Can Better Mental Healthcare Prevent Violence?

August 9, 2012

- See all 39 of my articles

CENTENNIAL, CO - JULY 23:  James Holmes (L) ma...

James Holmes

Water tossed into hot oil. Sodium tossed into water. Mentos tossed into a 2 liter bottle of soda. Some of the least restrictive gun laws in the world combined with a mental health care system that’s decades behind. Yup, I’m talking about things that don’t go well together.

First, let me get this out of the way: I’m not advocating taking away anyone’s rights to own a firearm. If I had more income to toss away I’d consider owning a handgun myself for the purpose of target shooting at a range – the Glock 19 just looks darn cool. That being said, there are a lot of improvements we can make to ensure mentally unstable people get the help they need. In absence of a gun, a desperate and mentally ill person will use other methods – in 2008 a Japanese man in Akihabara drove a truck into a crowd and then jumped out and started stabbing people. Guns don’t kill people, but they certainly make it orders of magnitude easier to kill people.

We’re all well aware of some of the more hyped mass shootings, but to see the list laid out is shocking. This list I’ve compiled, just from 1999 onward, is depressingly lengthy:

  • April 1999, Columbine.
  • July 1999, An Atlanta daytrader kills his family and then went to a trading firm and killed 9 more and wounded 13.
  • September 1999, A man opens fire in a Baptist church in Fort Worth, Texas, killing 7.
  • October 2002, A man and a minor carry out a series of 11 sniper-style shootings around the DC Beltway and in Northern Virginia.
  • August 2003, A Chicago man returns to where he was fired from 6 months prior and kills 6.
  • November 2004, In a hunting dispute in northern Wisconsin, six are killed and 2 are wounded.
  • March 2005, A man opens fire in a church killing 7, including the pastor and the pastor’s son.
  • October 2006, A milk truck driver enters an Amish school and in execution style kills 5 and severely wounds 6.
  • April 2007, Virginia Tech shootings.
  • August 2007, Three Delaware State students are shot execution style.
  • December 2007, A 20 year old man kills 9 and wounds 5 in a shopping center in Nebraska.
  • December 2007, A woman and her boyfriend shoot and kill 6 members of her family in their Washington State home, including 2 children.
  • February 2008, At a clothing store in Chicago in what authorities think is a robbery-gone-wrong, a man kills 5 and wounds another. The unidentified man is still at large.
  • February 2008, At Northern Illinois University a man kills 5 and wounds 21 before killing himself.
  • September 2008, A mentally ill man released from prison a month earlier shoots 8, killing 6 in Alger Washington.
  • December 2008, A man in a Santa Claus suit opens fire at a family Christmas party, then sets fire to the house and later kills himself. Nine were found dead in the house.
  • March 2009, A recently laid off man kills 11 in multiple locations, including 2 children.
  • March 2009, A heavily armed man kills 8 and wounds 2 at a Carthage, NC nursing home.
  • March 2009, Six people are shot dead in an upscale apartment building in Santa Clara, CA.
  • April 2009, A man enters a civic center in Binghamton, NY, and kills 13 before turning the gun on himself.
  • July 2009, Eight are shot in a drive by shooting on the campus of Texas Southern University, police conclude that it was gang-related.
  • November 2009, A US Army psychologist at Fort Hood, TX, kills 13 and wounds 29 others.
  • January 2010, A man near Appomattox, VA, kills 8 before being apprehended by over 100 police officers.
  • February 2010, A faculty member at The University of Alabama kills 3 and wounds 3 at a biology department meeting.
  • January 2011, Tuscon, AZ mass shooting. 18 people are shot including sitting US Representative Gabrielle Giffords, 9 die.
  • July 2012, Aurora, CO movie theater shootings
  • August 2012, A suspected White Supremacist enters a Sikh temple in Wisconsin and kills six and wounds 4 before being shot by police and then dying from a self-inflicted gunshot wound.

Please note, this is not even a complete list.

In the vast majority of these cases the people pulling the triggers had a severe mental health problem. I could write a whole other article or three on mental health parity in the United States, but to sum it up, mental health is decades behind “the rest” of health care. Anecdotally, I can say that I’ve actually met more than one doctor who says depression is “all in your head” – while technically true, I suppose, they seem to feel it’s not unlike attitude and you can just change how you feel. In addition, mental health issues are often misdiagnosed or go years without diagnosis. For example, as recently as 2000 a study showed that up to 69% of people with bipolar disorder were misdiagnosed and the average length of time that passes without a correct diagnosis can be as much as 10 years. Even when correctly diagnosed, at times law enforcement professionals are either untrained in proper procedure or unwilling to take a claim seriously. Recent evidence shows that James Holmes’ psychiatrist warned police that he was a danger weeks before the Aurora, CO shootings.

Next, there is the very real issue of mental health issues having a stigma of weakness or instability associated with them. Many people don’t seek help for mental illness thinking that the problem is temporary, or not treatable. Others don’t seek help for fear of being marginalized – the media often associates mental illness with violence and aberrant behavior.  The glorification of the American media has molded an image of the perfect person that is often near-unobtainable. We think that everyone should be content, cheerful, witty, grounded, have a great job, and a body like a supermodel and anything outside these “norms” has something wrong with them. Even when confiding with family and friends people are often told they simply need to sleep more, or cheer up, or pray more – dangerous things to tell someone who is depressed.

Finally, mental health is still seen as a sticky area by insurance companies. It can sometimes take years between first seeing a doctor to when a patient then sees a referred psychiatrist. In 2010 in Arizona only 5% of insurance companies offered equal benefits for mental issues vs. other health issues. As recently as 2006 the National Alliance on Mental Illness gave the US a grade of “D” on mental health treatment and awareness. It’s ironic that some politicians claim the government is trying to get between you and your doctor when health care companies already do when your doctor refers you to a psychologist – all in the interest of their profit.

What can be done? First and foremost both the general public and the insurance companies need to realize that mental health is at least as important as the health of any other specific area. We are people because of our thoughts and deeds and emotions, not because we have good blood sugar levels or need a pill to get an erection. Being able to tell a doctor you’re depressed or anxious shouldn’t be a big deal. Having your health insurance fully cover your visit to a psychiatrist should be a no-brainer. If that doctor then refers you to counseling, that should also be covered. Finally better training for law enforcement on working with mental health professionals needs to be implemented. As seen with Aurora, CO, that could have made all the difference.

Enhanced by Zemanta

3 Comments (+add yours?)

  1. Martin Kelly
    Aug 09, 2012 @ 09:52:26

    Zarberg, I agree with everything you have written above. We do need to do more, but I cannot deremine a way to avoid incidences like in Aurora. Yes the police were warned, but what were they suposed to do? You cannot detain someone indefinately just because he could do something bad. We would almost need a set up like in Minority Report to actually interviene properly. In the case of the Gabrielle Giffords shooting, the young man was detained several time, but released.

    There are laws on the books to prevent mentaly unstable people from purchasing fire arms. There are also laws preventing investigation into a person’s mental health which make the arms laws almost impossible to enforce.

    No I have a rant that has nothing to do with our article. Why is this crime a mental health issue, the Sihk temple crime a case of domestic terrorism and the Fort Hood crime a case of workplace violance? In each case, the criminal intended to terrorize the victims because they were different then the criminal and deserved to die. The arguement can be made that each of the criminals is mentally unstable based on their irrational desire to kill. Shouldn’t each of these cases also be a “hate crime”? Just my fustration at the political aspect of terrible crimes that seem to me to marginalize the victims and provide celebraty to the criminal. OK, rant over.


  2. kosmo
    Aug 09, 2012 @ 10:14:46

    I think that most people think of domestic terrorism as involving perpetrators who have little previous interaction with the victims. With workplace violence, the victims often know the perpetrator.

    I personally think that the Fort Hood shooting was both domestic terrorism and workplace violence. It’s not an either/or relationship.


  3. Peter Shaw
    Aug 09, 2012 @ 12:32:34

    Good article and good comments. It is a crime to buy a gun with the intent of committing a crime too. Preventing violent mentaly ill people from buying firearms is bipartisan and supported by the NRA.

    I think we’ve all seen the benefits of sane people owning guns like Sarah McKinley the teen mother who shot dead two intruders. These incidences are not normally national news but it happens more often than people realize. As we saw with the Aurora shooter not all mentally ill are suicidal. Sane law abiding citizens arming themselves is a reasonable expeditious precaution.


Leave a Reply