that fact that there is only a modest correlation between this kind of violence and mental illness, most people continue to believe that one must harbor a psychiatric diagnosis to comment such heinous acts. It is time for more mental health professionals to speak up and lead the conversation. Unfortunately, people do not have to be insane, crazy, call it what you will, to do such things. As the author states "there is no reliable cure for men who harbor violent fantasies." I would just add that a significant lack of empathy is common among many of these perpetrators. This lack of empathy is often exhibited in people who are sociopathic or narcissistic, as well as some on the autism
spectrum. Bottom line however is that it should not be that easy to get your hands on a machine gun
2
Perhaps instead of once again throwing up our hands as "nothing more can be done", everyone involved in this issue should leave their pre conceptions at the door and think long nd hard about trying to do more.
If Nicolas Cruz and Adam Lanza and many other mass murderers, who showed dangerous signs to multiple people in different settings, are not obviously mentally ill enough to be prevented from buying or owning weapons, the problem is not that mental derangement is so hard to see. It is that those who work in the mental health system have become so afraid of overreacting that they prioritized their "rights" to murder over the right to life of innocents.
Amy Barnhorst is right, however, in her conclusion that what is critical is keeping angry young men (and women) away from guns whether or not they meet the excessively high standards for removing guns from the home and keeping people from purchasing more. The standard for gun ownership should be a lot higher than just not having a diagnosable serious mental illness. When the cowards in Congress can't even keep gun purchases away from people on the "no fly" lists we need some major changes.
It is much easier to ban guns with large, swappable magazines than it is to keep anything that is in circulation "out of the hands" of people who want it. We need strict laws with serious consequences for ownership of high-capacity magazines and the guns that accommodate them. It's the only answer that works.
1
"The one concrete benefit of officially committing him would be that he could be prohibited from buying a gun from any federally licensed retailer." Is that even true anymore, after the legislative action taken by the GOP and signed into law by POTUS a year ago? I am asking the question. What was the extent of that roll-back?
Decades ago, it was accepted wisdom that those who talk about suicide rarely actually kill themselves. After enough cries for help were ignored, with disastrous results, the accepted wisdom has become that, when a person talks about suicide, he or she needs immediate intervention.
Although I'm not a mental health professional, I would posit that the same new wisdom applies to those who threaten homicide. If the people closest to the patient in question were afraid of and for him, and he had, in fact, posted murderous intent and then bought a gun, the indications are that he genuinely was dangerous to himself or those around him. One's family tends to make allowances and cut a good length of slack; it if gets to the point when a person's behavior exceeds even his/her family's tolerance limit, the red flags are obvious.
I understand that the emergency psychiatrist who wrote this article had very little choice in her treatment, from a legal standpoint. However, her story does point out a potentially fatal gap in the ability of mental health and law enforcement professionals to constrain someone like her patient and remove all guns from his possession, while preventing him from purchasing more. The laws need to be changed to erase that gap. No, detainment of angry young men isn't the answer. Preventing their access to mass murder weapons is.
1
The article states you can't identify the population and therefore can't stop them from getting guns then it says we should find distance between these young men and their guns without giving us a way to do it.
If you can't identify these young men then how can you put distance between them and their guns.
You can't and the writer by this logic is making a argument although not stated is implicitly telling us that gun is that there has to be a distance between all young men and their guns because that would be the only way to put a distance between a population you can't identify and guns as this population would not have to be identified to stop them from getting a gun.
This is how the New York Times operates.
They want to advocate in this case a law to stop all young men from getting guns but will not state the real purpose of the article in the article.
This way they can state something and do not have to defend themselves from the statements they only implied.
So even though it wasn't stated I will state my objections to this implied message.
You should not take away a right people should have because some will abuse that right.
This population we want to separate from guns should also be separated from the use of cars because a young man can kill with a car as easily as kill with a gun.
Would we accept a law that would make it unlawful for all young men to drive because some will abuse that right.
You tell me.
You have no rights that are completely exempt from reasonable regulations to protect public safety.
The right to protest is in the First Amendment, yet you may still need permits for larger protests, and there are limits on where and when you can protest The right to free speech is in the First Amendment, but you do not have an unlimted right to threaten people or make fraudulent claims when you sell a product.
There is no reason the 2nd Amendment should be exempt from restrictions in light of our current frequent and serious harms to the safety of the general public from gun violence.
4
Like most liberals you miss my point completely
I was not alluding to the second amendment.
Just like we have a right to buy a car we should have the right to buy a gun.
There are many more people who are severely injured or die in car accidents than the number of people who are injured or die because of guns.
If we shouldn't' regulate who can own and drive a car why should we with guns.
This is not as crazy as you might at first think.
We know there are people who drink and drive.
I know of no laws that stops these people from buying or renting a car for example.
There are no laws that makes it illegal for a person who is drunk to buy gas.
There are ways to make it very difficult to drive a car while drunk which have been suggested by some but not by the Times.
My point was a simple one.
What applies to everything else that when used by some can result in great harm should also apply to guns.
1
But we do regulate who can drive cars. I fail to see your point.
And young men are not carrying out mass killings with cars. When they start doing that, it will be an issue of public safety that should be addressed just as we address any issue of public health.
Your generalizations about "liberals" is just silly. You are an individual; so am I. I made a measured, cogent response to your assertion that "you shouldn't take away rights because some people abuse them." I only said that all rights have limits. Our right to swing a fist stops at the other guy's nose.
Public safety is an American issue, not a partisan one. If widespread intentional "abuse" of a single right robs ten thousand Americans per year of their lives and ALL their rights, we need to re-examine how that right may be exercised without unnecessary danger to others not exercising it. That is not liberal or conservative; it is simply sensible.
3
The idea that mental illness, rather than guns, kills people is simply an attempt to avoid needed gun regulation. It is perverted, absurd, and cynical. Guns kill people. The NRA, its political contribution recipients, and other abettors are not serious about addressing deficiencies in the mental health system. They are solely interested in selling guns and ammunition. Mental health for them is a red herring.
In one fell swoop the NRA and its enablers have 1. diverted attention from the real problem, 2. threatened support to an under-resourced system, and 3. increased disincentives to seek treatment. A perfect trifecta.
1
Thank you! It authoritatively explains what I have been shouting at the television (again).
151
Barbara, please turn the television off, and maybe internet news too for good measure. They're designed to keep you watching and clicking by hacking into your brain and pressing all of your FOMO buttons. When you go back to these things, I recommend no more than 5-10 minutes a day. You will be a much, much happier person. Trust me on this; I post because I care.
People should feel terrified when they appreciate how little mental health professionals can do under state and federal law to mandate treatment for those who have anti-social personality disturbances- the kind that predispose someone to cause real harm. The author describes the limits perfectly- even if someone is involuntarily admitted to care, the most they get is 48 hours in a controlled environment. The law does not allow clinicians to involuntarily hospitalize people simply for demonstrating terrible judgment, bizarre behavior, or personality disturbance.
Those who have severe and persistent mental illnesses like bipolar disorder and psychotic disorders, who do end up hospitalized, are typically so afraid of other people when they are in the throes of mental illness that they are incapable of hurting anyone other than themselves, as they tend to isolate.
Someone who has personality disturbance and concerning traits can bypass the law and hospitalization by interviewing in a calm and deliberate way.
Even if they do end up hospitalized, the author’s point remains: what stops them from privately obtaining guns? Mental health treatment cannot solve that problem.
237
Here’s a true story:
Someone in the throes of psychosis, went to look at pistols, thinking suicide.
The seller eagerly told her how the pistol would harm another person.
The psychotic person felt paranoid, thinking the gun seller imagined she intended to harm someone.
So she fled!
Yes, these folks are generally not gonna harm anyone else.
1
But mental health treatment is a missing part of the solution!
10
i agree please read my post. This is due to court decisions and the mental disability rights activists, who care not for the general population's well being but only for a small minorirty of mentally ill people. Since when is it alright for someone even with a mental illness to go out and commit violent crimes? They also have the right to refuse or stop taking medications that will stabilize their condition. Something is obviously not right here.
2
So, the mental health system can’t stop them and obviously, law enforcement can’t stop them either. What makes anyone think that more laws will stop them? Something tells me that deranged criminals are not particularly interested in the law. There is no simple fix for this problem.
1
There are several strategies that would at least reduce the number of guns in the wrong hands as well as the damage guns can do
- No more magazines that can fire 30 rounds. That's for the military, not private citizens
- You have to be over 21 to own a gun ... if you can't drink legally, you can't be trusted with a gun
- Every gun would have a title much like a car has a title, so in the event of private gun sales, there's a chain of custody
- Every gun owner has to have a license similar to a driver's license, which would require both a written test and a safety awareness test
- Every gun owner would have to undergo a psychiatric exam before obtaining the gun license
- Gun owners would be required to carry liability insurance on their guns
These are all common sense and would not prevent responsible people from owning guns. A few bad people will always be able to get a gun, but let's make it as difficult as possible!
5
Agreed. No simple fix for some problems. But we certainly can and should keep assault weapons like the AR-15 out of the hands of civilians.
1
Laws may not stop people.
But Laws can stop gun sales and gun owning!
Laws can also LIMIT bullets being purchased.
5
The mental health professional is NOT making fair compatible comparison between her experience with the unidentified patient she describes and the reported deeply troubled reported psychological history of the alleged self professed "professional school shooter" Nikolas Cruz.
Florida public health / social services officials and the FBI, both of whom are reasonably presumed to be professionally qualified in identifying potential violent offenders, have publicly admitted their failure in recognizing obvious warning signs in Nikolas Cruz's behavior. Involuntary hospitalization would have been a temporary stop gap measure whereas denying Mr. Cruz access / possession to firearms on an interim basis would have been easier to effect at the state level.
2
I am a mental health professional, and fully agree with the author. It seems to me that politicians who put the emphasis on the mental health aspect of mass shooters intend to distract us from sensible gun control legislation. In other countries where there is poper gun control, mass shootings are rare. So the issue is clear: guns, semi-automatic/automatic weapons are too readily available in the US. Just when are the Americans going to choose our children, and our fellow citizens over guns? Just when are our politicians going to value the lives of their constituents over the NRA's money?
75
Another article reflecting the disdain in this country for men, particularly young men, and their particular issues in a society that's turned its back on them. It's no surprise that the writer, representing the mental health system in this country and female, would deny any responsibility in mass shootings. Much better to defer accountability and hide behind gun control, as if guns pull their own triggers.
Men in general, and young men as in this case and so many others, are the victims of enormous institutional failure in this country. Yes, I said "victims." But the author and most Americans don't believe men can be victims.
They don't believe that fatherless families, single mothers, school systems focusing only on "girl power," unnecessary drug treatment, mass shaming and a society that continues to throw them overboard can create mental health disorders in young men that drive them to mass shootings.
Yes, by all means keep focusing on the guns. And if you get your wish, lookout for pipe bombings, car/truck mass murder and other ways to kill.
A long as America can't look this problem straight in the eye and face up to the fact that mass shootings are about us and who we've become, it's all too easy to blame the weapon and walk away...just like this author did, with help from the NYTimes.
6
How about addressing the issues you mentioned AND making it harder for people to use guns irresponsibly? They're not mutually exclusive.
1
Your defensive stature keeps you from seeing the real problem, and it does indeed revolve around being a young male in America, although you should recognize that young males in many other countries display the same murderous anger. Where do think ISIS came from?
Go ahead, blame the author and everybody else for not solving the problem. But you yourself apparently have no solution either.
I would investigate ways to socialize these angry guys (because they usually are guys) with communities where they can bounce their anger off each other until they find a way to live with it or dissipate it.
Oh, this is just silly...yes, men are trapped within a system of our own making, but that touch of testosterone makes for a much more aggressive agent. Just compare the number of men who are incarcerated to the number of women. Of course, poverty and drugs play their roles, but so do things such as institutional racism and misogyny which are completely overlooked by you. Yes, I do blame the weapon and especially the system that allows for our country being flooded by weapons of all kinds.
This op ed piece is exactly right. The answer is in putting back into place the ban on semi-automatic and automatic weapons and bump stocks. Period. No one needs these weapons with the possible exception of law enforcement. They must be restricted. Meanwhile access to mental health services must be improved...with mental health given the same weight as physical health in our broken healthcare system.
271
MountainM, I think so many of us feel the same as you, but how do we retrieve these, the worst of weapons, that are already out there? This issue must be addressed, along with future bans, because it provides justification to the current owners: "I need mine because they have theirs".
3
you dont need an ar15 to kill a lot of people. ban the ar15 and there will be plenty of other guns, trucks, planes, knives et al with which to kill people.
we have to figure out the mental health side of this to make it stop.
There still is a ban on automatic weapons.
There never was a ban on semi-automatic weapons.
The overwhelming majority of weapons in use and for sale are semi-automatic.
Thank you! In Charleston where I work as a psychiatrist in both private practice and the academic setting (Medical University of South Carolina) hospitalization of individuals with true psychiatric illness is difficult. It often involves going to the emergency room and waiting several days for a bed to become available. There is another facility that is a little easier to get into but they do not accept most patients with Medicaid and they are frequently full as well. The prevailing idea that all shooters have any mental illness let alone an illness that is treatable further stigmatizes the vast majority of individuals with mental illness who are never violent. The National Alliance for the Mentally Ill released a thoughtful well-written statement to this effect.. Blaming shooting on mental illness is a smokescreen that avoids looking at the real issue - America's devastating and destructive romance with firearms & the pervasive misinterpretation of the 2nd Amendment.
438
Doctor,
Normal individuals don’t shoot strangers for no reason. Individuals who have mental issues do. The fact that we as a society can’t see that and detain them is a major part of the problem because where there are no guns the same people use knives and cars!
I need to ask, respectfully, why do you believe the 2nd Amendment has been pervasively misinterpreted?
I cannot believe the responses here from mental health professionals that directly contradict what my school psychologist friends and our police have direct knowledge of. WE had one of the earlier school shootings, remember the Thurston High School shooting May 21, 1998? Expelled student Kip Kinkel first murdered his parents before engaging in a school shooting at Thurston High School in Springfield, Oregon that left two students, Ben Walker and Mikael Nickolauson, dead and 25 others wounded. Kinkel is currently serving a 111-year sentence without the possibility of parole
Kids bringing weapons to school and talking about killing indicates some degree of mental illness. Sometimes people just blow my mind.
Amazingly Barnhorst has completely missed the topic under discussion. No one is suggesting designating people mentally ill and forcing treatment on them. What is being discussed is mandatory reporting [as is the law for teachers] and that the data go to a national background check data base. Bring bullets and knives to school, get reported -- before showing up with a gun. Then the subject would be unable to pass the background check. This is what is under discussion
Mandatory reporting is what we are talking about here and Barnhorst should have reported her patient.
2
Thank you- this needs to be widely circulated. Cruz's volatility and high risk for violence were well known, but you CANNOT commit someone unless there's "imminent risk", just like law enforcement cannot arrest someone until they have done something illegal. The only thing we CAN do is limit access to deadly semi-automatic weapons so that the damage, when it happens, it limited. This is true for all societies and cultures across the world.
36
I love your pointing out that "there are no reliable cures for insecurity, resentment, entitlement and hatred." We need to understand the difference between diagnosable illness and cultural cues connected to individual attitudes. However, I wonder if we did get boys with insecurity, resentment, entitlement and hatred into therapy, could they learn alternate ways of handling it? If therapy could help (real question), mightn't we require therapy -not hospitalization- for anyone espousing hatred on the grounds that they *are* a danger at some level?
9
As a practicing psychiatrist I think Dr. Barnhorst's article is quite accurate in explaining the complexities with mental health treatment. She is on the front line and there are some personalities that are determined to resist help as she points out. So often people want to be treated in the same passive way medical conditions are treated, and that doesn't always work out in mental health. As we are learning from PTSD, invisible wounds can result in violent behavior, and the individual must be willing to admit there's a problem before the problem can be addressed.
13
Not only can the mental health system not prevent mass shooters, neither can any feasible gun control system. As the Charlie Hebdo and Bataclan nightclub attacks show, even the tight gun control laws that France has can't stop mass murder.
We could probably reduce mass murders through better coordination between mental health professionals and the NCIS database. Higher penalties for illegal possession of a gun would likely also help reduce the day to day carnage that is a bigger problem than the much less frequent mass murder.
There needs to be compromise by both sides. I would suggest that whatever we do should be focused on keeping guns out of the hands of criminals and the mentally ill, while recognizing the right of sane, law abiding citizens to own guns for defense, hunting, target shooting or whatever.
1
"Not only can the mental health system not prevent mass shooters, neither can any feasible gun control system. "
This is contradicted by the facts. In developed nations with effective gun control systems, the number of mass shootings is far less. In fact, "the US had nearly double the number of mass shootings than all other [developed] 24 countries combined in the same 30-year period [1983-2013]." Between 1983 and 2013, the US had 78 mass shootings; Germany, in second place, had 7.
https://www.scientificamerican.com/article/6-things-to-know-about-mass-s...
The data is clear. Sensible gun control is the answer.
5
With the young males, hold accountable the parents and those responsible for them. The people who took in Cruz last month knew he had all those guns. They had a toddler and numerous pets, for pete's sake. Yet, they let him have the guns in their home - failing to even consider he had a duplicate key to the gun storage container. So many levels of stupid and careless enabled this 19-year-old man who was know to be dangerous to animals and his neighborhood and other classmates even in middle school. Tick tock. Every community has these young males and every community has adults who make excuses for them.
5
One can't eliminate anything in this world. But we can DRASTICALLY REDUCE, and gun control would certainly do this. What happened in France was extremely rare. That's why it was shocking and made the news. Here, something like that is "bah, just another day in the USA".
2
When the Republicans allowed unlimited corporate donations to political candidates, they said it was ok because voters could see who were making the donations and could judge accordingly.
They then proceeded to pass legislation to make it impossible for us to see who was making the donations.
Similarly, Republicans oppose gun restrictions because mental health is the real problem, and then proceed to cut coverage and funding for mental health.
35
Don't worry. The politicians have absolutely no intention of appropriating additional funding for mental health. It is just distracting talk designed to get them past another news cycle until the furor calms down.
53
This isn't going away. The odds of this being the last school shooting are somewhere between Slim and none, and Slim just left town.
This article perpetuates the intellectual fallacy that for us to consider a solution, it must be a complete, stand-alone solution or it's not worthwhile. The truth is that while the mental health system "can't stop mass shooters", it "can help to stop mass shooters". Right now it's a non-factor. The honest approach would be to make it one of the many factors that are considered during a background check.
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The fallacy addressed by the author is that mental health professionals are able to definitively identify likely mass shooters and then use existing laws to institutionalize these disturbed individuals on a long-term basis. As the author relates, this is not true in California. I would guess that a survey of the state laws governing non-voluntary institutionalization would validate the conclusions of this op-ed across the nation.
If you are proposing that a visit to a hospital should result in an alert that makes it more difficult for a would-be purchaser of firearms, that's something that needs to be taken up by politicians.
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And how would you operationalize that? Would you station a mental health clinician at every gun show and firearms store? I'm sure everyone would willingly submit to a mental health screening. What instrument would you use? PHQ9? Hamilton Depression Scale? You apparently missed the part about how most people with a propensity towards violence don't in fact avail themselves of the mental health system or if they do it is at a level that is not easily monitored (e.g. outpatient counseling). Who would pay for all this screening? You also apparently missed the part about stigmatization. The problem is guns. Other countries that have fewer guns have far less devastating episodes of mass violence (if any at all). But I am not hopeful that this country will ever come to its senses.
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"The honest approach would be to make it one of the many factors that are considered during a background check." Define "mental health system" and "considered". Any contact with the mental health system would preclude anyone from purchasing a gun? Fine - that will keep more people away from the mental health system and be a clear violation of constitutional rights. This is a tough issue without a simple solution. And Trump rescinded the reasonable approach taken by Obama, to enable authorities to do a gun check on anyone who is adjudicated incompetent by a court. That is all that would pass constitutional muster.
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Mental Health is just one item on a list of things or phenomena blamed for mass shootings in this country. Lack of prayer, video games, violent movies, drugs. immigrants, anything but people in possession of guns gets blamed for these shooting. Mental Health is a peripheral issue. The core issues is guns and their availability. There needs to be effective restrictions placed on access to and possession of guns by the general public. A good place to start is with assault style weapons. Theses weapons are designed for the purpose of inflicting mass casualties and have no business in the hands of the American public. The NRA and the beneficiaries of their largess will proclaim Mental Health and many other issues as the cause of gun violence as a diversion. We need not let that happen. The problem is the availability of the guns. We need to stay focused.
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The first thing to remember is that the mental health system, like every other health care system in this country has been struggling to keep up for years, and under the current administration, is now being decimated completely.
And while background checks, mental evaluations and just keeping guns out of the hands of troubled minds are all worthy solutions, what precipitates such violent tendencies in this society must also be confronted; and to a great extent that can be found in the violence in movies, on television, online and in video games, where blasting enemy soldiers, car thieves or aliens from outer space, is an enjoyable and acceptable substitute for the real thing.
Want to make a real change? -- make changes in the entertainment industry.....Then strengthen gun control laws.
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What does it take to commit a crime? Opportunity + Motive + Means.
The motive can be mental illness, but then what is mental illness given that medications for anxiety and depression are among the most subscribed in the country. More often, the motive is anger, revenge, power, the desire to harm. Are all of these signs of mental illness? Motive will always be there, so what we need to do is eliminate the means of gun violence--guns--and the opportunity to use them.
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Most, it takes testosterone. When 95% of all crimes are committed by males, then focus on the males. And focus on the Venn Diagram of influences, both biologic and societal. Duh.
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Where guns can not be the “means” trucks, autos and knives become the new means. Something needs to be done about the perpetrators too!
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As a psych nurse- thank you so much for this! "There are no reliable cures for insecurity, resentment, entitlement and hatred" is exactly what I have been trying to communicate over the past several years when "mental health issues" or "depression" are imagined to be the only explanation for these murders- and every other act of violence. America would love if mental health clinicians could simply treat every societal ailment at the psych hospital - sexism, racism, social isolation, poverty, domestic violence, trauma - wouldn't that be nice. That way America wouldn't have to confront and address any of these public health issues with real policy changes.
I wish "no reliable cures for insecurity, resentment, entitlement and hatred" was plastered on every billboard in America. We need to turn to policy change, rather than psychiatrists, nurses, and teachers, to help us out of these patterns, or they will not stop.
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This recently retired psych RN heartily agrees.
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Here's a modest proposal. Every weapon purchase to someone under the age of 25 must have the signature of an adult sponsor (maybe two). That sponsor is responsible for that young person's ownership of the weapon. If that young person goes astray - brandishing on social media, threatening others, or otherwise behaving in an irresponsible manner - that sponsor becomes legally liable.
Perhaps the NRA can enlist some of its most ardent supporters to enlist in such a program. Provide first-person example and accountability of responsible gun ownership.
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Regulate bullets and make gun owners purchase insurance, as well as financially holding them accountable to their victims and victims families - along with the cost of medical care and funerals.
Cruz stands to inherit half of the $1 million from his adoptive mother who died 3 months ago. ALL of that ought go to the victims and their families.
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People over 21 are adults.
We don't hold adults responsible for what other adults do.
As a physician, I agree that the mental health system - even with adequate funding that Republicans have undermined - is not even a small part of the answer. Dr. Barnhorst highlights that only a tiny fraction of mentally ill citizens come to attention. What about the large majority that doesn't? Even if we diagnosed serious mental illness where would we report it? Would they not be able to get guns or would their guns be taken away? Who would investigate them? And once such a system is known, do you really think mentally ill shooters would present themselves to healthcare professionals? And finally, those with depression or bipolar who simply snap one day . . . shall we prevent all citizens with very common manageable diseases to be denied guns?
Let's face it: Republicans hide behind the "mental health" argument. They know it. And now our children know it; let's hope they will humiliate the GOP-NRA conspiracy into not only banning future sales but removing weapons of rapid mass destruction from all but military milieus. AND I love Ross Douthat's idea of NO guns without strict supervision of all men under the age of 30. Common sense solutions to face down the EVIL of NRA propaganda.
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Const - You speak of "those with depression or bipolar who simply snap one day"...but some of these "snaps" may be caused by the prescription drugs they are taking. For examples, check out "SSRI Stories" for some who have snapped while on SSRI antidepressant drugs. How to regulate the risk of behavior change for those on medications is another conundrum.
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I write as a 66 year citizen and Licensed Clinical Social worker, now in private practice, who spent many years working and supervising others in community mental health and crisis systems. I am grateful to Dr Barnhorst for articulating the reality that mental health interventions will not change the personalities and behaviors of perpetrators such as Mr Cruz. It seems that over time the internet, availability of weapons, adoration of violence and macho behavior prevelent in our culture have encouraged the destruction of others for mindless gratification and expression of powerlessness.
One more point re Second Amendment “worship” to justify the need for citizens to own an arsenal of lethal weapons . What happens when this right is distorted such that I and every other peaceful human in the USA have lost our “right” to basic safety in public and “Freedom from violence”. We are no longer the “land of the free”. There are too many guns in America.
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So very well said. I am also a psychiatrist and I treat young people with psychosis. Even with psychosis it is very hard to predict a true threat. No way to see the future. Guns are too accessible for everyone. And gun violence isn’t a political issue, it’s a politicized one. Let’s give the issue back to public health where it belongs.
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Guns have as much to do with 'health' as the color of your underwear. Most people get very angry at someone at some point. If that (usually, temporarily) angry person doesn't have a fire arm, it's unlikely that anyone will be murdered.
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I also worked in this field and evaluated crisis patients for possible involuntary commitment. This opinion piece was right on. But, while gun violence may not be a political issue, gun regulations and laws are absolutely political issues.
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Yes, it is a politicized issue because the GOP has passed laws pushed by the gun lobby to prohibit studying the gun culture as a health issue. Nothing will change until people out vote the NRA.
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As a retired psychologist, I agree with your conclusions. The mental health issue is complicated as you explain very well. I am also pleased that you pointed out "that mental illness is rarely the cause..." The vast majority of people with mental illness, including those with depression, do not become mass murderers. Thank you for your insightful article.
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The author makes a reasonable request at the end of the article. Let's keep the guns out of these guys (and it's always guys) hands. The problem is, how do you do that? What criteria do you use? Who decides? It easy once they've gone over the edge and committed the crime, but that's not very helpful. If the mental health experts can't agree or spot them, what are we to do? Banning certain weapons is useful, but that hardly solves a problem where people can go to a pawn shop and with 25$ get a deadly easily concealed weapon. Not as deadly as an assault gun, but able, as we've seen repeatedly, to cause lots of damage.
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Thank you, Dr. Barnhorst, for this clear and convincing explanation of why focusing on mental health will not stop mass shootings.
It's an effective deflection for the NRA and cowardly politicians to blame "mental health" for the gun violence that saturates this country.
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Pity and excellent overview of why, though mental health services are desperately underfunded, limiting access to guns is the best practical and tactical strategy for reducing mass shootings.
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I agree completely. The only way we could address this issue through "mental health treatment" would compromise virtually every Constitutional protection other than the Second Amendment. The screening, treatment and confinement options available would insure that many thousands of innocent citizens would be deprived of their rights to life, liberty and the pursuit of happiness. Improved mental health care would be good for all of us, but it is far from a panacea. Let's end domestic violence and cure cancer while we are at it. The focus on mental health as it relates to gun related violence is a red herring designed to keep us from focusssing clearly on the obvious culprit (guns).
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I am grateful to Dr Barnhorst for bringing an element of rationality to the discussion about guns and mental health. Her dilemma in this particular case probably mirrors the situation of most mass shooters, and indeed of the majority of those who threaten violence to people they do not know. In the sense that these people's thoughts and beliefs are unhealthy there is a mental health issue, but there is no more a mental illness issue than there is for fat people who eat too much. Their families and their environment are probably unhealthy too, and it will take far more serious intervention to reduce the risk of more mass shooting. For a start, genuine attempts to limit the availability of guns to those who have a reasonable need for one (which should not include self defense) would work. Connecticut has shown that it can be done.
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Clearly the law is on the side of the prospective shooter until the shooting begins. But the implication is also that the laws are designed to give deference to freedom over the safety of others. Add to that, right-wing politicians receiving adulterous sums of money from the gun lobby - many, many more will have to die. Obviously, the only solution is to outlaw political gifts of money.
Conumdrum...
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"Why, some critics are demanding, didn’t he receive proper treatment? And can’t we just stop angry, unstable young men like him from buying firearms?"
We can. But only by casting the net wide enough that other men -- who believe themselves to be mature and stable enough to be trusted with those same firearms -- will have to forego them in the interest of the safety of all.
That is what it boils down to, finally. Will those who insist that they have a right to own killing machines simply because they think the Constitution enshrines such a right -- will they decide that their interpretation of the Second Amendment, and their right to play with dangerous toys and entertain fantasies of political apocalypse or heroic rescue override the right of the rest of their fellow citizens to live without fear of random mass murder at the hands of some other man who lacks that maturity and self-control?
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Yes. Yes it does. My guns haven't killed anyone. If they are killing machines they are apparently defective ones.
A very good article on how guns end up in the hands of those who will use them for killing others. But consider another angle.
"Adequate mental health care" is certainly being used a lot by gun promoters, the NRA, and Republican politicians these days as the key to ridding our society of mass murderers. It is a red herring, and they know it. It might work a couple of times in a couple of situations, but most mass murderers are actually very sane - just violent, angry, wanting revenge, etc.
And in the case of those who are insane, consider it just from a statistics point of view: Is it realistic in a nation of 300 million that we will find and cure all those who would turn to readily available guns at any moment? We would literally be looking for the needle in the haystack...
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Matthew, the NYTimes and many readers have claimed that the US doesn't do a good job of caring for the mentally ill and therefore they commit carnage. I think we all know that most people that have an acute or chronic mental health issue are NOT violent. However, it's been proven that those that torture animals as children will grow up to be violent and/or unstable at best. Yet, we cannot get animal abuse laws updated to reflect this.
Anyway, I'm just pointing out the hypocrisy I read day to day in the NYTimes and other outlets. Sometimes you cannot fix everything; actually you cannot regulate good behavior, only against bad.
Very astute; and we need to also realize the influence of Lucifer on vulnerable individuals and the diminishing influence of church and worship in our modern society.
"...but most mass murderers are actually very sane..."
Of course.
"...laws designed to preserve the civil liberties of people with mental illness place limits on what treatments can be imposed against a person’s will." Should these laws trump the second amendment? Obviously a political decision.
People are unpredictable, and those who are open and honestly trying to discuss and understand their problems with the unpredictability of life and arrange for therapy, counseling, treatment become categorized in violation of their privacy and rights.
The principal category is that of receiving mental health treatment. An involuntary period for observation is considered a commitment regardless of the outcome or personal bias of the diagnostic medical professional given the authority to label and prescribe.
Gone untreated are those who cannot or will not pay by the rules of convention (law). People in positions of political and social status can generally bypass the "red tape" imposed by a broad brush on the masses.
Hardly a criticism of the mental health system. We make laws and procedures not based on
how we want to treat others but how we want to be treated ourselves. As Dr.Barnhorst attests, violence is not such a common characteristic of mental health. Neither good nor problematic mental health. The same dialectics are employed to decide and declare the propriety of combatants in declared war, as for vigilantes, or stone-cold killers or torturors.
It's considered a serious and progressive idea to register newborns to vote (IMO, the sooner the better...maybe at age 18.) But to submit infants and children and 18 yr-olds to periods / weekends for behavioral and physical evaluations and developemental growth might never pass general scrutiny.
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It is impossible in California (and perhaps other states) to obtain treatment for an adult child that refuses to believe they are in need of help. As the author of this article stated, all they have to do is present a coherent explanation of their behavior, and the police are hamstrung. I know of a family with an adult child living in their home, who has on multiple occasions presented a threatening demeanor to his parents (their perception). They called the police, and when the police arrived, they interviewed the child, and then let the parents know that there was nothing they could do. How is that good for the parents, or for the adult child? Our mental health system is failing both sides of that coin, the adult child is untreated, and the parents are disconsolate over the behavior of their child.
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How is this a failure of the mental health system? That system is not Big Brother, they do not have an iron hand, or the right to intercede without demonstrable cause. They also did not make up the rules that they must obey, nor are they law enforcement, whose hands are also tied in such cases.
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I cannot count the number of times I was contacted by parents of a severely mentally ill young adult - bonkers, unpredictable - who refused medication and kept ‘escaping’ the household, but wasn’t deemed in need of hospitalization.
I know of two mental professionals (one a Child Psychiatrist Psychoanalyst, the other a Psychologist), who literally had to work alternate hours in order to keep an eye on their own offspring - a young adult with mental health problems and a potential to seek street drugs - in order to try and prevent ‘escaping’ the household.
Our mental health system needs revision and amplification. But that is separate from gun control.
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I worked in child welfare for almost 50 years and this letter is spot on. If every angry young man were detained our hospitals and prisons would be fuller than they already are. I'm not saying we shouldn't improve our treatment resources, but it is not the panacea some think it is. whole heatedly agree with the author's conclusion.
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The problem is mostly testosterone. Sadly, without it we would not reproduce.
The other factor is we live in a winner-take-all society. Sadly also, we seem to have no appetite to address that.
What's the famous line- America will do the right thing, after exhausting all other possibilities. I do wonder if and when that will occur.
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Once again healthcare is becoming unaffordable. My friends premiums doubled this year. Mental healthcare is shorted in most plans. It shouldn't be left to mental health professionals to stop gun violence. Read the NYTimes article dated 2/16/18. It is more effective to regulate guns. Yes, improve access to mental healthcare in the USA, but as this article says, let's not pretend the mental health system is going to stop the gun murders.
https://www.nytimes.com/2018/02/16/us/politics/fact-check-parkland-gun-v...
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Thank you, Dr. Barnhorst. Having been in your shoes many times during my professional career I can attest to teh absolute accuracy of your comments. Seeing common sense and a reality check appear in my morning news has made my day.
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Regulating guns is going to take a generation. At least. Getting our 300 million guns out of private hands would be more difficult than a manned expedition to the sun.
We should start by regulating bullets. Make them really expensive. Have all the guns you want, but if each bullet costs $20.00 the lure of going full auto will fade. You want to kill a deer-that's still affordable.
Bullets have essentially four component parts- projectile, cartridge, propellant, primer. The projectile can be made almost anywhere by machine tools, it would be impossible to control any aspect of their manufacture.
The cartridge is commonly reused, one can be fired many, many times.
The propellant could be taxed and controlled, it is essentially an explosive.
But the primer is a single use component, and made of very sensitive explosives that are tightly controlled in our existing systems. Their production requires sophisticated equipment, extensive safety systems. Making them at home is a prescription for loss of hands and life.
So tax primers. Heavily. Use that revenue to support mental health and mitigating the suffering of violence victims. And buy back guns.
And make guns non-inheritable or transferable. Your guns go into the ground with you. You can ask the embalmer to wrap your cold dead fingers around them.
The one challenge is when the word of an impending tax gets out the gun world will go crazy buying primers. There are ways around that also.
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Mark,
As you and most here know the ACLU “fixed” the Mental Health System making it difficult to impossible to commit anyone for “being a danger to themselves or others” (5150 them) until something terrible and usually fatal has occurred. The Police aren’t trained nor have the resources to intervene before hand as the latest incident demonstrates. The fact is that there is no mental health safety net there is much talk but little action until the terrible acts (usually warned about in advance) occurs!
Calling the authorities usually helps not in the slightest either as numerous cases including this one demonstrate. This is not surprising as in many areas the civil authorities can’t collect the trash, clean the feces from the sidewalks, or protect citizens in their homes.
The solution to mass murders is complicated as the increasing number of knife and vehicle attacks demonstrate. Making it it impossible for the unstable and the criminal to obtain ammunition and guns is a worthy goal. Let’s start with getting our local and national authorities taking reports of dangerous individuals seriously and give them the necessary tools to do so if they can’t do it under current law.
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