10 months, 1 week ago
The current focus by the politicians in their quest for social and human factors solutions to gun violence appears to be two-fold. First, there is a call for universal background checks. Even the NRA has indicated potential approval of this approach (while there is still vacillation and equivocation within the ranks of the NRA on this issue). While this is tempting, it won’t solve any problems, and instead it will lead to a national gun registry.
But if there is vacillation on the issue of universal background checks, there appears to be growing consistency in the call for more intrusive and comprehensive mental health checks for firearms ownership. Progressive and conservative alike, from politician to random interviewee on the street, casting aspersions on mentally troubled people and pointing to mental health screenings as the problem and solution, respectively, is the one area of agreement.
Walter Russell Mead weighs in in the affirmative on this problem – solution coupling:
Love it or loathe it, legislative gun control is unlikely to have much impact on violence American style. But there is another door to progress: taking care of America’s mentally ill. The good people at Mother Jones recently compiled a study, revealing that of the 62 mass shootings since 1982, 38 were carried out by a person suffering from mental illness (mostly men). Most had displayed signs of paranoia, depression, and other issues with mental health well before reaching for a weapon.
While most of the gun violence in America is committed by the clinically sane, the most horrific massacres are often the work of deranged people whose problems had come to the attention of family, neighbors or work associates.
I have shared before that I have a concealed handgun permit in my county, and in order to get permitted like this, one of the requirements is to sign over authority to examine your medical records to the county Sheriff. Any admissions to one of five or six regional hospitals for mental health or substance abuse issues would have been reason to have denied my permit. But I have often wondered, what if I had a recorded admission for some matter in one of the above two categories? What would that have proven? Little to nothing, as we will see.
What about the logical contraposition? I am in a fitness for duty program because I have unescorted access to nuclear power plants. Does that make me mentally stable? How about law enforcement officers, since they are in a similar kind of program? Anecdotal cases demonstrate problems.
Reports of Metro Police Lt. Hans Walters underscore the mental health component of the current gun control debate. Walters shot and killed his wife, a former police officer, and his son and then set fire to their Boulder City home before taking his own life.
Most would agree police departments conduct exhaustive background checks, screening tests, training and safety procedures before authorizing officers to carry and deploy a number of firearms. Yet a former colleague comments to the Las Vegas Review-Journal that Walters “didn’t seem out of the ordinary at all,” adding that “Cops are pretty intuitive. They can tell when something’s wrong with someone. He seemed totally fine.”
Beyond the anecdotal level, there are problems with diagnosis and with the very nature of psychology. One clinician weighs in this way.
Clinicians treating patients hear their fears, anger, sadness, fantasies and hopes, in a protected space of privacy and confidentiality, which is guaranteed by federal and state laws. Mental health professionals are legally obligated to break this confidentiality when a patient “threatens violence to self or others.” But clinicians rarely report unless the threat is immediate, clear and overt.
Mental health professionals understand that, despite our intimate knowledge of the thoughts of our patients, we are not very good at predicting what people will do. Our knowledge is always incomplete and conditional, and we do not have the methods to objectively predict future behavior. Tendencies, yes; specific actions, no. To think that we can read a person’s brain the way a scanner in airport security is used to detect weapons is a gross misunderstanding of psychological science, and very far from the nuanced but uncertain grasp clinicians have on patients’ state of mind.
What about diagnoses?
If mental health professionals were required to report severe mental illness (such as paranoid schizophrenia) to state authorities, it would have an immediate chilling effect on the willingness of people to disclose sensitive information, and would discourage many people from seeking treatment. What about depression, bipolar disorder, substance abuse or post-traumatic stress disorder, along with other types of mental illness that have some link to self-harm and impulsive action? The scope of disclosure that the government could legally compel might end up very wide, without any real gain in predictive accuracy.
Diagnosis is an inexact and constantly evolving effort, and it is contentious within the profession. To use a diagnosis as the basis of reporting the possibility of violence to the authorities would make the effort of accurate evaluation much more fraught. And what of the families and friends of the mentally ill? Should their weapons purchases be restricted as well? A little reflection shows how unworkable in practice any screening by diagnosis would be.
And more clinicians weigh in similarly:
“We’re not likely to catch very many potentially violent people” with laws like the one in New York, says Barry Rosenfeld, a professor of psychology at Fordham University in The Bronx….
A study of experienced psychiatrists at a major urban psychiatric facility found that they were wrong about which patients would become violent about 30 percent of the time.
That’s a much higher error rate than with most medical tests, says Alan Teo, a psychiatrist at the University of Michigan and an author of the study.
One reason even experienced psychiatrists are often wrong is that there are only a few clear signs that a person with a mental illness is likely to act violently, says Steven Hoge, a professor of psychiatry at Columbia University. These include a history of violence and a current threat to commit violence….
The next problem is that even if the science was capable of sustaining the load that we want to place it under, it still wouldn’t have the desired effect:
Perhaps most important, although people with serious mental illness have committed a large percentage of high-profile crimes, the mentally ill represent a very small percentage of the perpetrators of violent crime overall. Researchers estimate that if mental illness could be eliminated as a factor in violent crime, the overall rate would be reduced by only 4 percent. That means 96 percent of violent crimes—defined by the FBI as murders, robberies, rapes, and aggravated assaults—are committed by people without any mental-health problems at all. Solutions that focus on reducing crimes by the mentally ill will make only a small dent in the nation’s rate of gun-related murders, ranging from mass killings to shootings that claim a single victim. It’s not just that the mentally ill represent a minority of the country’s population; it’s also that the overlap between mental illness and violent behavior is poor.
Finally, it isn’t just anecdotal evidence that calls into question the whole notion that mental health professionals can bear the weight of societal violence, or even the warnings of mental health professionals themselves. Evidence doesn’t substantiate the current emphasis on mental health as the answer.
President Obama has called for stricter federal gun laws to combat recent shooting rampages, but a review of recent state laws by The Washington Times shows no discernible correlation between stricter rules and lower gun-crime rates in the states.
States that ranked high in terms of making records available to the National Instant Criminal Background Check System also tended to have tighter gun laws — but their gun-crime rates ranged widely. The same was true for states that ranked poorly on disclosure and were deemed to have much less stringent gun-possession laws.
For example, New York, even before it approved the strictest gun-control measures in the country last week, was ranked fourth among the states in strength of gun laws by the Brady Campaign to End Gun Violence, but was also in the top 10 in firearm homicide rates in 2011, according to the FBI.
Meanwhile, North Dakota was near the bottom in its firearm homicide, firearm robbery and firearm assault rates, but also had some of the loosest gun laws and worst compliance with turning over mental health records to the background check system.
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The Times analysis looked at the Brady Campaign’s rankings for strength of each state’s gun laws and at Mayors Against Illegal Guns’ rankings for how states perform in disclosing mental health data to the background check system. That information was then matched against the FBI’s 2011 gun-crime rankings for homicides, robberies and assaults.
The results showed no correlation among the strength of laws and disclosure and the crime rates.
For example, Maryland and New Jersey — both of them populous states with large metropolitan areas — have tight gun laws but poor mental health disclosure. But New Jersey’s gun-crime rate was in the middle of the pack, while Maryland ranked sixth-highest in homicides involving guns and second-highest in robberies with guns.
Delaware and Virginia, which both ranked high in mental health disclosure and ranked 18th and 19th in the Brady tally of tough gun laws, also had divergent crime rates.
Delaware ranked among the top 10 in number of gun robberies and gun assaults, while Virginia was in the middle of the pack on its measures.
My own view is somewhat more pedestrian and pragmatic. New programs to empower the government rarely avoid abuse, and man’s evil propensities always tend towards totalitarianism and excessive control. The innocent who get swept up in the mental health screenings and refused means of self defense will be considered the price to pay for government control. With the right administration, simply wanting means of self defense will be justifiable cause for denying such.
With so little good that can come from this emphasis, coupled with such a large chance for abuse, mental health isn’t the answer that the politicians tout it to be. As I have previously noted, the common element in the high profile gun violence cases (theater, schools, churches and malls) is that they’re all gun free zones. Glenn Reynolds points out that this causes a false sense of security. “Policies making areas “gun free” provide a sense of safety to those who engage in magical thinking, but in practice, of course, killers aren’t stopped by gun-free zones. As always, it’s the honest people — the very ones you want to be armed — who tend to obey the law.”
This is, as it were, the low hanging fruit. Tackle the easy things and leave the questionable ones behind.