“WE DON’T go around shooting people, the sick people do. They need to be fixed.” So said the gun-owning pensioner in the Korean War veteran’s hat, demonstrating outside Connecticut’s state capitol on March 11th. He was holding a sign reading: “Stop the Crazies—Step Up Enforcement of Current Laws”, and like many of the gun-rights supporters rallying in Hartford this week, he wanted to talk about how improving mental health care was the proper response to massacres such as December’s school shooting in Newtown, an hour’s drive away.
Your reporter was in Hartford to report on the gun lobby, and its campaign to push back against state and federal gun-control plans proposed after Newtown’s horrors, which saw 20 young children and six staff murdered. The politics of gun control will form the basis for this week’s print column, but this posting is about something more specific: the gun lobby’s focus on mental illness as the “true” cause of such massacres.
The message discipline of the National Rifle Association and congressional allies has been impressive. After an initial period of silence, the NRA came out with a consistent narrative about mass shootings. The problem, said such spokesmen as Wayne LaPierre, the NRA’s executive vice-president, was that criminals and the dangerously ill can get their hands on guns.
At moments, the NRA and supporters almost sounded like liberal gun-control advocates. “We have a mental health system in this country that has completely and totally collapsed,” Mr LaPierre told NBC television on December 23rd last year, days after the Newtown murders. The NRA backs the FBI-run instant background checks system used by gun dealers when selling firearms, Mr LaPierre noted. It supports putting all those adjudicated mentally incompetent into the system, and deplores the fact that many states are still putting only a small number of records into the system.
On the chill streets of Hartford this week, that same sentiment went down well with the Korean War veteran and his fellow demonstrators. All of which is perfectly sensible, yet puzzling. For the demonstrators, holding signs that read “Stand and Fight” and “Feels like Nazi Germany”, made clear their deep distrust of government. Did they really support a large expansion of officialdom’s right to declare someone mentally unfit, trumping their right to bear arms under the constitution’s second amendment? In Hartford the question provoked some debate. But most demonstrators followed the NRA’s line in opposing any talk of moving to “universal” background checks: jargon for closing the loophole that currently allows private individuals to buy and sell guns without any checks on the criminal or mental-health records of buyers. Almost 40% of gun sales currently fall through that loophole.
Mr LaPierre’s line is both clear and not. He supports improving the quality of the federal database used for background checks, but opposes using that same database more often, calling any talk of universal background checks a ruse paving the way for the creation of the national gun register that the government craves, so it can confiscate America’s guns.
He talks of improving mental-health treatment, but then uses the harshest possible language to describe the mentally ill, telling NBC:
We have no national database of these lunatics… We have a completely cracked mentally ill system that’s got these monsters walking the streets.
So what is really going on? Interviewing the Democratic governor of Connecticut, Dannel Malloy, he accused the NRA of a “bait-and-switch”, in which the gun lobby is trying to appear constructive without allowing any gun rules to change.
The argument quickly drifts into party politics. Marco Rubio, a Republican senator from Florida, casts the debate about post-Newtown gun controls as an either/or question, in which gun curbs and improved mental health are somehow antithetical. Responding to President Barack Obama’s calls for ambitious gun controls in the wake of the school shootings, including a renewed ban on assault weapons, Mr Rubio said:
Nothing the president is proposing would have stopped the massacre at Sandy Hook… Rolling back responsible citizens’ rights is not the proper response to tragedies committed by criminals and the mentally ill.
On the Democratic side, the new junior senator for Connecticut, Chris Murphy, asserts that the general public are not buying such arguments, which he calls a “smokescreen”. People understand that a mental-health system that can pick out mass murderers before they strike is a “policy illusion”.
On balance, the talk of a gun lobby smokescreen is fair. Examine the NRA’s arguments more closely, and Mr LaPierre demolishes his own suggestions even as he makes them. Ina ferocious speech to supporters in Salt Lake City on February 23rd, he predicted that criminal records and the mentally incompetent would “never” be part of a background check system, which was really aimed at “one thing—registering your guns”.
Instead, Mr LaPierre and allies paint a picture of an American dystopia, in which hand-wringing liberals, having closed down mental hospitals during the civil-rights era, refuse to put dangerous criminals behind bars:
They’re not serious about prosecuting violent criminals… They’re not serious about fixing the mental-health system. They’ve emptied the institutions and every police officer knows dangerous people out there on the streets right now. They shouldn’t be on the streets, they’ve stopped taking their medicine and yet they’re out there walking around…
The powerful elites aren’t talking about limiting their capacity for protection. They’ll have all the security they want… Our only means of security is the second amendment. When the glass breaks in the middle of the night, we have the right to defend ourselves
Such rhetoric has effects far beyond the world of gun rights. Both in Congress and in state legislatures around the country, politicians are debating proposals for increased supervision of the mentally ill, and mandatory reporting of those seen as posing a danger to themselves or others.
New York state has already passed a package of gun-control measures that includes a requirement for mental-health professionals—from psychiatrists to social workers and nurses—to report anyone deemed likely to seriously harm themselves or others. A report triggers a cross-check against a database of state gun licences and police may be authorised to find and remove that person’s firearms.
Such intense attention to mental illness—for years the forgotten Cinderella of public-health policy—both pleases and alarms doctors and academics working in the field. Professor Jeffrey Swanson of Duke University has written a commentary for the Journal of the American Medical Association, examining the “promise and the peril of crisis-driven policy”, and arguing that in a nation with constitutionally protected gun rights, the “real action in gun control is people control”, or preventing dangerous people from getting their hands on a gun.
That carries risks, he writes:
The first is overidentification; the law could include too many people who are not at significant risk. The second is the chilling effect on help seeking; the law could drive people away from the treatment they need or inhibit their disclosures in therapy. The third is invasion of patient privacy; the law amounts to a breach of the confidential patient-physician relationship. Mental health professionals already have an established duty to take reasonable steps to protect identifiable persons when a patient threatens harm. However, clinicians can discharge that duty in several ways… For example, the clinician could decide to see the patient more frequently or prescribe a different medication. Voluntary hospitalization is also an option for many at-risk patients
Reached by telephone as he waited for a flight, Professor Swanson elaborated on a fourth risk, that of over-estimating the small proportion of violent crimes carried out by the mentally ill. What’s more, he noted, the mental-health system is good at describing behaviour patterns but very poor at predicting specific acts by specific people. With hindsight, mass shooters are often described as obviously disturbed, he notes. “But you can’t go around locking up all the socially awkward young men.”
In one area—suicide by gun—mental illness plays a very strong role, Professor Swanson says, and closer supervision could do real good, despite the risks. In 2010 suicide accounted for 61% of gun-injury deaths in America.
Such statistics do not fit the narrative of the gun lobby, of course, with their insistence that a gun in the home makes citizens safer. Yet even here, where improved gun controls linked to mental health could do real good, it is vital to get the details right and avoid “knee-jerk” law-making, says Dr Howard Schwartz, chief psychiatrist and director of the Institute of Living, one of the oldest psychiatric hospitals in America, founded in Hartford in 1822.
The post-Newtown national discussion about mental health is distinctly double-edged, says Dr Schwartz. It may increase access to some programmes. But the debate is also being used by those with other motives. Mental illness is ubiquitous, he notes, with rates of schizophrenia or bipolar disorders more or less the same around the world, with some rare exceptions. Yet rates of gun violence differ dramatically between America and comparable countries. And those differences tally closely with differences in the accessibility of weapons. To Dr Schwartz the diagnosis is straightforward: “the NRA is demonising mental illness to distract from the obvious, in-your-face relationship between the availability of guns and murder rates.”
Opponents of gun controls may respond with familiar flurries of statistics. In Hartford, for instance, several pro-gun demonstrators cited the same talking point, claiming (falsely) that home invasion rates soared in Australia after that country banned the most powerful forms of guns in 1996, following a mass shooting. Actually, home break-in and robbery rates have fallen sharply in Australia since 1996, as have gun-death rates, with no corresponding rise in other forms of homicide.
America’s murder rate is four times higher than Britain’s and six times higher than Germany’s. Only an idiot, or an anti-American bigot prepared to maintain that Americans are four times more murderous than Britons, could possibly pretend that no connection exists between those figures and the fact that 300m guns are “out there” in the United States, more than one for every adult
Mr LaPierre of the NRA is a proud patriot. But when he talks of mentally ill “monsters” and “lunatics” walking the streets in such numbers that all prudent citizens must arm themselves to the teeth, he is slandering both them and his country, just as surely as any American-hating bigot.
(Photo credit: AFP)