Wednesday, April 10, 2013

Guns and mental illness

Alex Knepper explains what's wrong with our national conversation about them:

In the aftermath of the tragedy at Sandy Hook, the NRA called for a "national database" of the mentally ill, against which new gun sales can be checked. Similarly, President Obama has consistently advocated that Congress do something to prevent the mentally ill from possessing guns.

The general public's thought process seems to be something like this: Anyone who would use a gun to murder children must be crazy -- and crazy people should not have access to guns in the first place. But it is impolitic to use the word 'crazy,' which sounds too loaded, too politically incorrect. The polite way of expressing such a sentiment is to declare that 'mentally ill' people should not own guns.

Contrary to the general public's ignorant abuse of the term, though, 'mentally ill' does not mean 'crazy.' The term covers an extremely broad spectrum of disorders whose symptoms and causes vary significantly. Paranoid schizophrenia is classified as a mental illness, but so are Attention-Deficit Hyperactivity Disorder, and anorexia nervosa. The real question, then, becomes: Which mental illnesses should disqualify a person from owning a gun, and by what grounds do we justify singling out the people who suffer from them?

And this is where the argument starts to fall apart. As is usually the case, crafting a specific, viable policy plan is a bit more difficult than making empty emotional pleas to do something. While people with severe mental illnesses -- such as paranoid schizophrenia or major depression -- are somewhat more likely than the average person to commit acts of aggression, they account for only 4 percent of all violent crimes. Virtually all people with severe mental illnesses are just everyday men and women, no likelier than you or I to commit an act of violence. Of course, the authorities should investigate any credible claims of violent tendencies, but this is true regardless of the status of the suspect's mental health. The logic of a blanket policy targeting the mentally ill is identical to the logic of racially profiling Arab Muslims at airports.

My own experience as the close friend of a young woman with severe mental health issues has taught me that politicians, insurance companies, and the general public are astonishingly unfamiliar with what such people's day-to-day lived experiences are like. One of the most debilitating issues that my friend confronts is simple ignorance: Misconceptions about mental health issues are frighteningly common, and they can cause problems in school, work, and family life. Most mentally ill people have the ability to live normal lives -- but only with a network of support....

Michael Fitzpatrick, the director of the National Association for the Mentally Ill, expressed hope that President Obama's call for dialogue would help combat the stigma against the mentally ill. It hasn't, and it won't -- and it's easy to see why. The framing of this 'dialogue' is in the context of Sandy Hook; that is: in the context of violence and fear. What message does it send to the public that we only bother to talk about mental illness after an act of mass murder against children has taken place? The central question of the dialogue should be "How can society help those who suffer from mental illness?" But the dialogue as it has actually happened has centered around the question, "How can society protect itself against crazy people?" That's no way to craft good public health policy. It's time to stop scapegoating the mentally ill -- and start looking for real ways to help them.