Mental Health is one reason, but that means…

After the most recent mass shooting tragedy at Umpqua Community College, the new defense that it is not a gun problem, but is a mental health problem, have arisen. This is not an either/ or debate, as both are problems, but it is even more than that. But, let’s keep it simple and focus on mental health side for now, as there are some very telling things that need to be addressed.

Of course, someone killing people like this is indicative that there is likely a mental health issue. Even if the killer was aligned with a domestic terrorist group, wanted to commit a hate crime, or tried to start a race war as was the motivation in Charleston, SC, there is a sociopathic problem where the killer believes he is justified to do this.

Yet, as tragic as these types of mass shootings are in the US, the most prevalent reason for gun death is clearly a mental health concern and that is suicide. Suicides account for two-thirds of all gun deaths and are the leading cause of death in nine of the top ten states for gun deaths. Also, homes with a gun have a much greater propensity toward suicide than homes without a gun. All it takes is one impulsive act and it is over.

So, yes improving access to mental health is important. Denying access or restricting access to guns for those who have mental health issues is also a concern. Yet, that means you should not advocate actions to the contrary. What do I mean by this?

The folks who are shouting the loudest that this is not a gun issue, but is a mental health issue, have taken steps to block the path to addressing the mental health aspects, sometimes overtly advocating a policy change to make it easier to kill with a gun. The easiest example is the NRA, through the conservative group ALEC, has been supportive of state legislation that will make it a crime if a doctor asks a patient if he or she owns a gun. These laws are being considered in several conservative led states and have passed in a few.

So, think about this. The NRA, who says gun deaths are a mental health issue, advocates that a doctor cannot ask a presumably depressed patient if he or she has a gun at home. Maybe this doctor is already prescribing Lexapro, Risperdal or Seroquel, but the NRA and ALEC want to say it is a criminal act that the doctor inquires whether the patient has access to a weapon. Again, two-thirds of gun deaths in the US are suicide. I think it is well within the domain of the doctor to ask these questions.

But, it goes further. The retiring US Speaker of the House struck language earlier this year to some funding of looking at health care data in the US. He felt it was not appropriate to track gun death data as that was not germane to health issues. Please reread this statement as it takes a second to sink in. A conservative leader, whose party is heavily influenced by the NRA who says gun deaths are a mental health issue, does not want to spend our money to track reasons for gun deaths.

Finally, access to mental health care is key to this process. How are you going to do it? A behavioral psychologist, I used to work with, who helps employers design mental health wellness programs cites the following two statistics. 1 out of 5 people will have some level of depression during their lifetime. She also says that you can pick up any large employer’s health claim data and 1 out of 10 plan participants would be on depression medication. So, the need for access to mental health care is critical. The beauty is the Affordable Care Act provides more people with access.

Yet, the people who say gun deaths are more of a mental health issue also want to repeal the Affordable Care Act. If this is done, what would they propose to make sure access to mental health care exists? The ACA is successful in getting uninsured people access to health care, including mental health care. My recommendation is if this is what they believe, then they should do what most Americans want and continue the ACA and improve it.

We obviously need better gun governance. Two keys are detailed background checks on all sales and elongated waiting periods. Per various surveys, there is a clear majority of Americans who want these, even conservative voters. The waiting period may help save a life, as if someone is depressive, the wait may allow the impulse to wane. Yet, both of these steps along with some others, could help make a difference in gun deaths.

Yet, mental health is a concern. But, that means we should not restrict doctors from having conversations with their patients about guns, especially if they are treating a patient for depression. That means we should track gun death data and use it to make informed decisions. And, that means we should promote the access to mental health care through the Affordable Care Act. To do otherwise on any of these three issues, is highly hypocritical. Saying mental health is a concern and then doing the opposite is antagonistic to solving the problem. It has to be more than words.


17 thoughts on “Mental Health is one reason, but that means…

  1. Well said. Until we have courageous voters willing to vote in courageous legislators, these mass murders will continue.

  2. You briefly touched on limiting the access to guns for those who are mentally ill – which basically means mandatory background checks on anyone who wants to buy a gun. Otherwise a mentally ill person would be free to buy a gun from a private seller. Again, that’s not something it’s-all-because-of-mental-illness proponents actually want.

    • That is true. Yet, background checks on all transactions are needed. My key thrust is to illustrate the hypocrisy of saying it is due to mental health without doing anything about that aspect and actually promoting things counter to it. Thanks for your comments.

  3. Note to Readers: I had an interesting conversation yesterday with an economist who used to work for the Congressional Budget Office. We both like data-informed decisions and are not fans of political rhetoric replacing actual data and information. But, he said something that I liked a great deal. He said, in his role today he tells his folks it is not enough to be against something. That person needs to say what he or she would do alternatively and why. This applies to the above, but any issue in politics, business or life.

  4. Yet the mental health care treatment in this country consists of writing prescriptions and popping pills, rarely following up on what brought the patient for care in the first place; just more refills. The side effects of these drugs are enough to stop a gun purchase, not that anyone is asking what medication you’re taking on that application.

    • Lisa, you are right about the lack of counseling. A psychiatrist, if one is being seen, will see a patient for about ten minutes. Many are getting these drugs from a general practitioner, which is the pet peeve of my old colleague. Like you note, she wants people seeing a therapist, as well. A good one is worth their weight in gold. Thanks, Keith

  5. The situation you describe sounds like something out of Wonderland. I agree that we must vote those clowns out of office, but the line of those waiting to take their place seem to me to have foolish grins on their faces as well. We must pick and choose carefully and then hope the NRA doesn’t win them over on the promise of their future support.

    • Hugh, you are unfortunately correct. The gerrymandering enables extreme points of view to get elected. The NRA’s power to mobilize will defeat almost every candidate in a primary and many in a regular vote. Yet, are we finally reaching a tipping point with the public that something needs to be done? Keith

      • Yes. But, as I see it, those that should do it are disinclined to act. What is needed is a Constitutional amendment to eliminate PACS, but that would require that those who would be adversely affected by the amendment initiate it. It appears to be a Catch 22.

  6. Note to Readers: I saw an update on the statistic for suicides. The gun death rate is still running about 32,000 per year, with 60% of them being suicide. The statistic of 67% I cited is from the previous year. Also, heard in my city, that a two year old shot his grandmother in hrs back yesterday. This kind of shooting occurs too frequently.

  7. Note to Readers: For some reason, one of our candidates is on a “what-if” revisionist bent noting history would be different if the Jews were armed before the Holocaust. The questions we should be asking relate to today’s world:
    – what if people did not have a weapon on the car or on them after an alcohol induced fight or bout of road rage ?
    – what if teenage sons and daughters who got despondent over cruel social media did not know where Dad kept his gun ?
    – what if grandparents or other relatives did not leave a loaded weapon within reach of a toddler ?

    These are real questions that should be asked.

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