If it were humanly possible for the NRA to climb any higher on my personal s%^& list, they would have done so after Wayne LaPierre’s reprehensible press conference yesterday. His long, rambling monologue was full of so many vile and insanely awful ideas, it would be hard to single out the very worst one.
But since his “let’s arm everyone to the teeth” types of statements got the most play, I’m going to focus on his modest l’il proposal of “an active national database of the mentally ill.”
This is a thoroughly wretched idea for many reasons. As this very helpful New York Times article notes, the overwhelming majority of mentally ill people do not commit violent acts. Though some types of very serious psychiatric illnesses are linked to an increased risk of violence, the risk is small. Indeed, “[a]lcohol and drug abuse are far more likely to result in violent behavior than mental illness by itself.”
All right, you may say, then why don’t we just keep track of people we think might be dangerous and engage in violent behavior in the future? That, too, is not so easy:
Jeffrey Swanson, a professor of psychiatry at Duke University and a leading expert in the epidemiology of violence, said in an e-mail, “Can we reliably predict violence? ‘No’ is the short answer. Psychiatrists, using clinical judgment, are not much better than chance at predicting which individual patients will do something violent and which will not.”
Okay, so a database tracking the mentally ill is likely to prove useless for the purpose of stopping violence, that’s the first thing. But even worse, as Robert Kuttner argues in The American Prospect, is the fact that such a database would further stigmatize mental illness and deter mentally ill people from seeking the treatment they desperately need.
Kuttner writes about an acclaimed program for mentally ill teens in Portland, Maine called PIER. Teens heard about the program through public education efforts and referred themselves into it. Hospital admissions for psychotic breaks decreased dramatically as a result. Here’s the piece that relates to gun violence, writes Kuttner:
“These kids who go on gun rampages,” says [program head] McFarlane, “tend to be pre-psychotic. Most people with mental illnesses are not dangerous, but these are. They still have enough functioning to methodically plot out their attacks. They have lost capacity for judgment but not for planning.”
“At our very first family meetings,” McFarlane adds, “one of the things we emphasize is safety. Families get it. If they own guns, they either get rid of them, or lock them up.”
It may be a coincidence, but there have been no gun massacres in the communities that have programs modeled on PIER. However, referrals to Dr. McFarlane’s program and others like them are voluntary. Nobody is put into a database.
We need a well-funded health care system that does a much better job of identifying and treating mental illness. And, of course, we need to regulate guns. What we don’t need is an Orwellian surveillance state keeping tabs on anyone who ever sought the help of a mental health professional. Suffering people, who may be frightened, distrustful, or doubtful about the benefits of treatment to begin with, don’t need one more reason to avoid seeking help. The results could be tragic for themselves and those around them.
