Violence and Mental Health

The recent mass shooting at the Sandy Hook Elementary School in Newtown, Connecticut reinvigorated the national debate about gun control. While I believe that additional measures must be adopted to make it more difficult for criminals and the mentally ill to obtain firearms, it is equally important that Americans evaluate other areas in our society that may contribute to violent crime.

One major area where we need significant reform is mental health care. Because I am not a mental health professional, I am not qualified to give many specifics about improvements to mental health care; however, the recent mass shootings have clearly demonstrated significant failures in properly identifying and treating mental illness. Rather than just prescribing psychotropic drugs for people who are mentally ill, sending them home and calling it a day, we need to ensure that individuals who pose a danger to themselves or others are promptly committed, even against their will, to secure mental health facilities where they can receive appropriate treatment.

A family in my hometown LDS ward had a son with a serious mental illness, possibly some form of psychosis. A few years ago, when this young man was in his early 20s, his mother tried to have him committed involuntarily to a local mental hospital, but for a reason unknown to me, he was turned down. The young man killed his mother the next night because he perceived he had been told to do so in a psychotic hallucination. Unfortunately this kind of tragedy is hardly unique in America.

Paul Steinberg, a clinical psychiatrist, observed in a recent New York Times op-ed that our society has “too much concern about privacy, labeling, and stereotyping, [and] about the civil liberties of people who have horrifically distorted thinking. In our concern for the rights of people with mental illness, we have come to neglect the rights of ordinary Americans to be safe from the fear of being shot — at home and at schools, in movie theaters, houses of worship and shopping malls.”

Mr. Steinberg pointed out that over the last 50 years, there has been a huge “swing in mental health care…: too little institutionalizing of teenagers and young adults (particularly men, generally more prone to violence) who have had a recent onset of schizophrenia; too little education about the public health impact of untreated mental illness; too few psychiatrists to talk about and treat severe mental disorders.”

Jared Loughner, who shot and killed 6 people and injured 12 others (including a Congresswoman) in Tucson, Arizona in January 2011, had been suspended from Pima Community College the previous September because of bizarre behavior that caused college officials to believe he posed a danger to others. If Loughner’s behavior prompted school officials to worry about the safety of those around him, why wasn’t he committed to a mental institution for psychiatric evaluation? After the shooting, Loughner was diagnosed as a paranoid schizophrenic. The perpetrators of the Aurora and Virginia Tech mass shootings had also been flagged as a possible danger to others prior to the shootings. If they had been forcibly committed for complete psychiatric evaluation and treatment, those shootings may not have occurred.

Mr. Steinberg also noted, “severely ill people… fall through the cracks, in part because school counselors are more familiar with anxiety and depression than with psychosis. Hospitalizations for acute onset of schizophrenia have been shortened to the point of absurdity. Insurance companies and families try to get patients out of hospitals as quickly as possible because of the prohibitively high cost of care.”

Mr. Steinberg calls for improved insurance coverage, expanded hospital capacity, and lengthier care for patients with schizophrenia, as well as intense public education regarding how we treat schizophrenia. Perhaps Americans must be more willing to forcefully commit people with severe mental illness who may pose a threat to themselves or others. We also may need legislation that will make involuntary commitment easier. Furthermore, in the interest of public safety, taxpayers must be willing to help shoulder the burden of providing comprehensive treatment to psychotic patients. Unfortunately, it’s worth noting that Republicans, especially at the state level, have been systematically cutting public funding of mental health care.

While there might be merit to the notion that ineffective and inattentive parents and ever-eroding societal morals play a role in America’s gun violence problem, government cannot force parents to be responsible or coerce individuals to be moral citizens. We should look for constructive ways in all pertinent areas, including mental health care and gun laws, to minimize the likelihood of gun violence, even while recognizing that sometimes, despite our best efforts, bad things will occasionally happen.

5 Replies to “Violence and Mental Health”

  1. I’m not a LDS nor a Democrat, but I was asked to comment via Twitter so I will.

    I’m a social worker in Pennsylvania. Day in and day out I work with people with all types of mental illnesses, mental retardation, and substance abuse problems. The problems we have in society are simple. Not enough mental health care. Last year the state cut mental health spending 20%. 10% the year before that with an additional 5% cut halfway through the year, and many cuts before that going back all of my 10 years. Imagine getting a job that you love. You work and make $40,000 a year. The next year, your boss needs to save money. So he cuts your pay 5%. The same next year, the same next year. Finally in 10 years you’re making $20,000 a year working a $40,000 job and the same hours as when you first started.

    Now that we have that baseline, let’s move on to treatment. Treatment is lacking heavily. Psych medications play with the brain’s chemistry. Too little of this, bad things happen, too much, same thing; it’s called a therapeutic level when you can take a medication with the fewest side effect and the fewest symptoms. That rarely happens and often when new medications are given, the dosage is changed or the medicine taken incorrectly and the medication becomes worthless before it evens out in the blood stream and reaches that therapeutic level. Think of it as driving a car. You go from a stop light to 35 miles per hour in a short amount of time. During that acceleration, your engine and transmission work very hard. Once you reach that speed you want, your car can take it easy as it doesn’t take as much work to maintain speed than it does to make it. That is how the brain works on psych medicine.

    When you take psych medicine, your brain is used to being in one state doing one thing. Whether it be running fast, slow, or sputtering doesn’t matter. Now when you use an outside means to make it go faster, slower, or stop the sputtering, it takes a lot of work and time for the brain to get used to it. I’m not a marathon runner, I’m not used to running, so signing up for the Boston Marathon would take a lot of work to get me to where I would need to be in order to even attempt it. The same with the human brain.

    Dealing with the chemicals in the brain is trial and error. There is no test that will tell you how much serotonin is being produced, used, and removed by reuptake mechanisms. The way dosages are prescribed is based on what the patient tells the doctor and the problem with that is people lie. If they’re taking a medicine for a month and it doesn’t work, the psychiatrist either adds a new medication or increases the dosage. Now you took a brain from a stop sign, made it go 35 miles per hour, and are now trying to get it on the freeway! The psychiatrist has no way of knowing if the medication has made it to a therapeutic level or not, all the doctor knows is last month the person was depressed, and a month later, they’re still depressed.

    I wouldn’t be surprised that if it was studied and researched, to find that most all of the deadly mass shootings in the past 30 years were committed by someone being treated with psych meds and had recently stopped taking them or had a dosage change. There are even warnings on medications saying that they may cause suicidal or homicidal thoughts while taking the medication. If you’re suicidal already, is taking a drug that may make you even more suicidal a good thing?

    Don’t get me wrong, I think the medications are great when they work and when prescribed by a responsible person to a person whom realizes that no medication is going to be a wonder pill. However, that isn’t always the case. Community mental health treatment centers are underfunded, understaffed, and don’t have the amount of time to spend with each patient that they should or would like to. They have to see as many people as they can as quickly as they can to bill the most amount of money to pay the bills.

    Crimes happen like the Sandy Hook shooting and the first thing they want to do is ban guns. Enforcement costs money, a lot of money. Guess where that money will come from? That’s right, cutbacks and budget cuts in mental health. The same cutbacks that started the whole thing to begin with…

    1. Chuck- thank you for taking the time to read and comment. We appreciate getting the perspective of someone with your kind of expertise. I think you’re right — the adverse impact of these draconian cuts to our public mental health budget cannot be understated. Hopefully we’ll see some measure of course correction in the future.

  2. The problem we face as a nation right now is that mentally ill people are given medication and sent on their way. No mandatory therapy, nothing, because they can only get the services that they want to take. So instead of being taught coping skills and how to work through their problems, they’re just putting more medication in their bodies. This leaves them chemically dependent with no coping mechanisms. So if that person gets aggressive or wants to hurt themselves or others, they have no skills to talk themselves down. So as what happened in Colorado, Oregon, and Connecticut, they pick up a gun and start hurting people.

    Over 99% of gun owners don’t kill innocent people. A small percentage of gun owners have had to produce a weapon to stop a crime against themselves or others (I’m one of them), and fewer than that have ever had to fire their weapon. Gun owners and gun control laws don’t effect criminals because the very nature of the criminal is to break the law.

    If the Connecticut shooter had been institutionalized against his will, it would’ve made him Federally ineligible to touch a round of 9mm ammunition let alone a firearm itself. Nationwide he would’ve been denied the purchase of a firearm from any gun dealer. But he didn’t get the guns he used to hurt others and himself legally. He killed his mother, stole her guns, and stole her car. The Federal Gun Free School Zone Act of 1990 states that a person, without a legal firearms permit from that state, may not have a firearm within 1,000 feet of a school. The shooter took those guns to the school, a breech of Federal law. Then he killed 20 children and 7 adults before finally killing himself. Everything he did was a crime, except the suicide, only a few states have suicide as a crime (for the survivors).

    None of those laws stopped him from committing those horrible crimes. Now, I’ve heard every argument for gun control that may possibly exist, and they’re all prohibitively exclusive, expensive, or against the Constitution. And none of them, not one, would stop a criminal that has an AR, that has an AK, from committing these crimes. You can’t help criminals, but you can help the mentally ill before they become criminals.

    Not all mentally ill people will become criminals as well, we all know this. Statistically every one in three people experience mental illness in their lifetime. For some it’s a situational mental illness, usually caused by the lost of a loved one. Sometimes it’s an acquired mental illness like drug induced schizophrenia. There are many people with mental illnesses that cause no harm to anybody. But I do believe that a person with a serious mental illness combined with lackadaisical medication writing and management and a lack of coping skills can be a dangerous person to themselves or others during treatment or after suddenly stopping their medication(s).

    Currently the statistics show that around 75% of gun deaths in the US is criminal against criminal. And while there are around 11,000 people killed by firearms each year, there are over 18,000 people that commit suicide each year. A far larger number of people, at almost 190,000 people, are killed each year by a doctor’s malpractice or infections from treatment by their doctor. So I feel instead of spending all of this time on talking about gun control and spending all of this money enforcing laws against people whom are not a danger, they should instead spend that money on mental illness research and treatment and really do some good.

    They say that on average, 1 in 3 black men go to prison at one time or another in their life. I’m not in the least bit surprised. No, I’m not a racist, I’m a Social Worker. It might be a surprise to some that black men are statistically one of the last people you will find at a community mental health center. Young black children and teenagers don’t seek treatment as much as young white or Latino children and teenagers. A study by the U.S. Department of Justice’s Bureau of Justice Statistics (BJS) showing than 64 percent of local jail inmates, 56 percent of state prisoners and 45 percent of federal prisoners have symptoms of serious mental illnesses is an indictment of the nation’s mental healthcare system.

    The problems in society are great. But the biggest factor in crime it seems, is often a treatable condition. Early diagnosis and treatment will do more for this country than any laws or regulations ever could.

  3. Nearly every single mass shooting for the last two decades has been linked to psychotropic drug use/abuse. More specifically, antidepressants.

    We have had 25 years of SSRI antidepressant use. The FDA was finally forced to require stronger warnings about them, but to no avail. A lot of people using them improperly are ticking time bombs.

    http://psychintegrity.org/official-statements/2013/1/4/statement-on-the-connection-between-psychotropic-drugs-and-m.html

    http://www.prlog.org/12053258-isepp-calls-for-federal-investigation-into-the-link-between-psychotropic-drugs-and-mass-murder.html

    http://www.drugawareness.org/recentcasesblog/why-i-took-a-gun-to-school-1

    http://ssristories.com/

    Please note – this has been COMPLETELY ignored in the gun violence discussions. And no wonder, as Big Pharma is the most powerful lobby group in the world.

    The government was also given testimony post-Columbine regarding the negative effects of violent media as it relates to homicides. One physician state unequivocally that his research showed that violent media was a factor in up to half of all homicides. The federal government itself has made the claim that 80% of school shootings are linked to bullying. Again, these are mental health issues.

    Instead of focusing on causation, the government has decided that a better course would be to simply ban guns. This has never, ever stopped a determined killer. There is evidence that Adam Lanza, who we know WAS severely mentally ill, was trying to emulate the Norway (where guns are banned) mass murderer. Lanza was also obsessed with violent video games; the police report on his house stated that there were literally “thousands of dollars” worth of such games in the basement – a military shrine that he had created.

    In short, too many kids are drugged up, unmonitored zombies with no boundaries. And then we are so surprised when they kill each other.

  4. remember when Reagan dismantled the mental health facilities, now the people what would have been helped live on the streets.

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