Mental illness & gun violence: we need to be careful, here.

It has been several weeks since the Connecticut shooting, and I taken the time to reflect.  My thinking has evolved from my early knee-jerk reaction (how crazy was this guy?), which I think is a good thing.

On the page of posts I linked to about the tragedy, I included a quote from a friend of mine, Rebecca Wald, “why are Americans so profoundly concerned with proclaiming the right to access guns, and so profoundly unconcerned with the right to access mental health care?”   Then I also linked to When You Tie Shootings to Mental Illness by Kate Donovan.

These are not contradictory.

The conversation around mental illness needs to be taking place all the time.  The discussion about gun control needs to be taking place at the same time.

The two discussions should not be linked, except in the most tenuous way.  To do so taps into the worst stereotypes about the mentally ill, doing them a disservice, while failing to address the underlying problem of gun violence.

In many places in this country in this country,  those with illnesses such as schizophrenia or bipolar disorder face significant stigma.  (A friend of mine once rather offensively referred to these as “scare the neighbors” diagnoses.)  When society immediately identifies mass shootings as the act stemming solely from mental illness as opposed to other causes, that stigma deepens. People become even more afraid of mentally ill people than they may already be, even though the mentally ill are far more likely to be victims of violence than perpetrators.

I have people close to me who suffer from mental illness, including bipolar disorder, schizophrenia, and schizo-affective disorder.  I know the extent to which stigma has resulted in difficulty in them finding jobs, how they have lost would-be friends and community, how they have needed to keep important parts of themselves secret from others.  When you are mentally ill, to be honest about who you are often requires a great deal of courage.

Because if people think schizophrenics are violent, then how likely are they to let them into their home?  What if a business owner thinks a bipolar person may walk into their widget factory and kill other employees? How much liability would that businessman think they would be facing if they knowingly hired a person with bipolar disorder, regardless of whether that person in fact presents any risk?

In many parts of this country, it is less problematic to come out of the closet as gay than to come out of the metaphorical attic where the mentally ill reside. Bigots may detest LGBT people, but they don’t usually fear them.

This is not to say that mentally ill people do not sometimes commit atrocities.  Andrea Yates, whose doctor had practically begged her not to have any more children before her last pregnancy, was very, very sick when she killed her kids.  Seng-Hui Cho, the Virginia Tech killer, had been adjudicated mentally ill and ordered to attend treatment. There is a reason that federal gun laws prohibit anyone who has been found mentally ill by a court or who has been involuntarily committed to a psychiatric facility from purchasing or possessing a firearm.  Advocates for the mentally ill need to admit that these acts — and violence on a smaller scale — sometimes occur and stem from psychiatric causes.  The rest of us should be recognize that not all such tragedies fall into this class.

The tendency to classify all mass killers as mentally ill comes from a need for answers, a need to know why someone could do something so horrible.  If we could only identify these people we could protect ourselves.  We can force them to take medicine,* we can preemptively institutionalize them.  We can absolve ourselves of any responsibility we may have in the tragedy.  We can ignore the extent to which our failure to insist on decent gun control contributed to the death toll. It’s not our fault — they were crazy.

Yet that damns us on the other side of the equation.  If it is only the paranoid schizophrenics or those suffering from bipolar disorder or severe depression that walk into a school campus or workplace and open fire, then our collective willingness to reduce mental health budgets and make access to psychiatric services more difficult — if the only way to afford the care you need is to be hospitalized, e.g. — demonstrates a callous disregard for the potential violent death of innocents. And isolating and stigmatizing individuals makes it less likely that when a mentally ill person is in a dangerous state of mind someone will be in a position to intervene.

We need to restrict access to certain types of weapons, and increase access to  services. Each is independent of the other. Maybe if we attack both at once, we can reduce the possibility of large-scale massacres on the one hand, and improve the lives of suffering people on the other.

We have a moral imperative to try.

*This is a large and complicated issue.  Having watched people struggle with significantly  life-altering side effects (such as weight gain, significant cognitive effects, tardive dyskinesia, and others) from drugs which can lose their effectiveness with little warning, I view the “let’s just force-medicate everyone with little regard for their wishes or quality of life” with an extremely skeptical eye.

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