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.