2 months, 1 week ago
The gun restriction rule is a well-meaning policy that gets some things right, notably its support of federal efforts to improve detection of risky people who should not have legal access to guns. But despite its good intentions, what the policy actually does is take away the gun rights of a large category of individuals without any evidence that they pose a risk of harm to self or others, and without legal due process protections commensurate with abridging a constitutional right.
All we really know about many people in the affected category is that they have been found unable to work full time due to a mental health problem and an examiner for Social Security has decided, with some input from a licensed medical or psychological consultant, that they need help managing money. The mental health conditions in question might range from moderate intellectual disabilities to depression, bipolar disorder or schizophrenia. Based on one person’s judgment call, arrangements are made to have the government’s check sent to a representative payee. But this isn’t an index for whether or not someone should be allowed to own a gun.
Research on the relationship between gun violence and mental illness shows that the vast majority of mentally ill individuals are not violent or suicidal. Our group at Duke recently published a study of approximately 82,000 people diagnosed with serious mental illnesses in Florida between 2002 and 2011. We found that those with serious mental health disorders with records in the public behavioral health system were no more likely than the general adult population in Florida to use a gun to harm others (about 213 vs. 217 gun crimes per 100,000 people per year), and they were only slightly more likely to die in a gun-related suicide (about 13 vs. 9 gun suicides per 100,000 people per year). Thus, people with mental illnesses are no more dangerous to others when they have equal access to guns.
Our study, like many others, found that mental illness substantially increases the risk of suicide in general. Many, if not most, people who die from suicide have suffered from a mental illness. But our data also show that they are less like to use a gun when they do end their own lives, and are more likely to use other means. While 48 percent of suicides in the general Florida adult population involved guns, only 20 percent of suicides in our study population of people with serious mental illnesses involved guns. The annual rate — 13 gun suicides per 100,000 people with mental illness — shows that gun suicide is a rare event in this population. Moreover, only a tiny fraction of all people with mental illness who are at risk of suicide are Social Security disability beneficiaries with representative payees. Thus there just isn’t evidence that reporting these particular individuals to the National Instant Criminal Background Check system will prevent suicides.
No doubt, the ban on Social Security recipients buying guns wasn’t a well meaning policy. We’ve discussed this at length before. But ignoring the professor’s leftist leanings for the moment, he’s actually given some very good information from the perspective of a mental health professional.
His view comports with that of other mental health professionals as I’ve noted.
In a paper published in the American Journal of Public Health, Jonathan M. Metzl and Kenneth T. MacLeish investigate a number of common beliefs about mental illness and gun violence, including the idea that “psychiatric diagnosis can predict gun crime before it happens.” They write that “legislation in a number of states now mandates that psychiatrists assess their patients for the potential to commit violent gun crime.” New York, for instance, “requires mental health professionals to report anyone who ‘is likely to engage in conduct that would result in serious harm to self or others’ to the state’s Division of Criminal Justice Services, which then alerts the local authorities to revoke the person’s firearms license and confiscate his or her weapons.”
However, they argue, asking psychiatrists to judge who’s likely to become violent may be the wrong approach. They cite research showing that most gun violence isn’t committed by people who are determined to have mental illness — and that most people with mental illness don’t commit violence. According to one study, “the risk is exponentially greater that individuals diagnosed with serious mental illness will be assaulted by others, rather than the other way around.”
Random gun violence is a terrifying fact of American life, because of both the violence and the randomness. Terror bred by violence does not really require comment; they are twinned. But terror bred by randomness does, especially when it leads people to accept as true a reasonable story that is false, when a myth functions as an explanation. And that is what is happening with the way we talk about mental illness and random gun violence. Thankfully, a just published report in the Annals of Epidemiology pulls together the facts we need to consider if we really want to adopt evidence-based policies to reduce random gun violence.
The article, “Mental illness and reduction of gun violence and suicide: bringing epidemiologic research to policy,” is a comprehensive, critical survey of the available data (and it is surprisingly accessible and well-written for an academic treatise). It concludes that “most violent behavior is due to factors other than mental illness.”
[ … ]
Jeffrey W. Swanson, a professor of psychiatry and behavioral sciences at the Duke University School of Medicine and lead author of the article in Annals of Epidemiology was quoted in the UCLA Newsroom saying ”but even if schizophrenia, bipolar disorder and depression were cured, our society’s problem of violence would diminish by only about 4 percent.”
That is not very much. When people with mental illness do act violently it is typically for the same reasons that people without mental illness act violently.
“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 ….
And we’ve discussed Dr. Swanson’s views before. Furthermore, I deny with prejudice that social security recipients who want someone else to handle their finances constitutes mental illness. Most married couples have one individual who handles the finances, not two. The entire edifice of regulation was ridiculous in the supperlative anyway.
It was never intended for the protection of anyone. It was always intended as a trial balloon for gun regulations, first social security recipients, next those who are deemed by the courts as worthy of bans of some sort or another, perhaps because the individual believes in the second amendment, or better, that God gives us our rights and therefore they are as immutable as His nature.
Dr. Swanson has done us yet another service. He has explained that if the ban for social security recipients is based on the notion of prevention of suicide, then that was always a pretext. The elderly don’t use guns if they intend on committing suicide.