OLYMPUS DIGITAL CAMERA

By Dr. Robert B. Young

More attention is being paid to the role of mental illness in mass shootings the last several years, reasonably so since nearly all the perpetrators seem to have experienced significant reality distortion. Yet mental illness actually plays very little part in the incidence of “gun violence.” That phrase should mean “violence using guns,” but has come to imply, as its anti-gun originators intend, that guns are somehow the cause of the violence. Addressing this question as if the problem is mental illness vs. the availability of guns sets up a false choice. Some, like my fellow physician, Dr. Kimberly Yonkers, in a recent Washington Post opinion piece keep mistaking that one tree for the forest. But far more factors underlie violence, gun-related and otherwise. The problem is not mental illness … and it isn’t guns, either . . .

She’s quite right about the generally good availability of mental health treatment in our country compared to anywhere else in the world. She’s right that even if we could magically get everyone with any degree of mental illness treated, and if that somehow prevented all shootings in which the perpetrator exhibited mental illness, 96% of American “gun violence” would still occur.

We’re both 100% in favor of increasing entry to effective psychiatric treatment, especially for the most severely afflicted, and we know this would reduce some of their very rare violence. But this would make almost no difference in the overall amount of violence we experience in our society.

Jumping from this point to the conclusion that the only other way to reduce “gun violence” is to further restrict access to guns just isn’t logical. Most academic physicians follow the ossified, over 20-year-old anti-gun position of their leadership that “gun violence is a public health issue.” Notice how often we see that mantra? Dr. Yonkers gives a passing glance to the problems of “poverty, domestic violence and childhood exposure to bloodshed” as contributors to violence in America, but she doesn’t choose to explore them. Yet these and other socio-cultural issues are fundamental to the problem.

Physicians don’t read criminology research, so they entirely miss the value of gun use for self-defense (especially the great majority of instances in which no shots are fired). They don’t often address the tragic crime epidemic among undisciplined teens and young adults competing for gang and drug turf and money. Neither of these groups represents the mentally ill. They are, respectively, average citizens using guns for one of the purposes for which they’re intended, criminals misusing guns for their own antisocial reasons. And the mass shooters of the past 20 years, while likely mentally ill, neither availed themselves of adequate treatment options nor could have been stopped from acquiring their weapons by any existing or proposed law.

Like every anti-gun proponent, Dr. Yonkers presents skewed data. Yes, a number of developed countries have lower rates of gun homicide than ours. But the U.S.’s overall homicide rate is still low compared to worldwide rates and we have low (and decreasing) overall violent crime rates compared to nearly everywhere, despite so many other countries denying their citizens the right to gun ownership.

Suicide is very culturally influenced regardless of the availability of guns, and accidents are the clear responsibility of gun users. Consider all this in the context of the U.S.’s virtually unique protection of citizens’ right to keep and bear arms, with the greatest number of privately-owned firearms per person by far. That means we are already one of the safest populations of gun users in the world, even with the bad things that inevitably happen.

This is the bigger picture, one which biased observers like Dr. Yonkers can’t see or don’t want seen. But the American public is seeing it with a clearly positive view of the value of firearms to their lives.

There are so many more productive approaches than more limits on gun ownership, ones that would actually help decrease violence, gun-related and otherwise, such as:

  • Enhancing legal firearm use with universal shall-issue laws, which give criminals pause and are associated with decreases in violent crime almost everywhere they’re introduced.
  • Consistent prosecution and sentencing crimes committed with firearms and illegal gun purchases.
  • Eliminating fantasy “gun-free zones” (simplest, by allowing concealed carry, or at least using armed guards) that are always the preference of madmen wanting to cause the most harm.
  • Promoting real gun safety education, meaning how to use and manage firearms safely (via NRA and many other training resources) instead of quoting medical orthodoxy’s only advice: “Don’t keep them in your home but, if you must, lock guns and ammunition in separate places.”
  • Teaching all our children that police are our friends when we need help, but to do what they say, and never threaten them.
  • And yes, strengthening mental health commitment-to-treatment laws (especially for outpatient treatment) combined with very temporary removal of known weapons based on imminent clinical risk, with every step requiring due process as is currently followed for inpatient commitment.

I can’t wait for the real “conversation” to begin.

 

Robert B. Young, MD is a board-certified psychiatrist practicing in upstate New York who enjoys guns and shooting. He is a Distinguished Fellow of the American Psychiatric Association and an Associate Clinical Professor at the University of Rochester School of Medicine who has been recognized for excellence in medical teaching. He is very pleased, through Doctors for Responsible Gun Ownership, to dispel the myth of guns being health issues and to promote the human rights of self-defense and autonomy that our Constitution confirms.

Recommended For You

26 Responses to Is It Mental Illness, Guns Or…What?

  1. Until we debunk the idea that mental issues can be successfuly treated with medications we will continue to see horrific acts by otherwise decent people. None of the currently used medications do ANYTHING benificial for the patients, though in most cases they can provide a window of “manageability” by damaging the brain in some manner. Anti-depressants have a proven link to mania, loss of impulse control, suicide, and violence to include homicide. Ritalin which is a favorite kid candy in many schools can cause pshychosis and hallucinations just to name a couple items. Most if not all of the so-called “mass shootings” in the last few decades can be linked to these poisonous medications foisted on us by huge pharm companies and doctors that would rather prescribe poisonous medication cocktails than give a damn about their patients.

    • I agree wholeheartedly that we over medicate in America due to the massive profits made by the pharmaceutical companies, however anti-psychotic drugs and drugs to treat bipolar disorder among others are able to give people with these disorders a shot at a semi normal life. Schizophrenia can be helped a lot by medication, for instance.

      • Yes. The only real problem with psych meds is that so many see them as magical pills that you just take and POOF! the problem is over. They can be extremely effective used well and monitored, but none of them is a one-pill-fits-all, and few of them are effective long-term.

        If we want effective mental health care, we need to pick up John F. Kennedy’s program and actually provide the community outpatient centers he wanted. While the US may have better mental health care than much of the world, it is still crappy — we use jails for getting the mentally ill out of the way, despite the fact that it’s been overwhelmingly shown that having community care centers is better for them, for crime levels, and for overall budgets. The best are centers where troubled people can actually drop in and spend the night in a place that is safe and they know someone is there who understands.

        Sure, it would only be a drop in the bucket in actual misuse of firearms, but it would likely give us a dramatic drop in mass shootings, especially if “venting” options were available (a community mental health center I once lived near had a room where people could break things to get anger out; short-term, it’s darned effective).

        Besides that, when you warehouse the mentally ill — I’ll note that the three largest facilities housing the mentally ill in the U.S. are all jails — they tend to pick up very bad habits from their fellow inmates. That alone makes it a good idea to separate the populations!

      • You list some very serious mental disorders. All of which are very hard to treat because the “patient” would generally not see a need. Been through this with a friend. In the end I had to end the relationship. Her family was too liberal and also too preoccupied to admit something was wrong. Sad stuff but much more difficult than here is a sick person and here is the cure. People in this world won’t remove emotion from any decision and therefore we are destined to have useless laws and many sick people that are crying for help.

    • “Until we debunk the idea that…” ????

      How about just debunking the myth that you can be protected at any time in any fashion by these P.O.S.’s. Humh?

      Anyone claiming that they can protect you is not just wrong it is WRONGFUL, and should be OUTLAWED / FINED and examined thoroughly for their own manifest mental issues. Freekin MORONS!!

      The same goes for anyone claiming that your kids can be safe in schools, on playgrounds, etc., etc.

      A gun grab is a gun grab, if they were literally attempting to snatch it from your hand you’d pull away and draw on them. Don’t let them feel safe because they’ve achieved a stand-off distance.

    • Don,
      Not sure where you get your information, or medicenal education but I can assure you that “drugs” do provide benefit to patients across many different types of mental illness…..all the way down to helping you and your enlarged prostate, paranoia and anxiety. And before you start another ridiculous typing fury, the “chemicals” the big Pharm businesses use in many drugs, are found naturally occurring and in many of the things I am sure even you consume on a regular basis.

    • There is overmedication out there but there are lots of drugs that help people who are mentally ill cope with their illness. The problem with medication is very many patients become either resistant to a drug or think they are cured as the symptoms subside after they build up enough of the drug in their system. No one is ever cured, its like being an addict, it will always be there for the chronically mentally disturbed. This is a whole separate issue from PTSD and other more temporary conditions.

    • This smacks of the same logic of the anti-vax morons. “None of the currently used medications do ANYTHING benificial for the patients”? Calling bullshit. Post your data. Until then, you’re just as full of shit as the data-impaired Mommies Lacking Action.

    • Really? The medication does nothing? What hyperbole is that? I have seen Clozaril eliminate almost all the symptoms of Schizophrenia. I have seen antidepressants relieve clients of debilitating depression. I have seen focalin allow a child to concentrate in class so much so that she went from D’s and F’s to C’s and B’s. So before you vilify the pharmaceutical company’s I suggest you know your facts.

  2. This could simplify the gun control…..safety issue, So you want to buy a gun, then you’re to crazy to have one. Okay, you don’t want a firearm, you’re sane, yep problem solved.

  3. A high percentage of psycho shooters are prescribed SSRI medications. Congress doesn’t want to touch it, since it’s a billion-dollar-a-year business. But the evidence is overwhelming that SSRI meds cause a certain percentage of users to go off the deep end.

    • Yes — and almost invariably, they’ve just been assigned that drug and not monitored, and they have nowhere to turn should they happen to notice that their pill isn’t working right any longer.

      There are no magic pills. We need actual mental health care, not wand-waving pill-pushing wishful thinking.

    • That sounds more like correlation than causation. IE: Crazy people are prescribed drug X. Crazy people shoot up schools. Therefore, drug X causes school shootings.

      You need to post a little more data, otherwise you’re just pulling the same logic that the Bloomberg antis do, but with better finesse than you.

    • What about the incidents that predate SSRIs? And the fact that they were as common a hundred years ago as they are now?

  4. Here’s the basic problem- some folks are willing to commit violent acts. They will use the tools available to commit violent acts, and will prefer those tools and those victims/situations which give them the biggest advantage.

    • Correct. Many not taught personal responsibility for ones actions, morals or personal values, all of which only taught at home by a parent, not in a school. Who needs impulse control when “they” (the govt.) should provide all? “I see, I want, now give to me or else…”

  5. This piece by Dr. Young is the most cogent short statement on the subject I’ve ever read.

    And I strongly agree with commitment-to-treatment laws if protected by procedural safeguards and meaningful judicial oversight. I have seen the beneficial (indeed life-saving) benefits that anti-psychotic/anti-schiz meds can have on those with serious illness. I have also seen anti-depression meds wrongfully substituted for anti-psychotics for what I take to be reasons of practitioner fear, fear of the side-effects of many effective anti-psychosis meds. I sympathize with those fears, but not with the false solution.

    • Anti-psychotics can be tricky. I was on one once briefly, and one of the big points my doc made to me was that if while taking it as directed I started feeling paranoid at all, to throw the rest away, get somewhere peaceful, and call him immediately. I forget what it was, but one side effect — and not a rare one — was the possibility of tipping people into paranoia and even flipping to be a psychotic. My doc was involved in research on it; he was pursuing the hypothesis that it changed the brain chemistry in ways that in some people actually backfired because while it was doing its anti-psychotic thing it was doing other things, too. One thing he pointed out is that while these things are tested on patients, they don’t get tested on people who are fine — and his belief was that after a time they kicked some people back to being fine, and the effects on a brain that didn’t need them could be highly negative.

      This is why I regard ANY new medication with suspicion, even the pain-killers and the anti-constipation pills required to offset the pain pills’ side effect, given after some surgery. I refused to take them until a pharmacist had shown me actual data on interactions, not just the summaries on his reference charts. [And after viewing that info, I decided to put someone else in charge of my firearms briefly, just in case.]

  6. “Consistent prosecution and sentencing crimes committed with firearms and illegal gun purchases.”

    What possible difference does it make what weapon is used in a crime? Far more assaults and a great many murders are committed with hands and feet. The assault, murder, theft is the crime, not what is used as a weapon. And the best answer to that is rational, honest individual responsibility for defense of self and legitimate dependents, the truly helpless. Prosecution and sentencing do nothing to restore their lives.

  7. I’m surprised that Dr. Young hasn’t been booted out of the profession for espousing such radical views. A psychiatrist talking sense? Inconceivable!

  8. That was a pretty darned good write-up! Thank you Dr. Young.

    My only nitpick is the “police are our friends” comment. That is a topic for its own entire discussion.

  9. I kept waiting for the “all that being said, but…” point in the article. That point never came! Dr. Young admittedly wrote a point of view many of us here on TTAG already hold, albeit with greater credibility than most of us because of his credentials and information/experience level.
    Many of the comments bring up good points, too. I have known some people who wrongly thought they were “cured” when medication improved their symptoms and stopped treatment only to plunge over a cliff (figuratively, except one case where the guy committed suicide, sadly). Treating mental illnesses is complicated, to put it mildly.
    Hopefully, Dr. Young’s ideas will influence some of his peers and his better point of view will gain traction amongst them. Everyone would benefit from that eventuality.

  10. Good jobs, and secondarily good education will solve more problems than anything else. Or if we want to get more basic, investment in people prior to them becoming a problem. We can pay early by investing in people, with education that allows them to get good jobs and in the associated job opportunities in which case we have productive members of society, or we can pay later with violence and incarceration.

Leave a Reply

Your email address will not be published. Required fields are marked *